endoperiosem report group3

8/13/2019 EndoPerioSem Report Group3

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Valdez, Gianni MarieDemejes, Beryl Ann

Taupa, Monica Jane

Mendoza, HazelBenfit, Cali


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The evaluation of teeth to be restoredshould include these endodonticconsiderations:

(1) the health of the root canal system,

(2) the impact of planned restorativeprocedures on the pulp, and

(3) the magnitude of the restorative effort.


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1. Adequate obturation of the root canal

system

2. No sensitivity to percussion or biting

pressure

3. No sensitivity to palpation

4. No sinus tract5. No periodontal probing deeper than 3mm

6. No evidence of active inflammatory

disease


4/22

Restorations for endodontically treated teeth are

designed to replace the missing tooth structure

and to protect the remaining tooth structure from

fracture. The final restoration will include some

combination of:

o dowel

o core

o co ronal resto rat ion .


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Nonvital anterior teeth that have not lost tooth structure

beyond the endodontic access preparation are at

minimal risk for fracture and do not require a crown,

core, or dowel. Restorative treatment (amalgam or

composite) is limited to sealing of the access cavity.


7/22

When a nonvital anterior or posterior tooth has

lost signifi- cant tooth structure, a cast coronal

restoration is required. An intermediary

restoration, the dowel and core, is used to sup-port and retain the crown.


8/22

The dowel and core function together. The

core replaces lost coronal tooth structure

and provides retention for the crown. The

dowel provides retention for the restorativematerial of the core and must be designed

to minimize the potential for root fracture

from functional forces. The crown restoresfunction and esthetics and protects the

remaining root and coronal structure from

fracture.


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11/22

The dowel is a

metal post or

rigid restorative

material placedin the radicular

portion of a

nonvital tooth.


12/22

It functions primarily to aid retention of the restoration

and secondarily to distribute forces along the length of

the root. The dowel thus has a retentive role but does

not strengthen a tooth. Instead, the tooth is weakened if

dentin is sacrificed to facilitate larger dowel placement..


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The core consists of restorative material placed

in the coronal area of a tooth. This material

replaces carious, fractured, or otherwise missing

coronal structure and retains the final coronalrestoration.

The core and dowel are usually fabricated of

different materials:

o Cast Core

o Amalgam Core

o Composite resin Core

o

Glass-ionomero Coronal-Radicular Core


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Dowels can be cemented with:

o zinc phosphate cement,

o glass ionomer cement, or

o resin cements.

Zinc phosphate cement is a traditional dental luting

agent with a long and satisfactory clinical history. It

provides retention through interlocking of small

mechanical undercuts in the tooth structure andrestorative materials. The retention is suf- ficient for well-

designed dowels, cores, and coronal restoration of the

endodontically treated tooth.The inability to chemically

bond to residual tooth structure is also a disadvantage.


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Adhesive and resin cements differ from zinc phosphate

in that they bond to tooth structure and to most dowel

materials. This gives an added dimension to the luting

agents used for dowel and core restorations.

Glass ionomer cement bonds to dentin within the root

and becomes incorporated into a glass ionomer core,

forming a homogeneous unit. The anticariogenic effect of

glass ionomer materials is a major advantage. The

retention is similar to that of zinc phosphate cements, fora given dowel length and design.


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Most investigators used radiographic and

clinical findingsto evaluate treatmentresults.

Clinical evaluation often relics on subjectivefindings, such as report of pain or discomfort

upon percussion, that are subject to individual

variation.

However, resorting to only a radiographic

evaluationmay allow pathosis that is clinically

evident but produces no radiographic

manifestation to be overlooked


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The causes of endodontic failures have

been classified dif- ferently by several

authorities.

Grossman divided the causes into four

categories:

o

poor diagnosis,opoor prognosis,

otechnical difficulties, and


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Endodontic failure cases may be treated ineither of two ways:

o retreatment

o

surgery. Surgery may include extraction of the tooth,

resection, or hemisection of a root all of whichmean removal of the failed tooth or root with-out attempting to treat it. Surgery may also beused to correct endodontic failures by apicalcurettage, apicocctomy, and ret- rofitting of theroot canals.


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endoperiosem report group3

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