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The main objective of access cavity preparation is to identify the root canal entrances for subsequent preparation and obturation of the root canal system. Access cavity preparation can be one of the most challenging and frustrating aspects of endodontic treatment, but it is the key to successful treatment. Inadequate access cavity preparation may result in difficulty locating or negotiating the root canals. This may result in inadequate cleaning, shaping and filling of the root canal system. It may also contribute to instrument separation and irregularities of canal shape or procedural errors. These factors may ultimately lead to failure of treatment. Good access cavity design and preparation is therefore imperative for quality endodontic treatment, prevention of iatrogenic problems, and prevention of endodontic failure.
Dr Noor Hayati Azami
BDS (Mal). MClinDent in Restorative Dentistry (Mal),
Lecturer, Dept of Restorative Dentistry, University Malaya
Perforation is the mechanical and pathological communication between root canal system and the external tooth surface (AAE 2003). The cause of iatrogenic perforation is often a result of misalignment of burs or engine-driven instruments during endodontic access preparation, or negotiation of the root canals, or root canal preparation. Some are created during post space preparation during prosthodontic treatment. The aim of perforation repair is to maintain healthy periodontium and in the case of established periodontal breakdown, to re-establish tissue attachment. Timely management is essential for early detection that will garner a favourable outcome. In this lecture, prognostic factors related to repair, management, and treatment modalities will be discussed collectively.
Dr Siew Kai Ling