In the past, access cavities were standardized mainly dependent on the tooth type. However, with the advent of modern endodontic motor techniques using a dental operation microscope & loupes providing magnification & better illumination, the ‘ideal’ access cavity preparation has evolved from being based on individual tooth type to the preparation based on the shape of the pulp chamber morphology of the tooth being treated.

Access is the first & arguably the most important phase of non-surgical root canal treatment. However, it can be the most challenging and frustrating aspect of endodontic treatment. Therefore, for successful treatment, good access cavity design and preparation is imperative for quality endodontic treatment, prevention of iatrogenic problems & prevention of endodontic failure.

As novices to root canal therapy ourselves, one of the worst nightmares during access cavity preparation is perforation. Furthermore, there are several aspects of access cavity preparation that could go wrong without the correct knowledge & guidance that plagued us during our graduation days. Now, however, being armed with the correct knowledge & guidance, we can recognise the cause & prevent these procedural errors during treatment by following a set of few simple laws & guidelines that govern & dictate the access cavity preparation.

Access into the pulp chamber and the root canal system is the most critical step in root canal therapy. Unlike other aspects of Dentistry, root canal therapy is carried out with limited visual guidance. This, coupled with complex anatomy of the root canal system & various pathological conditions, makes the preparation of an ideal access a crucial step to gain success in treatment. Therefore, the objective of a well designed access cavity is to create a smooth, straight line path to the root canal system, while retaining as much tooth structure as possible.

Therefore, the purpose of this article is to highlight the common iatrogenic errors by General Dental Practitioners due to the lack of knowledge & awareness of certain internal anatomic features for a given tooth.

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