Restor Dent Endod.  2016 May;41(2):143-147. 10.5395/rde.2016.41.2.143.

Fibre reinforcement in a structurally compromised endodontically treated molar: a case report

• Soares R
• Ataide ID
• Fernandes
• Lambor R

• KMID: 2163297
• DOI: http://doi.org/10.5395/rde.2016.41.2.143

Abstract

The reconstruction of structurally compromised posterior teeth is a rather challenging procedure. The tendency of endodontically treated teeth (ETT) to fracture is considerably higher than vital teeth. Although posts and core build-ups followed by conventional crowns have been generally employed for the purpose of reconstruction, this procedure entails sacrificing a considerable amount of residual sound enamel and dentin. This has drawn the attention of researchers to fibre reinforcement. Fibre-reinforced composite (FRC), designed to replace dentin, enables the biomimetic restoration of teeth. Besides improving the strength of the restoration, the incorporation of glass fibres into composite resins leads to favorable fracture patterns because the fibre layer acts as a stress breaker and stops crack propagation. The following case report presents a technique for reinforcing a badly broken-down ETT with biomimetic materials and FRC. The proper utilization of FRC in structurally compromised teeth can be considered to be an economical and practical measure that may obviate the use of extensive prosthetic treatment.

Keyword

Biodentine; Endodontically treated teeth; Fibre reinforced composite; Reinforcement

MeSH Terms

Biomimetic Materials
Biomimetics
Composite Resins
Crowns
Dental Enamel
Dentin
Glass
Molar*
Tooth
Composite Resins

Figure

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  Figure 1 Preoperative photograph exhibiting extensive destruction of the coronal tooth structure.

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  Figure 2 Preoperative radiograph revealing a periapical radiolucent lesion in the region of the mesial and distal root of tooth #46, as well as compromised periradicular dentin at the coronal third of the mesial root due to a poor endodontic access cavity.

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  Figure 3 Working length determination radiograph.

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  Figure 4 Master cone length radiograph.

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  Figure 5 Post-obturation radiograph.

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  Figure 6 Biodentine placement on the floor and around the mesial orifice.

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  Figure 7 Incremental restoration with fibre reinforced composite.

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  Figure 8 Final overlying restoration with conventional composite.

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  Figure 9 Immediate post-treatment radiograph.

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  Figure 10 Six month follow-up radiograph.

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  Figure 11 One year follow-up radiograph showing appreciable healing in the periapical area.

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  Figure 12 Twenty month follow-up radiograph.

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  Figure 13 Clinical view after one year.

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