Access-related endodontic mishaps or procedural accidents are unfortunate occurrences that happen due to inattention or unpredictability. First and foremost, an accurate diagnosis is essential for success of any treatment. Once established, flawless treatment requires an adequate armamentarium and magnification comprising of loupes and microscopes. Even after adopting a correct regimen, mishaps may occur, which have been classified into five broad categories, treating the wrong tooth, missed canals, damage to existing restoration, perforations and crown fractures. In consideration of treatment of a wrong tooth, as before-mentioned, a correct diagnosis is essential for rehabilitation. Once the diagnosis has been established, the tooth should be marked with a felt-tip pen to prevent misconstrued treatment of a healthy tooth. Proceeding further, a misdirected and/or incomplete access to the root canal system could increase the probability of missed canals, later regressing the success of endodontic treatment. To prevent such an occurrence, various armamentaria apart from magnification and radiographs are: piezoelectric ultrasonics, micro-openers, dyes, champagne test, transillumination, explorer pressure, white line & red line tests, perio-probing, symmetry and color. A controversial matter, the removal of an existing crown with coronal disassembly devices has been recommended, to allow exploration of the actual tooth surface. Even if prosthesis or a large restoration has to be retained, specific cavosurface angles to the occlusal table have to be maintained specific to each material. One more colossal aberration is the creation of a perforation, which is a communication between the root canal system and the external tooth surface. Perforations have to be sealed surgically or non-surgically as soon as possible to prevent bacterial ingress and worsening of the prognosis of a tooth. A wide array  of materials have been advised for example, glass ionomer cement and calcium silicate materials like MTA. Lastly, preexistent infractions may be present which could becomea true fracture when the patient chews on the tooth weakened additionally by an access preparation. This can be averted by occlusal reduction of the tooth. In conclusion, adequate access has to be accomplished to suitably clean and shape the canal system and obturate the space. Moreover, acknowledging the long term prospects, the structural integrity of the tooth being treated must also be given due importance. Granting all this, if mishaps occur, appropriate management should be undertaken to prevent extraction.
Key words: Access, calcium silicate, champagne, disassembly, mishap, perforation

Corresponding Author: Dr. Akarsha S. Multani, House no. 503, Sector 7, Panchkula, Haryana, PIN: 134109

This article may be cited as: Makadia N, Patel N, Bhende R, Sayeed A, Patel D, Patel H. Access related endodontic procedural accidents: A Review. Int J Res Health Allied Sci 2016;2(4):58-65