Using of CAD-CAM in Minimal Invasive Prosthetic Treatments: Two Case Reports

Yıl 2024, Cilt: 10 Sayı: 3, 167 - 173, 31.12.2024

Aynur Beyza Çavuşculu Güdül , Şükriye Ece Geduk , Gaye Sağlam

https://doi.org/10.21306/dishekimligi.1481609

Öz

Direct restorative treatment of coronal losses in hard tissues such as caries, abrasion and fractures with amalgam or composite resins may not always be possible. In the prosthetic rehabilitation of teeth with increased crown destruction after endodontic treatment, different conventional treatment methods, including direct and indirect restorations, can be applied. In such cases, indirect treatment approaches such as inlays, onlays, overlays or endochrons are shown to be a successful approach to preserve the remaining tooth tissue while replacing the lost tissue. Endochrons are monoblock restorations that combine the core structure and crown restoration, providing retention from the pulp chamber (macroretention) and achieving sufficient stability with adhesive cementation (microretention). Overlays, on the other hand, are restorations that include the entire tooth cusps, which are indicated in large class II cavities with unsupported axial walls and the absence of both marginal margins. This case report describes the treatment of two different patients with excessive material loss in their molars with adhesively cemented endochrone and overlay restorations that preserve the remaining tooth structure. These restorations were fabricated using a computer-aided design-computer-aided manufacturing (CAD-CAM) system. With the use of CAD-CAM technology, it is aimed to prevent incompatibilities due to errors that may occur in conventional techniques. The restorations were prepared with Cerasmart, a hybrid ceramic material with a nanohybrid structure, which is produced monolithically with CAD-CAM technique and has the advantages of being easy to edit, re-polished, having good wear resistance, causing less wear on the antagonist tooth compared to glass ceramics, and short laboratory procedures.

Anahtar Kelimeler

adhesive cementation, CAD-CAM, endocrown, overlay

Minimal İnvaziv Protetik Tedavilerde CAD-CAM Kullanımı: İki Olgu Sunumu

Öz

Sert dokularda meydana gelen çürük, aşınma, kırık gibi koronal kayıpların amalgam ya da kompozit rezinler ile direkt restoratif tedavisi her zaman mümkün olmayabilir. Endodontik tedavi sonrası kron harabiyetinin arttığı dişlerin protetik rehabilitasyonunda, direkt ve indirekt restorasyonlar dahil olmak üzere farklı konvansiyonel tedavi yöntemleri uygulanabilir. Bu gibi durumlarda inley, onley, overlay ya da endokron gibi indirekt tedavi yaklaşımları kaybedilen dokunun yerine konması ile birlikte kalan diş dokusunun korunmasında da başarılı bir yaklaşım olarak gösterilir. Endokron, kor yapısı ve kron restorasyonunu bünyesinde birleştiren, pulpa odasından tutuculuk sağlayarak (makroretansiyon), adeziv simantasyon ile yeterli stabiliteyi elde eden (mikroretansiyon) monoblok restorasyonlardır. Overlay ise desteksiz aksiyel duvarlara sahip ve her iki marjinal kenarın bulunmadığı büyük boyutlardaki sınıf II kavitelerde endike olan, tüm diş kasplarını içeren restorasyonlardır. Bu olgu raporunda molar dişinde aşırı madde kaybı bulunan iki farklı hastanın adeziv olarak simante edilen ve kalan diş yapısını koruyan yaklaşımlardan endokron ve overlay restorasyonlar ile tedavisi anlatılmaktadır. Bu restorasyonlar Bilgisayar destekli tasarım-bilgisayar destekli üretim (CAD-CAM) sistemi ile üretilmiştir. CAD-CAM teknolojisinin kullanımı ile konvansiyonel tekniklerde oluşabilecek hatalara bağlı uyumsuzlukların önüne geçilmesi amaçlanmıştır. Restorasyonlar CAD-CAM tekniği ile monolitik olarak üretilen ve kolay düzenlenebilmesi, yeniden cilalanabilmesi, iyi aşınma direncine sahip olması, cam seramiklere kıyasla antagonist dişte daha az aşınmaya sebep olması, laboratuvar prosedürlerinin kısa olması avantajları nedeniyle nanohibrit yapıda hibrit seramik bir materyal olan Cerasmart ile hazırlanmıştır.

Anahtar Kelimeler

adeziv simantasyon, CAD-CAM, endokron, overlay

Kaynakça

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