Step 2 – Access Opening
Please see the diagram at the end of the section as a guideline for access openings. It is also important to check the angulation of your bur from different views to ensure that you are remaining within the outline of the tooth and have determined the proper long axis. REMEMBER to draw the long axis on the tooth you are going to access with a U-Mark pen. You should measure distance to the pulp chamber on the BW radiograph for posterior teeth and the PA radiograph for anterior teeth. Do not drill deeper than this depth!
There are 3 cardinal steps to access openings:
1. Outline deep in dentin to assess orientation and center the access.
2. Expose the pulp (the largest canal on multi-rooted teeth).
3. Unroof and refine.
Begin accessing your tooth by using an 012 or 014 diamond bur. Establish a straight-line access to all canals. If the access was done at a previous appointment, remove all the temporary material so that it will not dislodge and block the canals.
Clinic Tip: Do not be alarmed if you see some heme…this is normal if the tooth is vital.
Step 3 – Refine Access Opening
Do any refinement and final unroofing of the chamber with an Endo Z bur. Locate all canals and be sure you have visibility of all canal orifices. Do not hunt for canals and destroy critical dentin structure. Faculty will always help you locate canals when you are at the proper depth.
Page Updated: April 17, 2019