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Restauração do dente tratado endodonticamente com perda significativa de substância coronária : o conceito de endocrown
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Abstract(s)
Ainda existe um desafio importante para a maioria dos dentistas antes de ser otimistas sobre a reabilitação de dentes tratados endodonticamente com extensa destruição coronal.
Após o tratamento endodôntico, os dentes perderam suas características mecânicas (Ploumaki e al., 2013). Na verdade, eles tornaram-se frágeis, e isso está relacionado com a remoção da polpa e dos tecidos dentinários circundantes. As alterações biomecânicas existentes devido à terapia de canal radicular e ao grau de perda de tecido dentário, conduzem o dentista ao planeamento do tratamento restaurador.
É aceite que a perda de substância dentária e a quantidade de tecido residual são provavelmente os fatores mais preditivos, mais importante para o sucesso clínico a longo prazo (D.Incau e al., 2011). O curso de ação mais lógico é, portanto, adotar o método mais confiável e econômico em termos de substância dentária.
Além disso, as limitações ao uso de espigões intra-radiculares, como canais radiculares calcificados, canais estreitos ou fratura de um instrumento, levam os dentistas a pensar em outras alternativas, como o uso de endocrown, uma coroa endodôntica adesiva (Göhring e al., 2003).
Endocrown, sendo uma restauração parcial única, pode ser considerada uma boa alternativa para a restauração de dentes com grande destruição coronária e dificuldades no tratamento endodôntico.
Esta coroa seria fixada nas paredes internas da câmara pulpar e nas margens da cavidade para melhorar a retenção macromecânica e o uso de cimentação adesiva também melhoraria a microrretenção (Biacchi e al., 2012) (Al-Dabbagh., 2021) (Dartora e al., 2018).
Objetivo: Esta revisão bibliográfica pretende descrever as consequências da perda coronária e do tratamento endodôntico nos dentes e discutir a indicação e o uso de endocrown.
Métodos: A presente revisão bibliográfica foi realizada durante o período de dezembro de 2020 e janeiro de 2021. Para esse efeito foi realizada uma pesquisa recorrendo aos motores de busca online: Science direct, Pubmed, Google scholar e Medline. A pesquiza baseou-se no estudo da teoria publicada entre 2000 – 2021 composta por artigos escritos em português, inglês ou francês.
Rehabilitation of endodontically treated teeth with extensive coronal destruction still remains an important challenge for most dentists. After the endodontic treatment, teeth lost their mechanical properties (Ploumaki e al., 2013). Actually, they became fragile due to the removal of pulp and the dentin tissues. The biomechanical changes due to the degree of loss of dental tissue and the root canal therapy, lead the dentist to the restorative treatment planning. It is accepted that the loss of dental substance and the amount of residual tissue are probably the most predictive factors, most important for long-term clinical success (D.Incau e al., 2011). Therefore, it is important to adopt the most reliable and economical method in terms of dental substance. In addition, the limitations of using intra-radicular posts, such as narrow canals, calcified root canals or an instrument fracture, have encourage dentists to think about other alternatives, such as the use of endocrown, an adhesive crown (Göhring e al., 2003). The endocrown, considered as a single partial restoration, can be used as a good alternative for restoring teeth with major coronal destruction and difficulties in endodontic treatment. This crown would be fixed to the internal walls of the pulp chamber and on the margins of the cavity to improve macro-mechanical retention and the use of adhesive cementation would improve in addition micro-retention (Biacchi e al., 2012) (Al-Dabbagh., 2021) (Dartora e al., 2018). Objective: This bibliographic review aims to describe the consequences of extensive coronal destruction and endodontic treatment on teeth ans discuss the indication and use of endocrown. Methods: This bibliographic review was carried out during the period of December 2020 and January 2021. For this purpose, a search was carried out using the online search engines: Science direct, Pubmed, Google Scholar and Medline. The research was based on the study of the literature published between 2000 – 2021, consisting of articles written in Portuguese, English or French.
Rehabilitation of endodontically treated teeth with extensive coronal destruction still remains an important challenge for most dentists. After the endodontic treatment, teeth lost their mechanical properties (Ploumaki e al., 2013). Actually, they became fragile due to the removal of pulp and the dentin tissues. The biomechanical changes due to the degree of loss of dental tissue and the root canal therapy, lead the dentist to the restorative treatment planning. It is accepted that the loss of dental substance and the amount of residual tissue are probably the most predictive factors, most important for long-term clinical success (D.Incau e al., 2011). Therefore, it is important to adopt the most reliable and economical method in terms of dental substance. In addition, the limitations of using intra-radicular posts, such as narrow canals, calcified root canals or an instrument fracture, have encourage dentists to think about other alternatives, such as the use of endocrown, an adhesive crown (Göhring e al., 2003). The endocrown, considered as a single partial restoration, can be used as a good alternative for restoring teeth with major coronal destruction and difficulties in endodontic treatment. This crown would be fixed to the internal walls of the pulp chamber and on the margins of the cavity to improve macro-mechanical retention and the use of adhesive cementation would improve in addition micro-retention (Biacchi e al., 2012) (Al-Dabbagh., 2021) (Dartora e al., 2018). Objective: This bibliographic review aims to describe the consequences of extensive coronal destruction and endodontic treatment on teeth ans discuss the indication and use of endocrown. Methods: This bibliographic review was carried out during the period of December 2020 and January 2021. For this purpose, a search was carried out using the online search engines: Science direct, Pubmed, Google Scholar and Medline. The research was based on the study of the literature published between 2000 – 2021, consisting of articles written in Portuguese, English or French.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Endocrown Dente tratado endodonticamente Cimentação Cerâmica