Abstract
Stainless steel crowns are the most popular restoration technique for young permanent first molars treated endodontically. However, these restorations are not aesthetically appealing and need to be replaced. Endocrowns constitute a reliable approach for restoring severely damaged molars and premolars. Intraoral scanners (IOSs) are well tolerated by children and are easily and quickly implemented. We present an innovative treatment approach for endodontically treated teeth in children, using a digital workflow with IOS and computer-aided design/computer-assisted manufacturing (CAD/CAM) fabrication of the restoration. The protocol involves a thorough diagnostic phase and comprehensive treatment planning. Among the factors to be considered are the child’s behavior, the parents’ cooperation and compliance, and initial preparation including inhalation sedation, effective local anaesthesia and the use of a rubber dam. Full attention should be given to 1–2 mm of ferruling by the endocrown, which should be appropriately prepared to accommodate endocrowns for molars. IOSs include scanning of the prepared tooth and its antagonist, and scanning of the bite. CAD-CAM preparation of the restoration is followed by restoration bonding and follow up. Digital workflow should be considered in the treatment of endodontically treated molars since the high accuracy of the scanning enables definitive restoration in young patients.
Highlights
Several methods are available for restoring endodontically treated teeth, including the use of fixed partial dentures and various restorative materials [1]
We present an innovative approach for treating children after root canals, using a digital workflow with Intraoral scanners (IOSs) and computer-aided design/computer-assisted manufacturing (CAD/CAM)
The introduction of restorative digitalization protocols, with IOS and CAD-CAM, to the prosthetic field of dentistry has opened a new venue for paediatric dentists and practitioners who treat young children
Summary
Several methods are available for restoring endodontically treated teeth, including the use of fixed partial dentures and various restorative materials [1]. A number of publications have recommended that following endodontic therapy, posterior teeth require adequate full-coverage restoration. This is to reduce the risk of fracture, to provide a coronal seal that avoids bacterial infection and to restore function [2,3]. According to the guidelines of the American Academy of Pediatric Dentistry [4], metal crowns (SSCs) are indicated for treating permanent molars with extensive caries and developmental defects in children, following the failure of other available restorations, and for endodontically-treated teeth. The rationale for the use of SSCs is their cost-effectiveness, based on
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