Minimally invasive treatment options in fixed prosthodontics

U suvremenoj dentalnoj medicini teži se što većem očuvanju tvrdih zubnih tkiva te samim time i manjoj invazivnosti tijekom terapije. Pojava adhezivnog cementiranja uvelike je pridonijela razvoju minimalno invazivnog pristupa i široj upotrebi estetskih materijala, s naglaskom na keramiku. Minimalno invazivnim nadomjescima u fiksnoprotetskoj terapiji smatraju se ljuske, inleji, onleji, overleji, endokrunice te adhezivni mostovi. Najveće prednosti ovih nadomjestaka u odnosu na klasična rješenja u fiksnoj protetici, kao što su konvencionalni most ili potpuna krunica, jest očuvanje tvrdih zubnih tkiva. Ljuske su protetski nadomjesci koji su indicirani kod promjene oblika, nagiba, dužine ili boje zuba te kod zatvaranja proširenih aproksimalnih prostora. Izrađuju se u svrhu poboljšanja estetike osmijeha. Inleji, onleji, overleji imaju jednake indikacije kao izrada klasičnog kompozitnog ispuna, ali imaju bolja mehanička svojstva te bolju funkcijsku trajnost. Endokrunice se mogu izraditi na endodontski liječenim molarima s velikom destrukcijom krune, osobito na onima kojima je, zbog nepovoljne anatomije korjenova, onemogućena izrada klasične nadogradnje i krunice. Adhezivni mostovi su dobro rješenje kod mladih pacijenata kojima je, zbog dobi, kontraindicirana izrada implantata ili klasičnog mosta. Kod odraslih pružaju mogućnost nadomještanja jednog zuba. Zadaća je doktora dentalne medicine vratiti izgubljenu funkciju uz maksimalnu poštedu tvrdih zubnih tkiva te pritom zadovoljiti estetske kriterije pacijenta.In modern dental medicine the tendency is to preserve hard dental tissue as much as possible and therefore to apply minimally invasive approach during therapy. The appearance of adhesive cementation has greatly contributed to the development of minimally invasive approach and broader usage of aesthetic materials, especially ceramics. In fixed prosthodontics minimally invasive restorations are veneers, inlays, onlays, overlays, endocrowns and resin-bonded bridges. The biggest advantages of these restorations in relation to classical solutions in fixed prosthodontics, such as conventional bridges or full crowns, is preservation of hard dental tissue. Veneers are prosthetic restorations which are indicated to change the shape, inclination, length or colour of the teeth, as well when close widen proximal spaces. Their purpose is to improve the aesthetics of the smile. Inlays, onlays and overlays have the same indication as conventional composite fillings, but they have better mechanical characteristics and functional duration. Endocrowns can be made on endodontically treated molars with bigger crown destruction, especially on those on which traditional post and core and crown is a difficult task because of the roots anatomy. Resin-bonded bridges are good solutions for young patients for whom implants or classical bridges are contraindicated because of their age. In adults resin-bonded bridges offer the possibility of replacement of one tooth. The dentist should restore lost function aiming to maximally preserve the hard dental tissue and by doing so, satisfy aesthetic criteria of the patient