Materials for postendodontic reconstruction of the teeth

Endodontskim liječenjem patoloških procesa u zubnoj pulpi smanjuje se otpornost preostaloga zubnog tkiva, što može dovesti do loma i u konačnici gubitka zuba, zbog čega je izuzetno važna pravilna postendodontska terapija kojom se postiže okomita stabilizacija preostale zubne krune, nadoknada tvrdih zubnih tkiva te naposljetku restauracija zuba. Loša postendodontska opskrba zuba može dovesti do fraktura preostaloga zubnog tkiva te prolaska oralnog fluida ispod restauracije, što uzrokuje otapanja punila u korijenskom kanalu. Kako bi se to spriječilo, nužno je odabrati adekvatnu restauraciju. Tipovi restauracija koji se koriste za postendodontsku opskrbu jesu intrakanalne nadogradnje (metalne i bezmetalne, tj. estetske), endokrunice, direktni i indirektni ispuni. S time da u današnje vrijeme uvjerljivo prednjači upotreba estetskih materijala, što iz estetskih razloga, a što zbog jednostavnije izvedbe. Kao najbolji izbor nameću se kompozitni kolčići pojačani staklenim vlaknima uz odgovarajuće adhezijsko cementiranje jer pokazuju modul elastičnosti sličan dentinu zbog čega se okluzalne sile ravnomjerno raspoređuju na zub. To ujedno znači da će prilikom eventualnog loma oštećenja zuba biti blaža, lakše je ukloniti ostatak iz korijenskog kanala, te je, posljedično, mogućnost spašavanja zuba znatno veća. U slučaju kada korištenje klasične intrakanalne nadogradnje nije moguće zbog zavijenosti korijenskih kanala ili nedostatka prostora, odnosno kada zub ima sniženu kliničku krunu, za restauraciju se koriste endokrunice. Direktni i indirektni ispuni najrjeđe su indicirani tipovi restauracije zbog nemogućnosti da dovoljno očvrsnu zubnu strukturu.Endodontic treatment of pathological processes in the dental pulp reduces the resistance of the remaining tooth structure which can lead to breakage and ultimately tooth loss. Therefore, it is extremely important to apply correct postendodontic therapy to achieve a vertical stabilization of the remaining dental crowns, restoration of hard dental tissues and finally the restoration of teeth. Poor postendodontic reconstruction can lead to fracture of the remaining tooth structure and oral fluid passing under restoration, causing melting of the root canal filling. In order to prevent this, it is necessary to choose an adequate restoration. Types of restorations used for postendodontic therapy are intracanal upgrades (metal and non-metal, i.e. aesthetic), endocrown, direct and indirect restorative materials. At the present time, the use of aesthetic materials is convincingly superior to metal materials, due to aesthetic reasons and simpler preparation. Composite posts reinforced by glass fibre, with the appropriate adhesive cementation, imposed as the best choice because they show the modulus of elasticity similar to dentin, which is why the occlusal forces are evenly distributed on the tooth. This also means that possible fractures of tooth are not so severe, it is easier to remove the remains from the root canal, and consequently the possibility of saving the tooth is much higher. If the use of classical intracanal upgrade is not possible, because of complex root canal structure or a lack of space, or when restoring teeth with reduced clinical crown, endocrowns will be used. Direct and indirect restoratives are the rarest indicated types of restoration due to their inability to sufficiently harden and support tooth structure