Abstract
ABSTRACT The purpose of this clinical case description article was to present the planning sequence, indication, treatment and performance to obtain a crown of the Endocrown type. This clinical case description article illustrates a therapeutic option for functional and esthetic rehabilitation of a devitalized mandibular molar, presenting a small amount of remaining coronal tooth structure, by means of cementing a pure porcelain crown of the Endocrown type (Adhesive Endodontic Crown). A 39-year-old woman presented to the Graduate clinic of the Bauru Dental School (FOB), University of São Paulo (USP), with the complaint that tooth #36 had an extensive and unsatisfactory composite resin restoration. The lithium disilicate-based system of monolithic porcelain was used with the lost wax technique. This therapy promoted the stability and retention of the indirect restoration, without the need for performing reconstruction of the above mentioned tooth, either by means of a cast metal core or reconstruction with intracanal post, thereby reducing the treatment time. After the tooth preparation, the provisional restoration was done with acrylic resin to determine if the retention and stability of the remaining tooth was adequate to receive the indirect Endocrown restoration. The characteristics of the internal and external walls of the dental remnants, cervical termination, impression-taking, laboratory stages and adhesive cementation will be discussed. The major advantage of indicating an endocrown is the use of the dental remnants itself, particularly the pulp chamber, to promote retention and stability in cases without adequate height for performing complete dental and crown reconstruction.KeywordsAdhesive endodontic crown; Devitalized tooth; Lithium dissilicate.
Highlights
One of the most frequent problems dentists face is the restorative treatment of endodontically treated teeth with extensive coronal destruction, whose esthetic and functional recovery generates a great deal of confusion
In cases in which there is insufficient dental crown height in relation to the antagonist teeth, the fabrication of a total crown restoration of the Endocrown (Adhesive Endodontic Crown) type supported on a metal core or filling is an excellent option
Various authors have proposed the treatment of these teeth with total crowns supported by a cast metal core [1,2]
Summary
One of the most frequent problems dentists face is the restorative treatment of endodontically treated teeth with extensive coronal destruction, whose esthetic and functional recovery generates a great deal of confusion. Cases of endodontically treated teeth, in which it is impossible to place an intracanal post, or those that have insufficient coronal height, extensive destruction, and require additional stripping of dental structures, may be more recovered with the fabrication of restorations of the total Endocrown type This treatment consists of fabricating onlays, overlays and total crowns that use the entire depth, extension and inclination of the internal walls of the pulp chamber to promote stability and retention of the restoration, without the need to remove obstructions (such as filling materials) from the root canals [5,8,9,10].
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