Preparation for the endodontic access cavity is an important step in root canal treatment. Dentists use both traditional and modern minimally invasive techniques to access the cavity. Unlike traditional techniques, modern approaches aim to maximize tooth preservation, protect the surrounding walls and the pulp area, minimize tooth fracture, and avoid deformities.
What is access cavity preparation in Endodontics?
An access cavity is a technique to enter, irrigate, and obturate the root canal space. During an RCT, the dentist removes the microbes and infected pulp tissues while conserving the tooth root structure.
It helps in retaining the PCD or pericervical dentine and conserves the treated tooth. Improper cavity preparation prevents the dentist from locating the canal space and moving the instruments through the root canal area.
What are the types of endodontic cavity preparation?
Endodontic cavity preparation is broadly divided into two types – traditional cavity preparation and modern or minimally invasive cavity preparation.
Traditional endodontic cavity preparation
For a long time, dentists followed the conventional approach of cavity preparation. In a traditional access cavity (TAC), the dentist makes a straight-line entry to reach the apical foramen (mid-root) end. This process of accessing cavities prevailed for a long time due to the lack of proper diagnostic and imaging studies. The process involved the removal of the pulpal chamber roof which resulted in significant loss of the pericervical dentin. It also weakened the tooth structure.
Modern designs of cavity preparation
Technical advancement in general dentistry led to new and innovative designs.
Conservative Endodontic Access Cavity (CEC)
CEC aims for dentine preservation. Instead of straight-line access to the central fossa, the technique extends the access without removing the entire pulpal roof. It partially removes the pulpal roof and preserves the dentin structure.
Ninja endodontic access cavity (NECS)
Another name for NECS is ultraconservative access cavity or UEC. Instead of a straight-line approach, the Ninja technique follows an oblique projection. The parallel enamel cut is made at a 90-degree angle or more to the occlusal plane. The technique offers a better view of the canal orifices and enhances tooth fracture resistance.
Calla lily enamel preparation
Here, a 45-degree angle cut is made in the enamel. The shape resembles a calla lily. This allows the dentist to cover the entire occlusal area, remove undermined enamel, and prevent fracture. This process restores the dentinal wall and the enamel and improves dental structure strength.
Carries-driven access cavity preparation
This technique restores healthy dentin by removing caries and other decaying or poor tooth structures during access preparation.
Conclusion
Modern endodontic techniques have evolved with time. These techniques mainly focus on removing caries, locating the canal orifices, allowing proper visualization, accessing the root canal, and providing maximum preservation of the tooth structure. However, research studies show that minimally invasive techniques may often fail to achieve satisfactory results. Therefore, the right amalgamation of traditional and modern techniques can help in achieving the desired treatment.
Based in Delhi, AADEINDIA offers to provide a wide-ranging curriculum of endodontic courses in dentistry. These courses have been customized and designed to provide training to dentists.
