Alternative Restoration Technique of Damaged and Endodontically Treated Teeth With CADCAM

Ünalan Değirmenci B., Ersoy N. M., Aydoğdu H. M., Şahinbaş A.

37th Annual Conference of European Prosthodontic Association, Turku, Finlandiya, 21 - 24 Ağustos 2013, ss.78, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Turku
  • Basıldığı Ülke: Finlandiya
  • Sayfa Sayıları: ss.78
  • Çanakkale Onsekiz Mart Üniversitesi Adresli: Hayır

Özet

INTRODUCTION

The rehabilitation of endodontically treated teeth is a constant problem in reconstructive dentistry. When the remaining dental tissues do not provide sufficient retention for conventional restorations, the treatment may be carried out in several ways. “The gold standard”  is still the laboratory fabrication of metal restorations. However, there are different opinions on this type of treatment in scientific and professional circles [1, 2]. Pre-fabricated posts, different in shape and material, are a contemporary alternative of cast posts.Clinical experience has revealed certain problems with metal posts, such as tooth fracture or debonding [3]. Such root canal posts are designed for the retention of the crown restoration but not for root stabilization [4]. Moreover, there has been clinical evidence of more frequent root fractures in these cases compared to other types of prosthodontic reconstruction of pulpless teeth [5, 6]. With the development of adhesive systems and allceramic restorations, the need for new types of posts has emerged. Probably the biggest problem in the prosthodontic rehabilitation of endodontically treated teeth is the insufficient inter-occlusal space for a tooth restoration. There have been different solutions in the clinical practice. The development of ceramic materials, and especially dental CAD-CAM (computer-aided design and manufacturing) systems revitalized the possibility to produce single-unit restorations, all-ceramic endo-crowns, characterized by high biocompatibility and good mechanical properties. Today, these are defined as single unit restorations, corresponding to the prepared canal and morphologically shaped crown. Modern dentistry offers a wide range of different solutions for the production of these restorations.

PURPOSE
The aim of this study is restorating endodontically treated molar teeth with CAD/CAM endocrown which is an alternative to the post-core and full-coverage crown technique.
MATERIALS & METHODS
Two endodontically treated molar with damaged crowns were prepared for endocrowns. The endocrown technique comprises a circumferential butt margin and a central retention cavity inside the pulp chamber and constructs the both the crown and core as a single unit with CAD/CAM. ‘’Impression” is taken using the intraoral optical 3D scanner. The computer needs a couple of seconds to analyze data and present a virtual model of the prepared tooth with adjacent teeth (agonists). In the next stage, the clinician chooses one design of the restoration. The first option is to use the computer’s database to select available design which will be altered by the software tools to match the anatomical and functional characteristics of the individual patient.Endocrowns were made with the feldspatic porcelain CAD/CAM blocs and cemented at the same session.
RESULTS
This technique represents a promising and conservative alternative to full crowns and posts for the treatment of posterior non-vital teeth that require long-term protection and stability. The final restoration is checked in the mouth and polished to high gloss or glazed and individualized using pigments. The cementing of the endo-crown isachieved through the adhesive approach after pretreatment with hydrofluoric acid and silane.
DISCUSSION
The advances in the adhesive dentistry,ceramic materials and CAD-CAM technology are advantageous for the alternative endocrown restoration techniques. The use of endo-crowns in the reconstruction of endodontically treated teeth has recently become the subject of  numerous studies. The main disadvantage of endocrowns should be debonding and fracture regarding the shape and size of the root canal part and the material. However, clinical practice, according to literature data, shows the opposite.