Esthetic Restorations in Severely Darkened Anterior Teeth using Dental Post in the Root Canal
Authors: Raphael Monte Alto, Juliana Ferreira Batista Pereira, Mariana Ferreira Silva Ventura, Priscilla Carvalhal de Oliveira and Fabrício Perucelli.
Darkened teeth are always a challenge in the clinical routine, and when deciding the type of treatment, one should always select the most conservative one. In this context, whitening becomes an interesting alternative. However, due to the great relapse of this type of treatment, the patient usually ends up choosing a more definite solution such as crowns and veneers. Root canal cement must be reliable to create stability for the insertion of a dental post.
CASE REPORT
A female patient attended the subject of Integrated Clinic of the Fluminense Federal University (Rio de Janeiro – Brazil) indicated by the Discipline of Orthodontics with the application of an anterior crown with the appropriate format for future orthodontic finalization.
Endodontically treated teeth are susceptible to biomechanical failures especially when there is a significant loss of dental structure1. In such cases, the use of intraradicular retainers is necessary, mainly because the remnant structure is insufficient to adequately support and retain the final restoration2,3. Several techniques are available for the restoration of teeth with endodontic treatment and within this context choosing an inadequate method when restoring these teeth may compromise their longevity.
The tooth to be restored presented a good amount of coronal structure and conservative endodontic treatment, and the direct technique was indicated (see table 1).
The root canal was cleaned and dried with paper cones for the adhesive procedure and light-curing was performed for 40 seconds. With the aid of an insertion tip, Allcem Core dual cement (FGM) was applied in the root canal from the apical region to the coronary chamber.
The dental post Whitepost (FGM) DC-E 2 was inserted and the set was light cured for 40 seconds. The excess of the dental post was cut, and the occlusal adjustments were performed. The patient was submitted to periodontal surgery by Professor Ronaldo Barcellos at the Fluminense Federal University (Rio de Janeiro – Brazil). After 90 days, total crown preparation and molding were performed and sent to the laboratory. A total crown was made with composite for CAD/CAM with external characterization. After tests and adjustments, the crown was cemented.
| Technique | Indications | Advantages | Disadvantages |
| Direct. | Teeth with a lot of coronary remnants. | • Single section. • Low cost. |
Large amount of resinous cement. |
| Anatomical or direct modeling | • Teeth with little remnants. • Broad root canals. |
• Single session. • Low cost. • Less quantity of cement. • Less effect of the shrinkage stress. • Certainty of polymerization of the composite throughout the post. |
• Most critical technique. • Need to create expulsivity in the root canal. |
Table 1 – Indications, advantages, and disadvantages of each technique. Table from the book “Reabilitação estética anterior: o passo a passo da rotina clínica (Raphael Monte Alto e Colaboradores)”.
CLINICAL PHOTOS
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Fig. 1 – Initial smile -
Fig. 2 – Initial intraoral view. -
Fig. 3 – After absolute isolation, the composite restoration was removed from the palatal face to access the root root canal. -
Fig. 4 – Removal of gutta percha with peeso drill
FGM Products for Esthetic Restoration and Root Canal
FGM Dental Group products were used in this case to provide technical benefits to clinicians as the procedure was underway. Products like Allcem Core are suited to application within the root canal.
Allcem Core is a dual-cure resin cement that can be used for several indications beyond the case discussed in this report. These include, preparing a crown or core build-up, or performing indirect restorations like inlays, onlays, and overlays. It’s a suitable resin cement for prosthetic crown restoration procedures and works with composite, metal, metal-ceramic, and all-ceramic crowns. Intraradicular posts, whether made from carbon, quartz and metal, or fiberglass, can be used with this highly effective dental cement.
Allcem core is applied directly inside of the root canal. When set, it offers superior resistance to bending and compression. Clinicians appreciate the handling properties because it adheres to any substrate used for restorative and esthetic procedures.
The Dental post, Whitepost DC-E 2 was detailed in the case report. Used in conjunction with dental cement, Whitepost offers a suitable base for the final crown procedure. Whitepost is an esthetically compatible product that features a double tapered design and excellent fracture resistance. It is also radiopaque, making it suited to x-ray imaging during follow up consultations to evaluate the success of a procedure.
FGM Dental Group provides the most reliable dental products used for procedures ranging from simple dental esthetics to complicated and intensive dental restoration. From cements used in the root canal to resinous matrix core posts like Whitepost, FGM is a reliable supplier of safe and innovative solutions for practitioners.
