Endodontics

Errors in access opening: Perforation: Due to non attentive drilling toward the pulp chamber and miss orientation of bur while drilling into the pulp and lack of knowledge of the interior anatomy of tooth. Perforation can be seen in: Old patient: because pulp chamber receded. Big restorations and inlays, crowned tooth, tilted teeth. In ant. teeth if keep drilling in perpendicular direction toward the labial surface.


Cutting more apically: Flattening the floor of the pulp chamber: weakening of tooth structure, losing funneling of the canal orifice, wasting time. Perforation into furca. Gouging: Is to go around root orifice without perforation.


Shallow access opening and instrumentation through the pulp chamber or pulp horn, to know that it is not canal: Sever bleeding cannot be arrested. Color of dentine: floor-dark bluish, roof-white. Anatomical land marks of the floor of pulp chamber, convex, grooves connecting canal orifices together. Distinguish level of floor and roof through the radiograph.


Entrance through labial or proximal surface (do not give direct access). Inverse funnel access opening: the base of cavity should be narrower than the occlusal surface. Over extended preparation undermining enamel walls.


Narrow and conservative access opening: results of: Root canal debridement and obturation not sufficient. Bending of instruments. Missed canal. Discoloration because of remnant of pulp chamber roof (pulp horn remains).