Restoration of the Endodontically Treated Tooth 1 Flashcards
How do we assess RCT of a tooth? (2)
- Clinical assessment
2. Radiographic
What does a clinical assessment for an RCT include? (3)
- Coronal seal
- Restorations
- Crowns
- Leakage
- Caries - Amount of remaining tooth structure
- Is there enough to make a ferrule (dentine collar) to make a crown on - Is the tooth restorable?
- Can we isolate with rubber dam
List some clinical signs of endodontic infection (6)
- Swelling
- Sinus
- TTP
- Buccal sulcus
- Tender to palpation - Mobility
- Increased pocketing
- Perio diseae + root fractures
What does a radiographic assessment of an RCT include? (7)
- Root filling
- Length
- Quality of obturation e.g. voids - Unfilled/missed root canals
- Shape of canal
- Patency
- Fracture instruments
- Posts
- Sclerosis - Bone support
- Mild
- Moderate
- Severe - Crown to root ratio
- Pathology
- Periapical radiolucency
- Healing
- Resorption
- Perforations
What is coronal microleakage
Ingress of oral micro-organisms into the RC system
- Most important cause of RC failure
What are some problems post RCT/re-RCT?
- Lack or no ferrule
- Wide post holes
- Endodontic complications
- Fractured instruments
- Perforations
- Short/long root fillings
Restorations choices for RCTs
- DIRECT RESTORATIONS
- Composite
- Class III and IV - INDIRECT RESTORATIONS
- Crown/post crown
- Veneer
If a patient does not have intact marginal ridges, what restorative tx do we tend to go for?
Crowns/post crowns
Restoration option for:
Anterior teeth with intact marginal ridges
Direct restoration
- Composite
Restoration option for:
Anterior teeth with intact marginal ridges +/- discoloured crown (3)
Direct restoration
- Composite
- Bleaching
- Veneer
Restoration option for:
Anterior teeth with marginal ridges destroyed
Core build up with crown
Function of a post/core
Gain intraradicular support for a definitive restorations
What does a core provide?
Retention for crown
Where is a post placed?
Placed in the root canal
What is the core?
What the prosthesis is cemented to
eg. crown or bridge abutment
When do incisors/canines need posts?
When there’s extensive loss of coronal tooth tissue
As the pulp chamber and single root canal are not adeqaute to retain a core
Why do we avoid posts in mandibular incisors?
Due to thin/tapering/narrow mesiodistal roots
Why do we avoid posts in curved canals?
To avoid perforations
What is a ferrule
Dentine collar
1-2mm of vertical axial tooth structure within walls of a crown
Function of a ferrule
Prevents tooth fracture
If crown margin is not placed onto solid tooth, root fracture significantly increased
Advantages of prefabricated posts (3)
- Only 1 visit required vs 2 for custom posts
- No impressions + no fit visit required
- Chairside core build-up
What instruments do we use to remove a post?
- Ultrasonics
- Masseran Kit
- Eggler
- Moskito Forceps
Most common reason for post crown failure
Restorative reasons
- Caries around crown margins
