ENDODONTİK TEDAVİ SONRASI MOLAR DİŞLERİN, ENDOKRON İLE PROTETİK REHABİLİTASYONU: OLGU SERİSİ

Abstract

 Endodontik tedavi sonrası kron harabiyetinin arttığı molar dişlerin protetik rehabilitasyonunda, direkt ve indirekt restorasyonlar dahil olmak üzere farklı konvansiyonel tedavi yöntemleri uygulanabilir. Bilgisayar destekli tasarım/ bilgisayar destekli üretim (CAD/CAM) ve adeziv teknolojideki gelişmeler ile birlikte endokron restorasyonlar konvansiyonel sistemlere alternatif gösterilmiştir. Endokronlar, kor yapısı ve kron restorasyonunu bünyesinde birleştiren, çoğunlukla pulpa odasından, gerektiğinde de kök kanallarından tutuculuk sağlayarak (makroretansiyon), adezivlerle yeterli stabiliteyi elde eden (mikroretansiyon) monoblok restorasyonlardır. Bu olgu sunumunda kanal tedavili dişlerin endokron restorasyonları ile rehabilitasyonu dört farklı vakada ele alınmıştır. Vakalardan üçü, CAD/CAM sistemi ile lityum disilikat seramik bloklar kullanılarak üretilen molar endokron restorasyonları, bir vaka ise laboratuvarda indirekt kompozit rezin kullanılarak üretilen molar endokron restorasyonu açıklamaktadır. Bu olgu sunumunun amacı; madde kaybı fazla olan kanal tedavili dişlerdeki sağlıklı diş dokusunun ve kanal dolgusunun korunmasını sağlayan endokron restorasyonlarının aşamalarının anlatılması ve klinik takip sonuçlarının aktarılmasıdır.

Keywords

• Endokron,CAD/CAM,Tam Seramik

References

1. Aydın, D. Cam Seramik Endokronların Biyomekaniksel Özelliklerinin Preklinik ve Klinik Olarak Değerlendirilmesi. (Yayımlanmamış Doktora Tezi). Ankara: Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü; 2012.
2. Robbins JW. Guidelines for the restoration of endodontically treated teeth. J Am Dent Assoc 1990;120:558-566.
3. Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in a endodontically treated teeth. J Endod 2010;36:609-617.
4. Torabinejad M, Ung B, Kettering JD. In vitro bacterial penetration of coronally unsealed endodontically treated teeth. J Endod 1990;16:566-569.
5. Khayat A, Lee SJ, Torabinejad M. Human saliva penetration of coronally unsealed obturated root canals. J Endod 1993;19:458-461.
6. Einhorn M, DuVall N, Wajdowicz M, Brewster J, Roberts H. Preparation ferrule design effect on endocrown failure resistance. J Prosthet Dent 2019;28:237-242.
7. Gillen BM, Looney SW, Gu L-S, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fi llings on success of root canal treatment: a systematic review and meta-analysis. J Endod 2011;37(7):895-902.
8. Demarco FF, Corrêa MB, Cenci MS, Moraes RR, Opdam NJ. Longevity of posterior composite restorations: not only a matter of materials. Deny Mater 2012;28(1):87-101.

9. Tosun S, Özsevik A, Aydın U. Endodontik tedavili dişlerin restorasyonu: a systematic review. Gaziantep Med J 2016;22(1):33-38.
10. Kanat Ertürk B. Aşırı kron harabiyeti olan kanal tedavili dişlerde Cad/Cam ile endokron uygulamaları: Olgu serisi. J Dent Fac Atatürk Uni 2016;14:56-65.
11. El-Damanhoury H, Haj-Ali R, Platt J. Fracture resistance and microleakage of endocrowns utilizing three CAD-CAM blocks. Oper Dent 2015;40:201-10.
12. Martínez-Insua A, da Silva L, Rilo B, Santana U. Comparison of the fracture resistances of pulpless teeth restored with a cast post and core or carbon fiber post with a composite core. J Prosthet Dent 1998;80:527-32.
13. Akkayan B, Gulmez T. Resistance to fracture of endodon-tically treated teeth restored with different post systems. J Prosthet Dent 2002;87:431–7.
14. Mannocci F, Ferrari M, Watson TF. Intermittent loading of teeth restored using quartz fiber, carbon-quartz fiber, and zirconium dioxide ceramic root canal posts. J Adhes Dent 1999;1:153-8.
15. Soares CJ, Valdivia AD, da Silva GR, Santana FR, Menezes MS. Longitudinal clinical evaluation of post systems: A literature review. Braz Dent J 2012;23:135-40.
16. Sorensen JA, Engelman MJ. Ferrule design and fracture resistance of endodontically treated teeth. J Prosthet Dent 1990;63:529-36.
17. Ramírez-Sebastià A, Bortolotto T, Cattani-Lorente M, Giner L, Roig M, Krejci I. Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Investig 2014;18:545-54.
18. Magne P, Carvalho A, Bruzi G, Anderson R, Maia H, Giannini M. Influence of no-ferrule and no-post build up design on the fatigue resistance of endodontically treated molars restored with resin nanoceramic CAD/CAM crowns. Oper Dent 2014;39:595-602.
19. Ramırez-Sebastia A, Bortolotto T, Roig M, et al. Composite vs ceramic computer-aided design/computer-assisted manufacturing crowns in endodontically treated teeth: analysis of marginal adaptation. Oper Dent 2013;38:663-673.
20. Pissis P. Fabrication of a metal-free ceramic restoration utilizing the monobloc technique. Pract Periodontics Aesthet Dent 1995;7:83-94.
21. Bindl A, Mörmann WH. Clinical evaluation of adhesively placed Cerec endo-crowns after 2 years-preliminary results. J Adhes Dent 1999;1:255−65.
22. Forberger N, G¨ohring TN. Influence of the type of post and core on in vitro marginal continuity, fracture resistance, and fracture mode of lithia disilicate-based all-ceramic crowns. J Prosthet Dent 2008;100:264-273.
23. Moore P. Cerec Doctors Publications. Charlotte, NC, Dentsply Sirona, 2013
24. Lander E, Dietschi D. Endocrowns: a clinical report. Quintessence Int 2008;39:99-106.
25. Dietschi D, D.O., Krejci I, Sadan A. Biomechanical considerations for the restoration of endodontically treated teeth: A systematic review of the literature, Part II. Quintessence Int, 2008;39:117–129.
26. Rocca GT, Krejci I. Crown and post-free adhesive restorations for endodontically treated posterior teeth: from direct composite to endocrowns. Eur J Esthet Dent 2013;8:156-179.
27. Belleflamme MM, Geerts SO, Louwette MM, Grenade CF, Vanheusden AJ, Mainjot AK. No post-no core approach to restore severely damaged posterior teeth: an up to 10-year retrospective study of documented endocrown cases. J Dent 2017;63:1-7.
28. Jotkowitz A, Samet N. Rethinking ferrule a new approach to an old dilemma. Br Dent J 2010;209:25-33.
29. Biacchi GR, Basting RT. Comparison of fracture strength of endocrowns and glass fiber postretained conventional crowns. Oper Dent 2012;37:130-6.
30. Bindl A, Richter B, Mörmann WH. Survival of ceramic computer-aided design/manufacturing crowns bonded to preparations with reduced macroretention geometry. Int J Prosthodont 2005;18:219-24.
31. Otto T. Computer-aided direct all-ceramic crowns: preliminary 1-year results of a prospective clinical study. Int J Periodontics Restorative Dent 2004;24:446-455.
32. Zhu J, Rong Q, Wang X, Gao X. Influence of remaining tooth structure and restorative material type on stress distribution in endodontically treated maxillary premolars: a finite element analysis. J Prosthet Dent 2017;117:646-655.
33. Baraban DJ. The restoration of pulpless teeth. Dent Clin North Am 1967;11:633-653.
34. Carter JM, S.S., Johnson RR, Teitelbaum RL, Levine MS. Punch shear testing of extracted vital and endodontically treated teeth. J Biomech 1983;16:841-848.
35. Sokol DJ. Effective use of current core and post consepts. J Prosthet Dent 1984;52:231-234.
36. Milot, P., Stein, R.S. Root fracture in endodontically treated teeth related to post selection and crown design. J Prosthet Dent 1992;68(3):428-435.
37. Rosenstiel SR, L.M., Fujimoto J. (1995) Contemporary fixed prosthodontics,ed 2. St Louis: Mosby.
38. Shillingburg HT, H.S., Whitsett LD, Jacobi R, Brackett SE. (1996) Fundamentals of Fixed Prosthodontics,ed 3. Chicago:Quintessence .
39. Baba NZ, Golden G, Goodacre CJ. Nonmetallic prefabricated dowels: a review of compositions, properties, laboratory, and clinical test results. J Prosthodont 2009;18:527-536.
40. Balkenhol M, Wöstmann B, Rein C, Ferger P. Survival time of cast post and cores: a 10-year retrospective study. J Dent 2007;35:50-58.
41. Fokkinga WA, Kreulen CM, Bronkhorst EM, Creugers NHJ. Up to 17-year controlled clinical study on post-and-cores and covering crowns. J Dent 2007;35:778-786.
42. Zhu Z, Dong XY, He S, Pan X, Tang L. Effect of post placement on the restoration of endodontically treated teeth: a systematic review. Int J Prosthodont 2015;28:475-483.
43. Ona M, Wakabayashi N, Yamazaki T, Takaichi A, Igarashi Y. The influence of elastic modulus mismatch between tooth and post and core restorations on root fracture. Int Endod J 2013;46:47-52.
44. Assif D, Bitenski A, Pilo R, Oren E. Effect of post design on the resistance to fracture of endodontically treated teeth with complete crowns. J Prosthet Dent 1993;69:36-40.
45. Biacchi GR, Mello B, Bastings RZ. The endocrown: An alternative approach for restoring extensively damaged molars. J Esthet Restor Dent 2013;25:383-391.
46. Lin CL, Chang YH, Chang CY, Pai CA, Huang SF. Finite element analyses to estimate failure risks in the ceramic endocrown and classical crown for endodontically treated maxillary premolars. Eur J Oral Sci 2010;118:87-93.
47. Dejak B, Młotkowski A. 3D-Finite element analysis of molars restored with endocrowns and posts during masticatory simulation. Dent Mater 2013;29:e309-e317.