Prosthodontic restoration of endodontically treated teeth

Opskrba endodontski liječenih zubi složen je zadatak i obično zahtjeva nadoknadu velike količine izgubljenog tvrdog zubnog tkiva. Endodontski tretirani zubi imaju znatno različita mehanička svojstva u usporedbi s vitalnim zubima. Još uvijek postoje neslaganja o tome koja bi tehnika bila idealna za restauraciju endodontski tretiranih zuba jer se smatra da ti zubi imaju veći rizik od prijeloma od vitalnih zuba. Dostupnost adhezivnih dentalnih tehnika proširila je terapijske mogućnosti. Amalgamski ispuni i intrakanalni kolčići od lijevanog metala zamjenjuju se direktnim tehnikama izrade kompozitnog ispuna i intrakanalnim kolčićima ojačanih staklenih vlakana, od indirektnih tehnika keramički nadomjesci i kompozitne smole, čest su izbor zbog svoje estetske superiornosti. Nadalje, tehnike restauracije bez korištenja kolčića i nadogradnji dobivaju na popularnosti zbog svoje minimalne invazivnosti i pojednostavljenja kliničkih koraka. Manji defekti krune uspješno se nadograđuju materijalima kao što su kompoziti i staklenoionomeri. Kod liječenja većih defekata suvremena postendodontska opskrba zubi je usmjerena prema očuvanju tvrde zubne strukture pa se prednost daje indirektnim nadomjestcima kao što su inlaji, onalaji, overlaji i endokrune umjesto preparaciji zuba za krunice. Ipak, ukoliko plan terapije i preostala količina tvrdog zubnog tkiva zahtjeva preparaciju za krunicu, očuvanje ferulle efekta bi trebalo biti od najveće važnosti jer može dramatično poboljšati preživljavanje.Supplying endodontically treated teeth is a complex task and usually requires restoration of a large amount of lost hard dental tissue. Endodontically treated teeth have significantly different mechanical properties compared to vital teeth. There is still disagreement as to which technique would be ideal for the restoration of endodontically treated teeth, as these teeth are thought to have a higher risk of fracture than vital teeth. The availability of adhesive dental techniques has expanded therapeutic possibilities. Amalgam cores and cast metal posts are being replaced by direct composite and glass-fiber posts. Among indirect techniques, ceramic restorations and composite resins are a common choice, due to their aesthetic superiority. Furthermore, restoration techniques without the use of post and core build ups are gaining popularity due to their minimal invasiveness and simplification of clinical steps. Minor crown defects are successfully restored with materials such as composites and glass ionomers. In the treatment of major defects, the modern post endodontic treatment is focused on preserving the hard tissues, so preference is given to indirect restorations such as inlays, onlays, overlays and endocrowns instead of tooth preparation for crowns. However, if the treatment plan and the remaining amount of hard dental tissue require preparation for the crown, the preservation of the ferrule effect should be priority, as it can dramatically improve survival of endodontically treated teeth