Squeezing a “Ninja” access cavity into a narrow space
Patient has been referred on an emergency basis by referring dentist to treat an acute apical abscess on a lateral incisor. With a pronounced soft tissue swelling, and an excruciating pain, the immediate task is to relieve pressure by establishing drainage through opening up the pulp chamber
Teeth Crowding between 21 and 22 was making it difficult to prepare an access cavity on lingual of 22 without taking the risk of notching tooth 21. Thus, it would have been both easier and safer to preserve the enamel integrity of the central incisor through an incisal or a through buccal access on 22. Still, understandably enough, aesthetic was a concern to the patient who was willing to take this risk.
Using the enamo-cemental junction as a land mark for determining the location of the pulp chamber has been most helpful in the decision process as to where to initiate the access cavity and how to angulate the bur shaft. Luckily enough pulp chamber roof was not deep. In this specific case a very conservative access (Ninja style) cavity preparation as proven to be worthwhile to alleviate patient’s pain while preserving his smile. No more Ibuprofen needed!
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