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Endodontic Access: Proper Access for Maxillary Molars

Learning Objectives: 

After watching this video, the viewer should:

  • Understand how to properly access the mandibular molars in endodontic procedures
  • Know the sequence of instrumentation and steps associated with mandibular molar access

When initiating access on a maxillary molar it is essential to have proper straight-line access in order to ensure successful endodontic treatment. Using a high speed rotary instrument, remove the roof of the chamber. When the roof of the chamber is removed, change to a slow speed rotary instrument, preferably #6 or a #8 round bur, in order to remove tissue and debris from the chamber. A diamond bur can also be used at this stage to remove overhangs and refine straight line access.

Related Reading: 

  1. Abou-Rass, M., Frank AL, Glick DH: The anticurvature filing method to prepare the curved root canal. J. Am Dent Assoc. 101:792, 1980.
  2. Acosta Vigourox, Trugeda Bosaans,: Anatomy of the pulp chamber floor of the permanent maxillary first molar. J. Endod. 4:214, 1978.
  3. Baisden MK, Kulild JC, Weller RN: Root canal configuration of the mandibular first premolar. J. Endod. 18:505, 1992.
  4. Barnett F: Mandibular molar with C-shaped canal. Endod Dent Traumatol. 2:79, 1986.
  5. Beatty RG: A five-canal maxillary first molar. J Endod . 10:156, 1984.
  6. Mauger MJ, Waite RM, Alexander JB, Schindler WG: Ideal endodontic access in mandibular incisors. Endod. 25:206, 1999.
  7. Nosonowitz DM, Brenner MR: The major canals of the mesiobuccal root of the maxillary 1st and 2nd molars. NY J. Dent 43:12, 1973.
  8. Vertucci FJ: Root canal anatomy of the human permanent teeth. Oral Surg 58:589, 1984.
  9. Ruddle CJ: Microendodontics: identification and treatment of the MB2 system. J Calif Dent Assoc 25:313, 1997.
  10. Deveaux E: Maxillary second molar with two palatal roots. J. Endod 25:517, 1999.
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