The access preparation
was sealed with a cotton pellet and cavit.
Endodontic access was begun 10 minutes after solution deposition, success (anesthetic efficacy) was defined as none or mild pain (Visual Analogue Scale recordings) on endodontic access preparation or pulp extirpation.
The patients were instructed to raise their hands if any pain was felt during access preparation and pulp extirpation.
The patients were instructed to definitively rate any discomfort or pain during access preparation and pulp extirpation by using a Heft-Parker 10- cm VAS (Fig 1).
The facility's procedure was reviewed and enhanced to include additional access preparation steps.
The cannulation procedure for buttonhole access should begin with access preparation, including a four step approach:
It is there- fore considered important to have thorough knowledge of variations in tooth/canal anatomy which can aid in location and negotiation of canals as well as their subsequent management.3 For a successful treatment outcome careful interpretation of angled radiographs proper access preparation
and a detailed exploration of the interior of the tooth are essential prerequisites.4
When there is only single canal it is usually located in the center of the access preparation
if not in center then dentist should search second canal on the opposite side.
However, the modification in the access preparation
may be required to permit the instrument to penetrate, unimpeded, to the apical constriction i.e an apical reference for the correct working length during the cleaning and shaping can be a very frustrating procedural error.
Emphasizing the biological rationale rather than how-to instructions, they address key clinical areas for a range of pulp and periapical conditions, and give advice on access preparations
, cleaning and shaping, obturation, and temporization and restoration.