Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem 91120, Israel.
Endodontic Department, Hebrew University, Hadassah School of Dental Medicine, Jerusalem 91120, Israel.
Int J Environ Res Public Health. 2020 Feb 20;17(4):1364. doi: 10.3390/ijerph17041364.
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.
不锈钢冠是牙髓治疗后的年轻恒牙最常用的修复技术。然而，这些修复体在美观上并不理想，需要更换。而嵌体冠则为严重受损的磨牙和前磨牙提供了可靠的修复方法。口内扫描仪（IOS）被儿童很好地耐受，并且易于快速实施。我们提出了一种针对儿童牙髓治疗后牙齿的创新治疗方法，该方法使用数字工作流程、IOS 和 CAD/CAM 制作修复体。该方案包括全面的诊断阶段和综合治疗计划。需要考虑的因素包括儿童的行为、家长的合作和依从性，以及初步准备，包括吸入镇静、有效局部麻醉和使用橡皮障。全冠应注意 1-2 毫米的颈缘，并且应适当预备以容纳磨牙的嵌体冠。IOS 包括预备牙及其对颌牙的扫描，以及咬合的扫描。CAD/CAM 制作修复体后进行修复体粘结和随访。由于扫描的高精度可以为年轻患者提供最终修复，因此应考虑在牙髓治疗后的磨牙治疗中采用数字化工作流程。
