Mandibular Molar Access Open: Approaches Based on Starting Points

Discover the Best Starting Point for Access Open
When performing access cavity preparation on mandibular molars, the starting point on the occlusal surface and the approach direction play a crucial role in treatment. Using Dental EndoMaster, we explored the ideal starting points, directions toward the pulp chamber, and canal orifice locations.

1. Starting from the Central Pit

Let’s begin with the most common starting point, the Central pit.

• Viewing from the bucco-lingual perspective, the bur’s path angles toward the buccal side as it progresses downward.

• This angulation occurs due to the natural inclination of the tooth within the arch.

• Ignoring this and approaching perpendicularly to the occlusal surface could result in perforation or failure to access the pulp chamber.

2. Between the Central Pit and Buccal Ridge

Next, we shift the starting point slightly buccally, between the Central pit and the Buccal ridge.

• From here, the bur approaches the pulp chamber at a slight buccal angle.

• This alignment closely matches the access cavity’s path with the canal trajectory, creating a smoother and more natural entry.

3. From the Buccal Ridge Center

Now, let’s move further buccally and start from the center of the Buccal ridge.

• At this point, the bur can be directed perpendicularly to the occlusal surface for straightforward access.

• This approach preserves the lingual tooth structure, maintaining the tooth’s integrity.

• However, undercuts may occur near the lingual pulp horn, requiring additional cleaning during the procedure.

4. From the Mesio-Buccal Cusp

Finally, starting from the Mesio-buccal cusp, the bur approaches the center of the pulp chamber.

• This method also provides a clear view of the pulpal floor.

• While effective for locating the MB canal, it can result in significant undercuts on the distal pulp horn, necessitating careful attention.

Simulate Your Approach with Dental EndoMaster

We’ve demonstrated various starting points for mandibular molar access cavity preparation using Dental EndoMaster.

Which starting point do you usually choose?

By simulating different approaches, you can clearly understand the relationship between the bur’s direction, the canal trajectory, and the anatomical landmarks.

With Dental EndoMaster, you can refine your skills and gain confidence for clinical practice. Start your simulation today and master the art of precise canal access!