Bilateral lesion centered access cavity preparation in mandibular first premolars: A case report

Abstract

Lesion-centered access cavity preparation has gained attention due to the conservative and reliable approach to the main canal with preservation of tooth structure and aesthetics. Traditional access cavity preparation in tooth with cervical caries causes increased loss of tooth structure. In this case report, a cervical approach of access cavity preparation and root canal therapy was attempted by excavation of the cervical caries on right and left mandibular first premolar. A 38-year-old patient was referred with the chief complaint of pain in the left and right lower back tooth region for past 1 week. Based on the clinical and radiographic findings, a diagnosis of irreversible pulpitis was established. Minimally invasive access cavity preparation was completed through the Bucco-cervical surfaces, canals were located using DG-16 probe, straight line access was established, cleaning and shaping was carried out using flexible heat-treated rotary files and obturated. The cervical access cavity was restored with composite resin to re-establish aesthetics and function. Treatment was completed with reduced iatrogenic damage to tooth structure with conservation of occlusal surfaces and a follow -up was done after 1 year to evaluate the prognosis.