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ePaper created 2018-03-06, 08:52:14 | version 1.38.0
trends & applications | Fig. 3a Fig. 3b Fig. 3c Fig. 4a Fig. 4b Fig. 4c Fig. 5 Fig. 6 Fig. 7 Fig. 8 Figs. 3a–c: Cleaning the isthmus with an ultrasonic tip for endodontic surgery. The tip was used to remove calcification and shape the isthmus, with mesial access to preserve the occlusal surface. Figs. 4a–c: Cleaning the isthmus with an ultrasonic tip for endodontic surgery. The tip was used to remove calcifi- cation and shape the isthmus, with mesial access to preserve the occlusal surface. Fig. 5: Pre-op periapical radiograph of tooth #16, which presented with mesial caries. Fig. 6: Cleaning the pulp horns with an ultrasonic tip. Fig. 7: Post-op periapical radiograph, in which the preserved tooth structure can be seen. Fig. 8: Post-op periapical radiograph, in which the preserved tooth structure can be seen. – access allows exploration and cleaning of the pulp chamber without removing the pulp horns and with minimal removal of the roof. According to these points, we consequently discuss in which clinical situations preparing a conservative access cavity is recommended. Teeth with irreversible pulpitis or necrosis due to Class V cavities After removal of the caries, a sound occlusal surface can be obtained. Therefore, in this case, it is advised to prepare a conservative access cavity in order to pre- serve the tooth structure. This applies likewise to teeth with irreversible pulpitis or necrosis due to proximal car- ies that does not extend to the occlusal surface. In these cases, after eliminating the entire carious lesion, it is possible to extend the preparation a little bit occlusally to perform the endodontic treatment through a mesial or distal cavity. Teeth with irreversible necrosis or necrosis caused by preparation below crowns and bridges In such cases, if the pulpal pathology is due to the preparation of the teeth and provided that no carious le- sion exists and the crown or a bridge has definitive mar- gins, it is ideal to prepare a conservative access cavity for structural and aesthetic reasons. roots 1 2018 13