Description
The restoration of endodontically treated teeth is often required and may represent a challenge as there is no consensus on ideal treatment. The failure of endodontically treated teeth is usually not a consequence of endodontic treatment, but inadequate restorative therapy or periodontal reasons.
Join us in this exclusive session with Dr Ruchika Jindal, Senior Consultant Endodontist to learn more about the Stresses that the endodontically treated tooth needs to be restored back to form, function and aesthetics and updates on contemporary adhesive techniques.
Résumé
- Pre-endodontic evaluation is crucial, focusing on restorability, occlusal contacts, periodontal health, biological width, and crown-to-root ratio. This assessment determines the feasibility and requirements for restoration after root canal treatment.
- Case selection involves a holistic approach, considering the strategic position and functionality of the tooth, presence of cracks or fractures, patient's medical condition (especially bisphosphonate therapy), and the nature of any peri-apical lesions. Economic and time constraints also play a significant role in treatment planning.
- Post-endodontic restoration is vital, increasing the success rate by approximately 10%. It prevents contamination, retains core buildup, reinforces root structure, prevents fractures, establishes good occlusion, and provides a marginal seal to prevent microleakage.
- Restoration types range from temporary orifice barriers (zinc oxide-based materials like Cavit or IRM) to permanent restorations, including amalgam or composite core buildups. Temporary restorations offer immediate protection and sealing.
- Posts are categorized as cast posts and cores (custom-made) or prefabricated posts (fiber posts). They can also be classified as active (for shorter roots) or passive. Passive, tapered posts are generally recommended. Proper post placement timing, length (two-thirds of root length or 5-7mm of apical GP), diameter (one-third of root), and ferrule (360-degree collar) are key for success.
- Fiber posts offer advantages by mimicking dentin's flexibility, reducing stress on the tooth structure. Crowns, both provisional (custom-fabricated or preformed) and permanent (metal, zirconia, EMAX), are crucial for cuspal coverage, especially in molars.
- Endocrowns, which integrate coronal restoration with an apical extension into the pulp space, can be a simpler and more fracture-resistant alternative to traditional post and core crowns. Tooth preparation for crowns involves specific reductions on facial, occlusal, incisal, and lingual/palatal surfaces, with varying margin types.
- Clinical cases demonstrate composite restorations, fiber post placements, and core buildups with crowns. Success hinges on factors controlled by both the clinician (sealing the canal, preventing microleakage, reinforcing tooth structure) and the patient (cooperation, maintaining systemic health, and practicing good oral hygiene).
Exemple de certificat
À propos des intervenants
Dr Ruchika Jindal
Endodontiste consultant
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