Reconstruction of endodontically treated teeth after excessive loss of tooth structure: Two case reports

Abstract

The prognosis of endodontically treated teeth depends not only on the success of the endodontic treatment, but also on the type of reconstruction. The use of fiber-reinforced resin (FRR) posts to restore endodontically treated teeth has gained popularity due to its mechanical and esthetic characteristics as well as properties of modern adhesive systems. The aim of this article was to show a clinical technique to reconstruct endodontically treated teeth with great loss of tooth structure using direct fiber-reinforced post systems and direct composite restorations. The first case was a patient with the fractured right second lower premolar. The tooth was endodontically treated and reconstructed thereafter. After the preparation of the root canal and cementation of a FRR post, particular attention was paid to the incremental and curing techniques adopted to reconstruct coronal part of the tooth. The second case was a patient with the fractured first right lower incisor. This tooth was treated in the same way. Direct composite reconstruction of endodontically treated teeth is an alternative to the prosthodontic therapy and can postpone prosthodontic therapy for a long time.

Prognoza endodontski lečenog zuba ne zavisi samo od uspešno izvedene endodontske terapije, već i od pravilne restauracije zuba i njegovog vraćanja u funkciju. Kompozitni kočići ojačani vlaknima poslednjih godina dobijaju na popularnosti u rekonstrukciji endodontski lečenih zuba zahvaljujući svojim estetskim i biomehaničkim osobinama, te mogućnosti ostvarivanja adhezivne veze za zub. Cilj ovog rada je da na primerima iz prakse ukaže na mogućnost konzervativne terapije endodontski lečenih zuba s velikim oštećenjima krunice primenom kompozitnih kanalnih kočića. Kod jedne pacijentkinje s frakturom donjeg desnog drugog premolara obavljeno je najpre endodontsko lečenje, a potom je urađena konzervativna restauracija. Posle preparacije prostora za kanalni kočić i njegovog cementiranja, krunični deo zuba je restauriran direktnim kompozitnim ispunom slojevitom tehnikom. Na isti način je lečen i donji desni centralni sekutić druge pacijentkinje. Restauracija devitalizovanih zuba s opsežnim lezijama konzervativnim lečenjem je dobra alternativa protetičkoj restauraciji, koja protetički tretman može odložiti za duži vremenski period.