Overlay on non-vital tooth

19 Jan 2018 - 22964

The protection of the cusps on a non-vital tooth is very important to reduce the risk of fracture

Fig. 1

Initial occlusal aspect

Fig. 2

Initial x-ray, you can see the D4 lesion in the mesial part of 15.

Fig. 3

Isolation with the rubber dam.

Fig. 4

Pulp exposure during decay removing.

Fig. 5

Aspect of the tooth after endodontic treatment and the post space preparation on palatal root canal.

Fig. 6

Adhesive phases for the fiber post cementation and build-up stratification, etching for non-vital tooth is from 30 to 60 seconds, aspect after washing out of the etching agent.

Fig. 7

Digluconate solution of chlorhexidine at 0,2% to inhibit metal-proteinases, primer, drying primer on the canal with a paper point and the last picture with the adhesive application.

Fig. 8

Fiber post conditioning with silane and a thin layer of bonding agent.

Fig. 9

Fiber post cementation with dual cure composite cement and the stratification of a micro hybrid composite to complete the build-up.

Fig. 10

Composite overlay conditioning, the etching agent is only used to clean the internal surface of the restoration.

Fig. 11

Composite conditioning: alumina sandblasting, silane and bond.

Fig. 12

Overlay check before rubber dam positioning, isolation and adhesive steps: etching, chlorhexidine, primer and bond (without curing it).

Fig. 13

Heated micro hybrid composite used for cementation, proximal floss to remove the excess, sonic tip for cementation, glicerine air-block for the last cure, different final point of view.

Fig. 14

Buccal aspect and final x-ray aspect.

 

Conclusions

Partial indirect restorations with adhesive cementation are, today, the first choice to restore single non-vital tooth, with this kind of restoration we can protect the tooth from the occlusal strength and we can ensure to the patient a good esthetic result and a biologically conservative kind of restoration.

Bibliography

1. Hayashi M, Okamura K, Wu H, Takahashi Y, Koytchev EV, Imazato S, Ebisu S. The root canal bonding of chemical-cured total-etch resin cements. J Endod. 2008 May;34(5):583-6.

2. Magni E, Mazzitelli C, Papacchini F, Radovic I, Goracci C, Coniglio I, Ferrari M. Adhesion between fiber posts and resin luting agents: a microtensile bond strength test and an SEM investigation following different treatments of the post surface. J Adhes Dent. 2007 Apr;9(2):195-202.

3. Goracci C, Ferrari M. Current perspectives on post systems: a literature review. Aust Dent J. 2011 Jun;56 Suppl 1:77-83.