Three-dimensional-guided removal and preparation of dental root posts

• Verfasst von: Schwindling, Franz Sebastian [VerfasserIn]
• Verfasst von: Tasaka, Akinori [VerfasserIn]
• Verfasst von: Hilgenfeld, Tim [VerfasserIn]
• Verfasst von: Rammelsberg, Peter [VerfasserIn]
• Verfasst von: Zenthöfer, Andreas [VerfasserIn]
• Titel: Three-dimensional-guided removal and preparation of dental root posts
• Titelzusatz: concept and feasibility
• Verf.angabe: Franz Sebastian Schwindling, Akinori Tasaka, Tim Hilgenfeld, Peter Rammelsberg, Andreas Zenthöfer
• Jahr: 2020
• Jahr des Originals: 2019
• Umfang: 5 S.
• Fussnoten: Available online 16 May 2019 ; Gesehen am 27.03.2020
• Titel Quelle: Enthalten in: Journal of prosthodontic research
• Ort Quelle: Amstedam [u.a.] : Elsevier, 2009
• Jahr Quelle: 2020
• Band/Heft Quelle: 64(2020), 1, Seite 104-108
• ISSN Quelle: 1883-1958
• DOI: doi:10.1016/j.jpor.2019.04.005
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: CBCT
• Sach-SW: Dental root post
• Sach-SW: Endodontically treated teeth
• Sach-SW: Guided technique
• Sach-SW: Post-And-Core
• K10plus-PPN: 1693426579

Abstract

Patients - This case report presents a novel method to remove glass fiber-reinforced composite root posts in a minimally invasive way while simultaneously shaping the canal for a new post-endodontic restoration. A multi-morbid, handicapped 62-year-old patient was referred with a horizontally fractured maxillary incisor presenting approximately 1 mm residual coronal tooth height. Endodontic revision was necessary, which required removal of a glass fiber-reinforced composite post. A cone-beam computed tomography (CBCT) scan was imported into conventional implant-planning software and matched to a stone cast of the intraoral situation. Position, length, and axis of the future post were planned virtually. Based on this planning, a tooth-supported splint was three-dimensionally (3D) printed. This splint allowed use of a 2.2-mm spiral drill for removal of the fractured post and shaping of the root canal for a new cast post-and-core. This metal post-and-core was adhesively cemented and prepared for a zirconia single crown veneered in the labial aspect. - Discussion - This method currently requires use of CBCT-based, ionizing 3D imaging. Additional refinements to this approach can be made regarding spiral drill design and coating as well as regarding the post-and-core workflow. - Conclusions - 3D-guided post-endodontic management is feasible. More research is needed to balance higher radiation doses against therapeutic success.