Department of Prosthodontics and Dental Materials, School of Dentistry, University of Siena, Siena, Italy.
Department of Oral Surgery, School of Dentistry, University of Siena, Siena, Italy.
J Esthet Restor Dent. 2022 Jan;34(1):65-80. doi: 10.1111/jerd.12880. Epub 2022 Feb 8.
This article provides an updated overview of restorative procedures of endodontically treated teeth.
The different techniques and procedures to restore an endodontic treated tooth were considered in the last decades. While they are generally performed using bonding procedures in combination with or without the placement of a post into the root to build up the abutment, there has been a lack of interest in restorative difficulties that can be faced. Failures are represented such as debonding of the post, fracture of the root, decementation, and/or fracture of the restoration, microleakage of the margins. Essentially, the presence of a sufficient failure is considered a key point of a long prognosis. Different clinical factors can directly influence the type of restoration and the longevity of the treatment. The restorative difficulty evaluation system (RDES) is proposed in this article. This new system is composed of eight different clinical factors that are divided into six levels of difficulties. The RDES is composed of 1. Endodontic complexity and outcome, 2. Vertical amount of coronal residual structure and dimension of the pulp chamber, 3. Horizontal amount of coronal residual structure, 4. Restoration marginal seal, 5. Local interdisciplinary conditions, 6. the complexity of the treatment planning, 7. Functional need, 8. Dental wear and esthetic need.
This article reviews the RDES and outlines critical steps and tips for clinical success.
The RDES allows to any clinician to evaluate restorative difficulties when an endodontic treated tooth must be restored, combines clinical aspects that can involve from the single tooth to a full mouth rehabilitation.
本文提供了牙髓病治疗后牙齿修复方法的最新概述。
在过去几十年中，人们考虑了不同的技术和程序来修复牙髓病治疗后的牙齿。虽然它们通常使用粘结程序与或不与将桩放入根管中以构建基台相结合来进行，但人们对可能面临的修复困难缺乏兴趣。失败的表现形式有桩的脱粘、根的断裂、粘固剂的分离和/或修复体的断裂、边缘微渗漏等。本质上，存在足够的失败被认为是长期预后的关键。不同的临床因素会直接影响修复类型和治疗的耐久性。本文提出了修复难度评估系统（RDES）。这个新系统由 8 个不同的临床因素组成，分为 6 个难度级别。RDES 由 1. 牙髓治疗的复杂性和结果，2. 冠残余结构的垂直量和牙髓室的尺寸，3. 冠残余结构的水平量，4. 修复体边缘密封，5. 局部跨学科条件，6. 治疗计划的复杂性，7. 功能需求，8. 牙齿磨损和美学需求组成。
本文回顾了 RDES，并概述了实现临床成功的关键步骤和技巧。
RDES 允许任何临床医生在需要修复牙髓病治疗后的牙齿时评估修复难度，它结合了从单个牙齿到全口修复的临床方面。
