Restor Dent Endod.  2019 Aug;44(3):e27. 10.5395/rde.2019.44.e27.

A CAD/CAM-based strategy for concurrent endodontic and restorative treatment

• Escobar PM
• Kishen A
• Lopes FC
• Borges CC
• Kegler EG
• Sousa-Neto MD

• KMID: 2457507
• DOI: http://doi.org/10.5395/rde.2019.44.e27

Abstract

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

Keyword

CAD-CAM; Dental Onlay; Endodontics; Dental Restoration

MeSH Terms

Adhesives
Cementation
Computer-Aided Design
Continental Population Groups
Dental Pulp Cavity
Endodontics
Follow-Up Studies
Hemorrhage
Humans
Inlays
Molar
Occlusal Adjustment
Pulpitis
Rubber Dams
Sodium Hypochlorite
Tooth
Adhesives
Sodium Hypochlorite