PROBLEMS OF CHOOSING A METHOD OF DENTAL TREATMENT OF TEETH AFTER ENDODONTIC INTERVENTION

Abstract

The optimal way to restore the anatomical structure of teeth after endodontic intervention is a controversial topic. Teeth after endodontic intervention have different properties compared to intact living teeth. Changes in these properties are associated with volumetric loss of hard tissues, caries, final preparation of the cavity taking into account access to endodontic treatment. Choosing the optimal method of dental treatment of teeth requires compliance with many factors, such as: prevention of infection penetration into root canals, restoration of tooth contacts, restoration of chewing functions, protection against further carious and non-carious destruction, restoration of tooth aesthetics. Dentists are now more than ever aware of the interdependence of the endodontic and restorative aspects of dental treatment and how much this will affect achieving the best long-term outcome. Controversies of the clinical relevance of endodontic and restorative treatment choice issues are mostly unanswered based on clinical data and scientific evidence. The modern approach to tooth restoration after endodontic intervention is an important topic. To improve clinical outcomes, it is important to determine the effectiveness of treatment, the importance of preserving tooth structure, the choice of treatment method with restorative materials, and the integration of digital dentistry to improve diagnosis and treatment principles. Research rationale. The purpose of this study is to find and use literature data on the effectiveness of modern methods of dental treatment after endodontic intervention in Ukraine. Materials and methods. Scientific data from a review and systematic analysis of the literature were used. Materials were searched using the Google Scholar, PubMed, Google Scholar databases and open sources of the World Health Organization, the Ministry of Health of Ukraine and other government web portals of Ukraine. Results, Discussion. After conducting a literature analysis to compare the effectiveness of using cast metal inserts and fiberglass posts, we can come to the conclusions that retrospective studies on the relationship between successful restorations and such factors as the type of tooth, the volume of residual hard tissues, the number of occlusal contacts, the type of the final restoration and the position of the tooth in the dental arch are the main criteria for choosing a treatment method. A controversial choice is that metal abutments are associated with a higher risk of root fracture, their manufacture requires laboratory techniques, while the use of fiberglass posts is associated with a higher risk of decementation, and overloading of fiberglass posts leads to their fractures. Conclusions. Decision-making and the choice of methods of dental treatment after endodontic intervention remain difficult. However, the interdependence of endodontic treatment and restoration of the crown part of the tooth is clearly established. Physicians must consider both aspects of treatment equally to ensure the best possible outcomes for their patients. The use of digital scanning enables an accurate volumetric assessment of the residual hard tissues of the tooth, which can be used to provide tangible qualitative results of the analysis and decision-making with the choice of treatment method. The choice of treatment method is not defined in a single protocol and requires further careful study with new experimental developments, based on the latest technologies of world leaders in dentistry.