In Vitro Fracture Resistance of Endodontically Treated Premolar Teeth Restored with Prefabricated and Custom-Made Fibre-Reinforced Composite Posts

(1) Background: The study aimed to compare and analyse the differences between the features of prefabricated fibre-reinforced composite (FRC) posts and custom-made FRC posts in the form of a tape and confirm the necessity of using FRC posts in teeth treated endodontically in comparison to direct reconstruction with a composite material. (2) Methods: Sixty premolars after endodontic treatment were used. The teeth were divided into four groups (n–15). Group 1: teeth with embedded prefabricated posts (Mirafit White); group 2: teeth with embedded prefabricated posts (Rebilda); group 3 teeth with embedded custom-made posts in the form of a tape (EverStick); group 4: teeth without a post restored with composite material. The compressive strength of the teeth was tested using the Instron-5944 testing machine until the sample broke. The crystal structure of the investigated posts was detected with the X-ray diffractometer (3) Results: During the experiment, the maximum values of forces at which the damage of the restored premolar teeth after endodontic treatment occurred were obtained. The best results were obtained for teeth rebuilt with Rebilda Posts (1119 N), while teeth with cemented Mirafit White posts were the weakest (968N). Teeth without an embedded FRC post, rebuilt only with light-cured composite material, obtained the lowest value—859 N. (4) Conclusions: The use of FRC posts increases the resistance to damage of an endodontically treated tooth when compared to direct restoration with light-cured composite material.

Management of a fractured endodontically treated tooth with crown lengthening and glass fibre post: A case report

Purpose: This clinical case discusses the step-by-step implementation of a core and a post system that uses a single resin composite material for cementation of a glass fibre post and core build up of a fracture endodontically treated maxillary left first premolar with gingivectomy as a crown lengthening procedure. Clinical considerations: Several materials and methods has been discussed in the literatures regarding restoration of endodontically treated teeth with minimal tooth structure left which require fibre post and core build up. Gingivectomy as a crown lengthening is also a common procedure that facilitates restorative dentistry. This case presents a restoration of a tooth with a short clinical crown by gingivectomy and post core build up by glass fibre post with a mono-block technique or core-and-post technique with dual cure composite resin as a luting and core build up material. Conclusion:Post and core is needed to restored tooth with little tooth structure remaining.Glass fibre post are prefabricated posts which makes it easy to manipulate and reduces chairs side time among other advantages. Use of single material system for post-and-core reduces the steps of manipulation and chair side time compared to conventional techniques. Clinical significance: More measures are required when different materials are used for post-cementation and core build-up, increasing the chair time and the number of interfaces between the materials. However, these shortcomings can be overcome by the mono-block technique where only one material is used for both cementation and core build up. Update Dent. Coll. j: 2021; 11(2): 38-42

Diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to multiple teeth by endo- ortho interdisciplinary approach using PRF & MTA

Diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to one or multiple tooth requires a precise scientific approach based on sound principles. Interdisciplinary therapy integrates individual disciplines to function as a comprehensive unit providing consistent and predictable treatment results. A thorough logical diagnostic approach and treatment planning must be executed by each member of endodontic-orthodontic team when an esthetic and healthy makeover of a patient’s dentition is planned. Precise communication is important to provide patients with desired results. This case report presents one such approach for diagnosis, treatment planning & management of patient undergoing orthodontic therapy with blunderbuss canal’s in relation to one or multiple tooth. After careful clinical and radiographic evaluation, the patient was diagnosed with Angle’s Class I malocclusion with spacing in maxillary and mandibular arch, and blunderbuss canal’s irt 35 & 45. The treatment consisted of initial endodontic approach by starting treatment irt 35 and 45, followed by fixed orthodontic approach using passive self-ligating bracket system and by-passing the endodontically treated tooth. Regular follow-up to observe apexogenesis and continuous evaluation of the case is being done.

Provisórios em prótese fixa: revisão integrativa da literatura e técnicas para confecção

INTRODUCTION: The temporary fixed denture is an important part of the treatment, being an intermediate phase necessary for the manufacture of the definitive denture. OBJECTIVE: Present materials and their properties; as well as the techniques for making provisionals in Fixed Prosthesis, through an integrative literature review. MATERIAL AND METHOD: Search for the articles took place in the BVS and PubMed, published in portuguese and english, between 2000 and 2020. The search strategy used was: (Denture, Partial, Temporary) AND (Polymers) AND (Denture, Partial, Fixed) AND ("Dental Prosthesis" OR "Flexural Strength" OR "Dental Polishing"). The inclusion criteria were complete studies and available; studies of temporary fixed denture on teeth. The exclusion criteria were studies of provisional prostheses on implants. The complete data of the selected texts were extracted by the reviewers. Techniques for temporary fixed denture were presented regarding the stages of preparation, literature reviews and case reports. RESULTS: The studies addressed the application of different materials and techniques, in addition to laboratory research being prevalent. There was a heterogeneity between study objects and variables, with emphasis on the use of different polymers, techniques and adding reinforcement. CONCLUSION: The revised literature presented several of temporary materials. The techniques reported were the use of silicone mold, acetate matrix and CAD / CAM. And the most common techniques to be performed in the daily clinic were adaptation of the stock facet (on the preparation tooth and endodontically treated tooth), adapted resin or ball and silicone mold or matrix.

GUIDED ENDODONTIC ACCESS

We have come a long way in dentistry from “extension for prevention” to “prevention of extension”. Asimilar approach in endodontics is going to change the future of dental practice with Minimal Invasive Endodontics (MIE). MIE mainly includes preservation of structural integrity of tooth, alternate access cavity designs, guided endodontic access, modern burs, cleaning and shaping, 3D irrigation and disinfection, magnication aids like loupes and dental operating microscope. Survival of an endodontically treated tooth depends mainly on its remaining structural integrity after access preparation. The concept of Conservative endodontic cavities (CEC) was introduced to preserve the pericervical dentin (PCD), which is crucial to transfer the occlusal load to the root. In traditional endodontic cavities (TEC) much of PCD is lost which reduces the fracture resistance of tooth. Guided endodontic access was introduced as an attempt to preserve the PCD. It ensures predictable outcome without any procedural errors. The present paper attempts to narratively summarize the scope of Guided endodontic access in dental practice and explain its benets to the practitioners compared with conventional technique

An Innovative Approach for the Management of Complex Crown Fracture - A Case Report

A tooth can be broken due to many reasons, out of which deep cervical caries can be the one leading to destruction of the whole buccal surface of the tooth. So, to preserve such kind of tooth, root canal treatment is the ultimate treatment option followed by proper selection of the restorative means of such endodontically treated tooth. endodontically treated tooth (ETT) has loss of tooth structure and changes in physical characteristics. Therefore, proper selection of restoration for ETT is mandatory to maintain almost the same level of strength and regaining its functional abilities. The decision of doing restoration of endodontically treated teeth depends on many factors like the amount of tooth structure remaining, condition of the opposing tooth, etc. In cases of less than 50 % tooth structure remaining post and core followed by crown is the best treatment option. This article showcases a case report of treatment of anterior teeth with deep cervical caries. The posts used in these cases were fiber post which were luted and the core build up was done with ParaCore, which is a glassreinforced composite by Coltene. Deep cervical caries can lead to destruction of the whole buccal surface of the tooth. So, to preserve such kind of tooth, root canal treatment followed by proper selection of restoration for endodontically treated tooth is mandatory to maintain almost the same level of strength and to regain its functional abilities. This article showcases a case report of treatment of anterior teeth with deep cervical caries.

Rationale for the use of a design of Emax CAD on an endodontically treated tooth. Clinical case

Elimination of aesthetic and functional tooth disorders is one of the most popular areas in the daily practice of a dentist. The desire to achieve an ideal aesthetic result plays an important role in the choice of material for restoration. Replacing lost tooth tissues in aesthetically demanding patients is a very difficult task, for the dentist and for the restoration material.

Endodontic Retreatment and Comprehensive Endo-Prosthetic of Premolars: A Case Report

Background: The failure of endodontic treatment caused by failure of the restoration and bacterial invation. Alongside proper chemical and mechanical preparation and hermetic obturation of the root canal system, another essential factor is ensuring a permanent and hermetically-sealed restoration following endodontic treatment. Endodontic retreatment encompasses the efforts to salvage a failing previously endodontically treated tooth. As a result of advances in endodontic materials and adhesive systems, restorations in the form of fiber post and adhesively cemented crown are becoming a choice in cases of teeth that have extensive damage. Case: A case is presented a 45-year-old female was referred to Prof. Soedomo Dental Hospital with a complaint of pain in mandibular second premolar which was earlier endodontically treated. Clinical and radiographic examinations showed damaged restorations, gutta percha filling that are not hermetic and radiolucent on periapical. A successful endodontic retreatment premolar using rotary retreatment file and preparation with crown down technique using rotary progressive multiple tapering file, with comprehensive endo-prosthetic treatment using prefabricated fiber post and porcelain fused to metal crown. Conclusion: Clinical and radiographic evaluation after 6 months showed complete healing and good adaptation of the restoration. The outcomes of this case showed that failure of endodontic retreatment respond favorably to endodontic retreatment, with proper indication, prefabricated fiber post and porcelain fused to metal crown can provide an effective conservative and esthetic option for reinforcing endodontically treated teeth.

Systematization of expert approaches and problematic aspects of endodontic treatment quality assessment

Annotation. The lack of unified approach or algorithm for expert assessment of the endodontic treatment quality is the reason for registration of various prevalence indicators considering unsuccessful outcomes of pulpitis and periodontitis treatment, misinterpretation of the results and occurrence of problematic situations during the process of forensic dental assessment of iatrogenic dental status changes. Objective – to systematize and analyze the existing problematic aspects of expert assessment of the endodontic treatment quality and identify the most reasoned approaches for objectification of the endodontic interventions consequences. During provided research the calculation methodologies of indexes designed for assessing the consequences and results of endodontic treatment were studied. Additionally, a retrospective analysis of publications with described cases of complex and commission forensic medical and forensic dental examinations of dental care defects was provided, including endodontic treatment cases, cases with errors during endodontic interventions, and also relevant expert conclusions. Revealed that following index indicators could be used as the most expedient approaches for the objectification of endodontic interventions consequences: Peri-Apical Index (PAI), CBCT-PAI, Complex Periapical Index (COPI), Endodontically Treated Tooth Index (ETTI) and PESS (Periapical and Endodontic Status Scale); however, such indexes do not fully assess the quality of iatrogenic manipulations in the structure of the endodont. Thus, for a comprehensive assessment of the derived parameters associated with the dental treatment quality, and quality of endodontic interventions in particular, it is advisable to include in the forensic dental evaluation protocol the main domains, such as technical characteristics, level of patient satisfaction, level of service provided, additional components of the treatment process, and also additional ones, such as verification of experience, quantification of quality of life associated with changes in dental status, and stratification of the effectiveness of treatment.