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A simple method for the restoration of fractured anterior teeth
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OUR READERS A simple method for the restoration of fractured anterior teeth Ibrahim F. Tuluno~lu, DDS, PhD, a and Omer G~Jrduysus, DDS, PhD b Hacettepe University, Faculty of Dentistry, Ankara, Turkey
Fractured anterior teeth are usually restored with conventional post-core and crown techniques after being treated endodontically. The more extensive the required restoration, the more time-consuming and techniquesensitive the procedure becomes) Factors affecting the retention and stability of the post-core and crown restorations are location of fracture, state of remaining tooth structure, post design (preparation length and diameter), and cementing material and technique .2,3 Fractures that do not involve the epithelial attachment can be readily restored with a direct post-core in one visit. A more conservative procedure for these situations is presented.
Presented at the First International Symposium on Oral Biology, Istanbul, Turkey, September 1995. ~Assistant Professor, Department of Prosthodonfics. bAssistant Professor, Department of Endodontics. J Prosthet Dent 1997;78:614-15.
PROCEDURE A dental student fractured his maxillary right lateral incisor (Fig. 1). The fracture line was located above the gingival epithelial junction, the pulp was exposed, and there was no periodontal disease. After endodontic treatment, the post space was prepared with a no. 3 Peeso reamer (Batch no. 212, Maillefer, Zurich, Switzerland) for insertion of an intrapulpal titanium screw post (Pulpadent stopping screws, Zurich, Switzerland)(Fig. 2). The fractured crown was repositioned to the remaining tooth structure, and a hole was prepared in the crown portion to align it with the canal preparation for the screw post. The screw post and fractured crown were positioned and cemented to the remaining root with the Metabond C&P resin luting cement (Parkell Bio-Materials Division, Farmingdale, N.Y.) (Figs. 3 and 4). 4~8
Fig. 1. Coronal part of fractured tooth.
Fig. 3. Radiographic view of completed restoration.
Fig. 2. View of root after endodontic treatment.
Fig. 4. Intraoral view of completed restoration.
614
THE JOURNAL OF PROSTHETIC DENTISTRY
VOLUME 78 NUMBER6
TULUNO(~LU AND GORDUYSUS
THE JOURNAL OF PROSTHETIC DENTISTRY
REFERENCES
Fig. 5. [ntraoral view of completed restoration after 2 years.
Figure 5 presents a clinical view o f the tooth 2 years after restoration. Eleven individual teeth have been treated with this procedure over the last 4 years with only one reported complaint in a situation in which the restored tooth became decayed and a new restoration was required.
1. Colman HL. Restoration of the endodontically treated teeth. Dent Clin North Am 1979;23:647-62. 2. Yoeli Z, Raviv E, Stern N. Clinical procedures in fabricating post and core restorations: case reports. Quintessence lnt 1992;23:749-53. 3. Hudis S, Goldstein GR. Restoration of endodontically treated teeth: a review of the literature. J Prosthet Dent 1986;55:33-7. 4. Prati C, Nucci C, Montanari G. Shear bond strength and microleakage of dentine bonding systems. J Prosthet Dent 1991 ;65:401-7. 5. Tanaka T, Fujiyama E, Shimizu H, Takaki A, Atsuta M. Surface treatment of nonprecious alloys for adhesion-fixed partial dentures. J Prosthet Dent 1986;55:456-62. 6. Meiers JC, Jensen ME, Mayclin T. Effect of surface treatments on the bond strength of etched-metal resin-bonded retainers. J Prosthet Dent 1985;53:185-90. 7. Ohno H. New conversion method of metal surfaces for resin bonding. Conversion effects for pure metals in dental precious metal alloys. Dent Jpn 1990;27:101-8. 8. Matsumura H, Yoshida K, Tanaka T, Atsuta M. Adhesive bonding of titanium with a titanate coupler and 4-META/MMA-TBB opaque resin. J Dent Res 1990;69:1614-6. Reprint requests to: DR. IBRAHIMFEVZlTULUNOGLU 8AHCELIEVLERI 5 SOK. 41/1 06490 ANKARA TU RKEY Copyright © 1997 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/97/$5.00 + 0. 10/4/85334
B o u n d v o l u m e s available to subscribers
Bound volumes of The Journal of Prosthetic Dentistry are available to subscribers (only) for the 1997 issues from the publisher at a cost of $76.00 ($89.00 international) for Vol. 77 (January-June) and Vol. 78 (July-December). Shipping charges are included. Each bound volume contains a subject and author index, and all advertising is removed. Copies are shipped within 30 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Volumes 75 and 76 are also available. Payment must accompany all orders. Contact Mosby-Year Book, Inc., Subscription Services, 11830 Westline Industrial Drive, St. Louis, MO 63146-3318, USA; phone (800)453-4351, or (314)453-4351. Subscriptions must be in force to qualify. B o u n d volumes are n o t available in place o f a regular Journal subscription.
DECEMBER 1997
615
i
OUR READERS A simple method for the restoration of fractured anterior teeth Ibrahim F. Tuluno~lu, DDS, PhD, a and Omer G~Jrduysus, DDS, PhD b Hacettepe University, Faculty of Dentistry, Ankara, Turkey
Fractured anterior teeth are usually restored with conventional post-core and crown techniques after being treated endodontically. The more extensive the required restoration, the more time-consuming and techniquesensitive the procedure becomes) Factors affecting the retention and stability of the post-core and crown restorations are location of fracture, state of remaining tooth structure, post design (preparation length and diameter), and cementing material and technique .2,3 Fractures that do not involve the epithelial attachment can be readily restored with a direct post-core in one visit. A more conservative procedure for these situations is presented.
Presented at the First International Symposium on Oral Biology, Istanbul, Turkey, September 1995. ~Assistant Professor, Department of Prosthodonfics. bAssistant Professor, Department of Endodontics. J Prosthet Dent 1997;78:614-15.
PROCEDURE A dental student fractured his maxillary right lateral incisor (Fig. 1). The fracture line was located above the gingival epithelial junction, the pulp was exposed, and there was no periodontal disease. After endodontic treatment, the post space was prepared with a no. 3 Peeso reamer (Batch no. 212, Maillefer, Zurich, Switzerland) for insertion of an intrapulpal titanium screw post (Pulpadent stopping screws, Zurich, Switzerland)(Fig. 2). The fractured crown was repositioned to the remaining tooth structure, and a hole was prepared in the crown portion to align it with the canal preparation for the screw post. The screw post and fractured crown were positioned and cemented to the remaining root with the Metabond C&P resin luting cement (Parkell Bio-Materials Division, Farmingdale, N.Y.) (Figs. 3 and 4). 4~8
Fig. 1. Coronal part of fractured tooth.
Fig. 3. Radiographic view of completed restoration.
Fig. 2. View of root after endodontic treatment.
Fig. 4. Intraoral view of completed restoration.
614
THE JOURNAL OF PROSTHETIC DENTISTRY
VOLUME 78 NUMBER6
TULUNO(~LU AND GORDUYSUS
THE JOURNAL OF PROSTHETIC DENTISTRY
REFERENCES
Fig. 5. [ntraoral view of completed restoration after 2 years.
Figure 5 presents a clinical view o f the tooth 2 years after restoration. Eleven individual teeth have been treated with this procedure over the last 4 years with only one reported complaint in a situation in which the restored tooth became decayed and a new restoration was required.
1. Colman HL. Restoration of the endodontically treated teeth. Dent Clin North Am 1979;23:647-62. 2. Yoeli Z, Raviv E, Stern N. Clinical procedures in fabricating post and core restorations: case reports. Quintessence lnt 1992;23:749-53. 3. Hudis S, Goldstein GR. Restoration of endodontically treated teeth: a review of the literature. J Prosthet Dent 1986;55:33-7. 4. Prati C, Nucci C, Montanari G. Shear bond strength and microleakage of dentine bonding systems. J Prosthet Dent 1991 ;65:401-7. 5. Tanaka T, Fujiyama E, Shimizu H, Takaki A, Atsuta M. Surface treatment of nonprecious alloys for adhesion-fixed partial dentures. J Prosthet Dent 1986;55:456-62. 6. Meiers JC, Jensen ME, Mayclin T. Effect of surface treatments on the bond strength of etched-metal resin-bonded retainers. J Prosthet Dent 1985;53:185-90. 7. Ohno H. New conversion method of metal surfaces for resin bonding. Conversion effects for pure metals in dental precious metal alloys. Dent Jpn 1990;27:101-8. 8. Matsumura H, Yoshida K, Tanaka T, Atsuta M. Adhesive bonding of titanium with a titanate coupler and 4-META/MMA-TBB opaque resin. J Dent Res 1990;69:1614-6. Reprint requests to: DR. IBRAHIMFEVZlTULUNOGLU 8AHCELIEVLERI 5 SOK. 41/1 06490 ANKARA TU RKEY Copyright © 1997 by The Editorial Council of The Journal of Prosthetic Dentistry. 0022-3913/97/$5.00 + 0. 10/4/85334
B o u n d v o l u m e s available to subscribers
Bound volumes of The Journal of Prosthetic Dentistry are available to subscribers (only) for the 1997 issues from the publisher at a cost of $76.00 ($89.00 international) for Vol. 77 (January-June) and Vol. 78 (July-December). Shipping charges are included. Each bound volume contains a subject and author index, and all advertising is removed. Copies are shipped within 30 days after publication of the last issue in the volume. The binding is durable buckram with the journal name, volume number, and year stamped in gold on the spine. Volumes 75 and 76 are also available. Payment must accompany all orders. Contact Mosby-Year Book, Inc., Subscription Services, 11830 Westline Industrial Drive, St. Louis, MO 63146-3318, USA; phone (800)453-4351, or (314)453-4351. Subscriptions must be in force to qualify. B o u n d volumes are n o t available in place o f a regular Journal subscription.
DECEMBER 1997
615