Restoration of ally Treated Tooth

7/31/2019 Restoration of ally Treated Tooth

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Restoration of endodontically

treated tooth

Prepared by:

Rawa Omar

Supervised by:

Prof .Dr. Salam Al-

Qaisi



Are Endodontically Treated

Teeth More Brittle?Contrary to common belief, endodontically treated teeth

are not more brittle . No difference in moisture content was

found between endodontically treated and vital teeth . Theaccess cavity in combination with an early loss of one or both

marginal ridges leaves the tooth at serious risk. A direct

relationship exists between the amount of remaining tooth

structure and the ability to resist occlusal forces

[Restoration of Endodontically Treated Teeth Review and Treatment Recommendations, Iris

Slutzky-Goldberg,etal International Journal of Dentistry

Volume 2009, Article ID 150251.



Factors influence the choice of

technique Type of tooth

The amount of remaining coronal tooth

structure: the most important prognosis-determining factor



Criteria of teeth to be restored

1. Good apical seal.2. No sensitivity to pressure.

3. No exudates.

4. No fistula.5. No apical sensitivity.

6. No active inflammation.











Extension of the axial walls of the crown apical

to missing tooth structure provides what’s

known bythe FERRULE:

It helps to:

1. Bind tooth structure together

Restoration of endo. teeth



Methods to create ferrule inextensively destryed tooth

- Reduce root length and increase crown length

(crown: root ration unfavorable)

- Reduce root length and unchanged crown length (crown:

root ratio is favorable(

Ortho. extrusion Surgical crown lengthening



Some of the areas of general agreement regardingpost design include:

When a post is needed, remove little if any additional dentin beyond what isneeded to perform the root canal treatment.

Retain a minimum of 4 mm of gutta-percha apically .

Use a post designed to incorporate mechanical features that resist rotationalforces Since forces concentrate at the crest of bone during function, place thepost to extend apical to the crest of the bone. One “rule of thumb” is that the

post should extend “into bone” at least as far as it protrudes “out of bone.”

Should endodontic retreatment be necessary“retrievability” is an important

property of a post and should be considered in post selection.

AMERICANASSOCIATION OFENDODONTISTS Spring/Summer 2004



INDICATIONS FOR A POST

The primary function of a post is to retain a core in a tooth

with extensive loss of coronal tooth structure.

preparation of a post channel adds a

degree of risk to a restorative procedure:

Disturbing the seal of the root canal filling, which may lead tomicroleakage

Removal of sound tooth structure, which weakens the root and

may result in

premature loss due to root fracture

Increased risk of perforation.



Post Classification

Custom

Can be cast from:-Direct pattern in pt mouth

- In direct pattern inlaboratory

Prefabricated

•metal alloy•Carbon fiber posts•Composite fiber posts•Ceramic (zirconia) posts

– ceramic composite



Restoration of endo. teeth

Prefabricated

dowelsNon-eshetic

Titanium

Carbon fiber

Esthetic

Zirconia

Fiber reinforced

composite resin matrix



A: smooth, tapered; B: Tapered serrated; C: Threaded tapered; D:

smooth, parallel-sided; E: serrated, parallel-sided; F: Threaded,

parallel-sided



Mechanical Properties

Product Flexural Tensile Flexural Elastic Fiber Percent ofStrength Strength Modulus Modulus Used Fiber

(Gpa) (Mpa) (Gpa) (Gpa)Stainless Steel 800 n/a n/a 200 n/a n/aTitanium Alloy 1000 n/a n/a 110 n/a n/a

Gold Alloy n/a n/a n/a 77 n/a n/aZirconium Oxide 820 n/a n/a 200 n/a n/aC-Post 1100 2900 120-140 17.8 Carbon 64Aesthetic Plus 1400 2200 44 15 Quartz 62D.T. Light 1600 2050 46 15 Quartz 60FibreKor 960 1200 13.5 n/a Glass 42Para Post White 990 1200 29.5 n/a glass 42

Snow Post n/a 1229 n/a 45.1 Zirconium 65Dentin 15-40

Pitel M., Hicks N.- Evolving Technology in Endodontic Posts. Comp. Of Cont. Educ. in Dent.January 2003.

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2/3 length of the root

1/2 distance of the remaining root into the

bone4 mm of apical seal

Equal to length of clinical core

Ferrari M., Scotti R.- Classification of Endodontic Posts (Chapter 2). In Fiber Posts. Characteristics andClinical Applications. Masson. 2002

Shillingburg H. T., Kessler C. J.- Restoration of Endodontically Treated Teeth. Quint. Books. 1982 McLean A. Predictably restoring endodontically treated teeth. 1998; J Can Dent Assoc 64(11): 782-787

Method for determining the length of the

post:



Custom-made Posts

Direct Technique:

direct pattern fabricated in the patient’s

mouth using either autopolymerizing orlight-polymerizing resin. Recommendedfor single canals





Custom-made Posts

Custom-made Post:

Indirect Technique: utilizing an impression for the

post space and indirect pattern fabricated in thelab.

More appropriate for multiple canals





Core :

Restorative material that replace coronal tooth structure .

Physical characteristic of core:

High compressive strength.

Dimmensional stability .

Ease of manipulation.

Short setting time for cement.

An abillity to bond to both tooth & dowel.



One-piece post crown

Two-piece post crown



Core Materials

Amalgam

Zinc oxyphosphate

Glass ionomer

Composite

Cast Metals (gold, silver….)



Amalgam

• Biggest advantage: doesn’t shrink, so doesn’t

place stress on the bond

• Disadvantages – Esthetics, only to be used in molars

– May stain hard and soft tissues

–Corrosion→expansion→fractures

– Environmental concerns

– Cannot be prepped in the same session



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Luting Materials

If a post is not cemented in the samevisit as the post space is prepared, the

post space is filled with calcium hydroxidepaste and sealed bacteria-tight until thepost can be cemented. In this wayinfection of the post space and the rootdentin is avoided.



LUTING FIBER POSTS

Fiber posts are usually luted with lightlyfilled composite resins. Light penetration

is limited, so dual-cure of self-cure lutingresins must be used



Provisional restoration:

If a cast post & core is made,anadditional provisional restoration isneeded while post & core being

fabricated.



Provisional Restoration



THANK YOU

Documents

Restoration of ally Treated Tooth