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Rehabilitation with DC fit 0.4 fiberglass post and Allcem Core

Author: Prof. Dr. Carlos José Soares

37-YEAR-OLD FEMALE PATIENT.
Chief Complaint: Fractured tooth 15

Initial evaluation

Patient arrived with element 15 in need of prosthetic rehabilitation due to extensive loss of tooth structure.

Treatment performed

A 37-year-old patient came to the Dental Hospital of the Faculty of Dentistry of the Federal University of Uberlândia/MG, after endodontic treatment for functional and esthetic rehabilitation. The initial clinical examination, of tooth 15, showed temporary sealing with glass ionomer and the radiographic examination showed relief of 2/3 of the canal.

In the rehabilitative planning, it was rehabilitated with two Whitepost SYSTEM posts cemented with the combination of Ambar Universal APS adhesive system and Allcem Core dual composite cement, which was also used to build the filling core.

The final restoration was done using a digital scanner and a BRAVA Block glass-ceramic composite crown machined in CAD-CAM, which was also cemented with Allcem Core dual composite cement. The final result shows satisfactory esthetic and functional recovery with a high degree of patient satisfaction.

Step by step

1 | Initial image of the patient’s smile.

1 | Initial image of the patient’s smile.

2 | Initial digital periapical radiograph of tooth 15.

2 | Initial digital periapical radiograph of tooth 15.

3 | Clinical appearance of tooth 15 after temporary restorative endodontic treatment with Maxxion R glass ionomer cement

3 | Clinical appearance of tooth 15 after temporary restorative endodontic treatment with Maxxion R glass ionomer cement

4 | Periapical radiograph with endodontic treatment completed and canal relief.

4 | Periapical radiograph with endodontic treatment completed and canal relief.

5 | Occlusal view after absolute isolation.

5 | Occlusal view after absolute isolation.

6 | After removing the Maxxion R, the Whitepost DC SYSTEM FIT 0.4 post was tested inside the root canal.

6 | After removing the Maxxion R, the Whitepost DC SYSTEM FIT 0.4 post was tested inside the root canal.

7 | Canal preparation with specific Whitepost SYSTEM DC FIT 0.4 post reamer drill.

7 | Canal preparation with specific Whitepost SYSTEM DC FIT 0.4 post reamer drill.

8 | Cutting the apical region of the post to adapt the cylindrical portion to the cervical region of the tooth.

8 | Cutting the apical region of the post to adapt the cylindrical portion to the cervical region of the tooth.

9 | Whitepost SYSTEM DC FIT 0.4 post adaptation test.

9 | Whitepost SYSTEM DC FIT 0.4 post adaptation test.

10 | Application of 17% EDTA irrigating solution in the root canal.

10 | Application of 17% EDTA irrigating solution in the root canal.

11 | Selective acid etching of enamel with root canal protection with a cotton ball.

11 | Selective acid etching of enamel with root canal protection with a cotton ball.

12 | Active application Ambar Universal APS self-etching adhesive system.

12 | Active application Ambar Universal APS self-etching adhesive system.

13 | Photoactivation of the adhesive system for 20 seconds.

13 | Photoactivation of the adhesive system for 20 seconds.

14 | Insertion of the Allcem Core dual composite cement into the root canal using a self-mixing applicator tip.

14 | Insertion of the Allcem Core dual composite cement into the root canal using a self-mixing applicator tip.

15 | Insertion of posts, starting with the buccal post followed by the post in the palatal canal and completion of the coronal abutment with Allcem Core dual composite cement.

15 | Insertion of posts, starting with the buccal post followed by the post in the palatal canal and completion of the coronal abutment with Allcem Core dual composite cement.

16 | Photoactivation of Allcem Core dual resin cement after 5 minutes of selfmixing

16 | Photoactivation of Allcem Core dual resin cement after 5 minutes of selfmixing

17 | Filling core with Allcem Core dual composite cement.

17 | Filling core with Allcem Core dual composite cement.

18 | Complete crown preparation finished, appearance in occlusion.

18 | Complete crown preparation finished, appearance in occlusion.

19 | Cemented provisional crown.

19 | Cemented provisional crown.

20 | Adaptation of the retractor wire in the gingival sulcus for digital scanning.

20 | Adaptation of the retractor wire in the gingival sulcus for digital scanning.

21 | Scanning of the preparation with occluded view.

21 | Scanning of the preparation with occluded view.

22 | Verification of contact points for occlusal adjustment before cementing the crown made of BRAVA Block.

22 | Verification of contact points for occlusal adjustment before cementing the crown made of BRAVA Block.

23 | Polishing with Diamond Flex felt discs using Diamond Excel diamond polishing paste.

23 | Polishing with Diamond Flex felt discs using Diamond Excel diamond polishing paste.

24 | Shotblasting the inner surface of the glass-ceramic composite crown with aluminum oxide for 20 seconds.

24 | Shotblasting the inner surface of the glass-ceramic composite crown with aluminum oxide for 20 seconds.

25 | Active application of Prosil silane inside the crown for 1 minute.

25 | Active application of Prosil silane inside the crown for 1 minute.

26 | Active application of Ambar Universal APS adhesive for 20 seconds with Cavibrush.

26 | Active application of Ambar Universal APS adhesive for 20 seconds with Cavibrush.

27 | Photoactivation of adhesive for 20 seconds.

27 | Photoactivation of adhesive for 20 seconds.

28 | Insertion of Allcem Core dual composite cement inside the crown.

28 | Insertion of Allcem Core dual composite cement inside the crown.

29 | Photoactivation for 40 seconds per side after 5 minutes of self-blending.

29 | Photoactivation for 40 seconds per side after 5 minutes of self-blending.

30 | Final aspect of the cemented crown.

30 | Final aspect of the cemented crown.

31 | Final radiograph after cementation, demonstrating good adaptation of the rehabilitation protocol.

31 | Final radiograph after cementation, demonstrating good adaptation of the rehabilitation protocol.

32 | Frontal view demonstrating esthetic harmony and a coherent buccal profile of the cemented crown

32 | Frontal view demonstrating esthetic harmony and a coherent buccal profile of the cemented crown.

Products used