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Maxillary Ovoid

# Maxillary Lateral Incisor

[Previous tooth Maxillary Central Incisor FDI 11 · 21](https://endo-guide.app/access-cavities/max-central-incisor)[Next tooth Maxillary Canine FDI 13 · 23](https://endo-guide.app/access-cavities/max-canine)

![Maxillary lateral incisor — ovoid palatal access cavity with a single canal orifice](https://endo-guide.app/images/access-cavities/atlas/maxillary-lateral-incisor.webp)

Maxillary lateral incisor — ovoid palatal access cavity with a single canal orifice

 Average Length 22.0 mm

 Root Development 11 years

 Universal # 7, 10

 FDI # 12, 22

### Access Cavity Design

Shape Ovoid

OrientationLonger axis oriented labiopalatally; centered slightly toward incisal on palatal surface

Entry PointPalatal surface, just above cingulum

DimensionsM-D: 1.13 mmB-L: 1.39 mm

Landmarks

- Cingulum as inferior boundary of access
- Lingual fossa — natural guide for bur placement

Do Not Invade

- Incisal edge (preserve for esthetics and function)
- Labial wall (esthetic zone — maintain dentin thickness)

### Canal Anatomy

#### Configurations

Single canal (Vertucci Type I)80-85%

Two canals merging (Vertucci Type II, 2-1)10-12%

One-two-one (Vertucci Type III, 1-2-1)3-5%

Two separate canals (Type IV) or other<3%

#### Canal Positions

 MC Main Canal

Ovoid/elliptical cervically, round at mid-root and apex; may bifurcate in middle third

 B Buccal Canal

When 2 canals present (Type II/III/IV)

 P Palatal Canal

When 2 canals present, often narrower

#### Danger Zones

- ⚠Distopalatal root curvature in apical third — risk of ledging, transportation, or separation
- ⚠Labial perforation if access directed too far labially
- ⚠Thin root dentin in mid-root — strip perforation risk with aggressive filing

### Clinical Tips

Warning

Distopalatal curvature in apical third in ~58% of teeth — pre-curve files and use flexible NiTi

Warning

Check for dens invaginatus on radiograph before access — most common in this tooth (0.25-10%)

Technique

If file appears off-center on radiograph, suspect bifurcation — take angled radiograph (SLOB rule)

### Anatomical Variations

#### Dens Invaginatus (Dens-in-dente)

0.25-10% (most common in lateral incisors)

Invagination of enamel organ into tooth structure. Oehlers Type I: confined to crown (most common). Type II: extends past CEJ into root. Type III: communicates with periodontal ligament or apical foramen.

Access Modification: Type I: modified access to debride invagination. Type II/III: may require combined endodontic-surgical approach or intentional replantation

#### Two Roots / Two Separate Canals

<3% (rare, documented case reports)

Bifurcation of root in middle or apical third with two separate canals and foramina. May have labial and palatal roots.

Access Modification: Extended labiopalatal access to locate both orifices; CBCT for mapping

#### Peg-shaped Lateral Incisor

~2.8%

Conical, undersized crown with simplified root canal anatomy. Usually single small canal.

Access Modification: Smaller access cavity; conservative preparation due to reduced dentin thickness

### Other teeth in the atlas

Maxillary

[Maxillary Central Incisor](https://endo-guide.app/access-cavities/max-central-incisor)[Maxillary Canine](https://endo-guide.app/access-cavities/max-canine)[Maxillary First Premolar](https://endo-guide.app/access-cavities/max-first-premolar)[Maxillary Second Premolar](https://endo-guide.app/access-cavities/max-second-premolar)[Maxillary First Molar](https://endo-guide.app/access-cavities/max-first-molar)[Maxillary Second Molar](https://endo-guide.app/access-cavities/max-second-molar)

Mandibular

[Mandibular Central Incisor](https://endo-guide.app/access-cavities/mand-central-incisor)[Mandibular Lateral Incisor](https://endo-guide.app/access-cavities/mand-lateral-incisor)[Mandibular Canine](https://endo-guide.app/access-cavities/mand-canine)[Mandibular First Premolar](https://endo-guide.app/access-cavities/mand-first-premolar)[Mandibular Second Premolar](https://endo-guide.app/access-cavities/mand-second-premolar)[Mandibular First Molar](https://endo-guide.app/access-cavities/mand-first-molar)[Mandibular Second Molar](https://endo-guide.app/access-cavities/mand-second-molar)

For Educational Purposes Only

Access cavity designs based on established endodontic principles. Always refer to current literature and clinical guidelines.

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