26 April 2020
The coronary seal is just as important as the apical seal.
Endodontic treatments will have good prognosis and their long life will be ensured, if we have completed treatment not only of the endodontic system but also of the restorations part.
We are witnesses ourselves, but there are also have many studies that proves that most endodontic failures come from mismanagement in the restorative phase.
Therefore the treatment plan and preliminary evaluation are crucial. Before making any endodontic treatment we must always answer to the question: “Is the tooth restorable or not?”
In this case report I will try to describe an endodontic treatment along the restorations phase.
Male patient, 40 years old came to our clinic with the bite pain complaint on tooth 14. The tooth had a composite filling OD.
Diagnosis suspected : parodontitis apicalis symptomatic
Treatment plan and evaluation : Root canal treatment
The first step in endodontic treatments after anesthesia is to isolate the operative field.
In cases where there is an aproximal filling then it is preferable to make multipletooth isolation and put a wood wedge to protect the ruberdam in that space.
To save our time: instead of preendo build up, we can use liquid dam as an aproximal barrier during endodontic treatments.
Let`s not forget that we treat endodontic spaces and not just onla the cannals.
Warm vertical compaction
Provisional filling in the endodontic cavity ( Cavit ) and then GIZ (glasionomercement)
Design of the crown
The restorative phase: etching
Preserve the enamel as much as possible for a better adhesion
Pre-intra-post operative X-rays
The concept of minimally invasive dentistry in these treatments is essential and crucial.
Exploring the anatomy of a tooth does not mean to loose tooth structure.
Therefore a proper endodontic endo access cavity allows the exploration and cleaning of the endodontic spaces. Where at the same time we maintain a healthy tooth structure which is important for the restorative phase.
Endodontics ( Volume 1 Diagnosis in Endodontics, Arnaldo Castelluci
Post Placement and Restoration of Endodontically Treated Teeth: A Literature Review Richard S.Schwartz,James W.Robbins
The Effects of Endodontic Access Cavity Preparation Design on the Fracture Strength of Endodontically Treated Teeth: Traditional Versus Conservative Preparation Taha Özyürek, Özlem Ülker, Ebru Özsezer Demiryürek, Fikret Yılmaz
-Fracture Strength of Endodontically Treated Teeth with Different Access Cavity DesignsGianlucaPlotino, Nicola MariaGrandeDDS, AlmiraIsufiDDS, PietroIoppolo EugenioPedullà RossellaBediniDSc, GianlucaGambariniMD,LucaTestarelli
-Minimally invasive dentistry (Endodontics)James L Gutmann