Integração multidisciplinar na reabilitação pós traumatismo dentário
DOI:
https://doi.org/10.21270/archi.v5i5.1714Resumo
Dentes tratados endodonticamente com extensas perdas de estrutura dentária causadas por traumatismo dentário representam um desafio clínico. Para a reabilitação destes dentes, se faz necessária a utilização de meios que promovam retenção e longevidade às restaurações. O uso de pinos de fibra de vidro pré-fabricados associados às restaurações diretas tem representado uma alternativa eficaz, que vêm alcançando prognósticos favoráveis. O objetivo deste trabalho é descrever um caso clínico relacionado a um traumatismo dos incisivos superiores, e mostrar o tratamento integrado proposto. O tratamento a ser realizado nos dentes 11 e 21 consistiu na obturação do canal radicular, com posterior cimentação de pinos de fibra de vidro e realização de restaurações adesivas diretas, auxiliadas por meio de enceramento diagnóstico e a utilização de guia palatina de silicone. Nos dentes 12 e 22 realizou-se o tratamento restaurador com resina composta. Diante este traumatismo complexo envolvendo grande destruição coronária, os pinos de fibra de vidro associados às restaurações diretas possibilitaram a reabilitação e mostraram-se como indicações viáveis, pois devolveram a função, estética, protegeram o remanescente dental e preveniram possíveis recontaminações do canal radicular.Descritores: Endodontia; Traumatismos Dentários; Pinos Dentários; Resinas Compostas.
Downloads
Referências
Goerig AC, Mueninghoff LA. Management of the endodontically treated tooth. Part I: concept for restorative designs. J Prosthet Dent. 1983;49(3):340-5.
Sivers JE, Johnson WT. Restoration of endodontically treated teeth. Dent Clin North Am. 1992; 36(3):631-50.
Assif D, Gorfil C. Biomechanical considerations in restoring endodontically treated teeth. J Prosthet Dent. 1994; 71(6):565-7.
Fernandes AS, Dessai GS. Factors affecting the fracture resistance of post-core reconstructed teeth: a review. Int J Prosthodont. 2001;14(4):355-63.
Christensen GJ. Post concepts are changing. J Am Dent Assoc. 2004; 135(9):1308-10.
Bitter K, Kielbassa AM. Post-endodontic restorations with adhesively luted fiber-reinforced composite post systems: a review. Am J Dent. 2007; 20(6):353-60.
Fernandes AS, Shetty S, Coutinho I. Factors determining post selection: a literature review. J Prosthet Dent. 2003;90(6):556-62.
Skupien JA, Cenci MS, Opdam NJ, Kreulen CM, Huysmans MC, Pereira-Cenci T. Crown vs. composite for post-retained restorations: a randomized clinical trial. J Dent. 2016; 48:34-9.
Pegoretti A, Fambri L, Zappini G, Bianchetti M. Finite element analysis of a glass fibre reinforced composite endodontic post. Biomaterials. 2002; 23(13):2667-82.
Lanza A, Aversa R, Rengo S, Apicella D, Apicella A. 3D FEA of cemented steel, glass and carbon posts in a maxillary incisor. Dent Mater. 2005; 21(8):709-15.
Wu MK, Pehlivan Y, Kontakiotis EG, Wesselink PR. Microleakage along apical root fillings and cemented posts. J Prosthet Dent. 1998; 79(3):264-9.
Hommez GM, Coppens CR, De Moor RJ. Periapical health related to the quality of coronal restorations and root fillings. Int Endod J. 2002; 35(8):680-9.
Iglesia-Puig MA, Arellano-Cabornero A. Fiber-reinforced post and core adapted to a previous metal ceramic crown. J Prosthet Dent. 2004; 91(2):191-4.
Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod. 2006; 32(9):828-32.
Chan FW, Harcourt JK, Brockhurst PJ. The effect of post adaptation in the root canal on retention of posts cemented with various cements. Aust Dent J. 1993; 38(1):39-45.
King PA, Setchell DJ. An in vitro evaluation of a prototype CFRC prefabricated post developed for the restoration of pulpless teeth. J Oral Rehabil.1990; 17:599–609.
Christensen GJ. Posts and cores: state of the art. J Am Dent Assoc. 1998; 129(1):96-7.
Asmussen E, Peutzfeldt A, Heitmann T. Stiffness, elastic limit, and strength of newer types of endodontic posts. J Dent. 1999; 27(4):275-8.
Demarchi MG, Sato EF. Leakage of interim post and cores used during laboratory fabrication af custom posts. J Endod. 2002; 28(4):328-9.
Heling I, Gorfil C, Slutzky H, Kopolovic K, Zalkind M, Slutzky-Goldberg I. Endodontic failure caused by inadequate restorative procedures: review and treatment recommendations. J Prosthet Dent. 2002; 87(6):674-8.
Faria AC, Rodrigues RC, Almeida Antunes RP, Mattos MG, Ribeiro RF. Endodontically treated teeth: characteristics and considerations to restore them. J Prosthodont Res. 2011; 55(2):69-74.
Saunders WP, Saunders EM. Coronal leakage as a cause of failure in root-canal therapy: a review. Endod Dent Traumatol. 1994; 10(3):105-8.
Sharaf AA. The application of fiber core posts in restoring badly destroyed primary incisors. J Clin Pediatr Dent. 2002; 26(3):217-24.
Alves FB, Vieira RS. Effects of eugenol and non-eugenol endodontic fillers on short post retention, in primary anterior teeth: an in vitro study. J Clin Pediatr Dent. 2005; 29(3):211-4.
Subramaniam P, Babu KL, Sunny R. Glass fiber reinforced composite resin as an intracanal post – a clinical study. J Clin Pediatr Dent. 2008; 32(3):207-10.
González-Lluch C, Rodríguez-Cervantes PJ, Sancho-Bru JL, Pérez-González A, Barjau-Escribano A, Vergara-Monedero M, et al. Influence of material and diameter of pre-fabricated posts on maxillary central incisors restored with crown. J Oral Rehabil. 2009; 36(10):737-47.
Zarone F, Sorrentino R, Apicella D, Valentino B, Ferrari M, Aversa R, et al. Evaluation of the biomechanical behavior of maxillary central incisors
restored by means of endocrowns compared to a natural tooth: a 3D static linear finite elements analysis. Dent Mater. 2006; 22(11):1035-44.
Rosentritt M, Fürer C, Behr M, Lang R, Handel G. Comparison of in vitro fracture strength of metallic and tooth-coloured posts and cores. J Oral Rehabil. 2000; 27(7):595-601.
Mendoza DB, Eakle WS, Kahl EA, Ho R. Root reinforcement with a resin-bonded preformed post. J Prosthet Dent. 1997; 78(1):10-4.
Grandini S, Sapio S, Simonetti M. Use of anatomic post and core for reconstructing an endodontically treated tooth: a case report. J Adhes Dent. 2003; 5(3):243-247.
Rosenstiel SF, Land MF, Crispin BJ. Dental luting agents: a review of the current literature. J Prosthet Dent. 1998; 80(3):280-301.