Post-endodontic toothrestoration

Poslijeendodontskom opskrbom endodontski liječenog zuba želimo nadoknaditi smanjenu otpornost preostalog zubnog tkiva na sva opterećenja kojima su izložena unutar stomatognatog sustava, odnosno usne šupljine. Nakon postavljanja pravilne indikacije za poslijeendodontsku opskrbu zuba, samu nadoknadu izgubljenog zubnog tkiva možemo učiniti različitim postupcima. Odabir postupka zavisi o količini sačuvanog zubnog tkiva, o smještaju zuba u zubnom nizu te o njegovoj okluzijskoj opterećenosti unutar stomatognatog sustava, o morfologiji endodontskog prostora i o estetskim zahtjevima. Ponekad, nažalost, odabir uvjetuju i materijalne mogućnosti i vremenska ograničenost pacijenta. Postupci koje izvodimo u svrhu poslijeendodontske opskrbe zuba mogu biti direktni i indirektni. Direktni podrazumijevaju neki od standardnih ispuna (kompozitni, stakleno-ionomerni ili amalgamski, dok su indirektni postupci izrada inlaya, onlaya i overlaya nekim od uobičajenih materijala (zlatni, keramički, kompozitni). Pored toga, endodontski liječeni zubi mogu se ojačati i različitim vrstama parapulpnih kolčića i intrakanalnih kolčića. Danas se uglavnom rabe nemetalni intrakanalni kolčići, koji mogu biti građeni od karbonskih niti, kolčići modificirani polietilenskim isprepletenim vlaknima, cirkonijevi kolčići, a ranije su se ugrađivali i kolčići izrađeni od srebropaladijevih, zlatnih i platinskozlatnih legura. U velikom broju slučajeva endodontski liječenih zubi razorenost preostalog zubnog tkiva je tako opsežna te se mora raditi protetska poslijeendodontska opskrba zuba.Post-endodontic restoration of an endodontically treated tooth is intended to compensate for the reduced resilience of the remaining dental tissue to all the burden it is exposed to within the stomatognathic system or inside the oral cavity. After the provision of the adequate indication for post-endodontic tooth restoration, the restoration of the lost dental tissue can be performed through different procedures. The most adequate procedure is selected depending on the quantity of the dental tissue that has been preserved, the arrangement of the tooth in the row of teeth and its occlusal burden within the stomatognathic system, as well as onboth the endodontic space morphology and aesthetic interventions required. Unfortunately, the selection occasionally depends on the patient’s material circumstances and time constraints. The procedures we perform for the purpose of post-endodontic tooth restoration can be direct and indirect. Direct procedures include some standard fillings (composite, glass ionomer cement fillings or amalgam), whereas the indirect procedures include making of inlay, onlay and overlay using some common materials (gold, ceramic, composite). Moreover, endodontically treated teeth can be enhanced with different types of both parapulpal posts and intracanal posts. Non-metallic intracanal posts are currently most frequently used. They may be manufactured from carbon fiber, posts modified with polyethylene interwoven fibers, zirconia-based ceramic posts, while posts made of silver-palladium, gold and gold-platinum alloys were most frequently used in the past. In a large number of cases of endodontically treated teeth, the damage of the remaining dental issue is so substantial that prosthetic post-endodontic tooth restoration is required