Komplike kuron kırıkları, daimî dişlerde görülen tüm travmatik yaralanmaların %20'sini oluşturmaktadır. Özellikle diş eti altına uzanan oblik kuron kırıklarında dişi, ağızda vital olarak tutmak, fonksiyonu ve estetiği sağlamak için multidisipliner bir yaklaşım gerekmektedir. Bu olgu raporunda, komplike kuron kırığı bulunan 2 hastanın koronal pulpotomi uygulanarak gerçekleştirilen vital pulpa tedavilerinden sonra 'computer aided design (CAD)'/'computer aided manufacturing (CAM)' ile yapılan restorasyonlarının takibi sunulmaktadır. CAD/CAM ile yapılan restorasyonların iyi bir fonksiyonel, estetik ve gingival uyum sağladığı gözlenmiştir. Sonuç olarak, CAD/CAM sistemleri daimî dişlerde travmadan dolayı oluşan komplike kuron kırıklarında alternatif olarak uygulanabilir.
Anahtar Kelimeler: Bilgisayar yardımlı tasarım; CAD-CAM; diş kırıkları; diş yaralanmaları; diş pulpasının açığa çıkması; pulpotomi
Complicated crown fractures have been reported to comprise approximately 20% of all traumatic injuries in permanent teeth. The oblique crown fractures especially extending subgingivally need a multidisciplinary treatment approaches because of preserving the vitality of the tooth is important aesthetically and functionally as well. The following two case reports describe treatment of complicated crown fracture by computer aided design (CAD)/computer aided manufacturing (CAM) supported restorations after vital pulp treatment performed by applying coronal pulpotomy. It was observed that the restoration performed with CAD/CAM had a good aesthetic, functional and gingival consistency. As a result, restorations supported CAD/CAM system can be applied as an alternative treatment method in permanent teeth that have been complicated crown fractures due to trauma.
Keywords: Computer-aided design; CAD-CAM; tooth fractures; tooth injuries; dental pulp exposure; pulpotomy
- Kunert GG, Kunert IR, da Costa Filho LC, de Figueiredo JAP. Permanent teeth pulpotomy survival analysis: retrospective follow-up. J Dent. 2015;43(9):1125-31. [Crossref] [PubMed]
- Hecova H, Tzigkounakis V, Merglova V, Netolicky J. A retrospective study of 889 injured permanent teeth. Dent Traumatol. 2010;26(6):466-75. [Crossref] [PubMed]
- Pashley DH, Ciucchi B, Sano H, Horner JA. Permeability of dentin to adhesive agents. Quintessence Int. 1993;24(9):618-31. [PubMed]
- Mörmann, WH. The evolution of the CEREC system. J Am Dent Assoc. 2006;137 Suppl:7S-13S. [Crossref] [PubMed]
- Peumans M, Valjakova EB, De Munck J, Mishevska CB, Van Meerbeek B. Bonding effectiveness of luting composites to different CAD/CAM materials. J Adhes Dent. 2016;18(4):289-302. [PubMed]
- Martins AV, Albuquerque RC, Lanza LD, Vilaca ÊL, Silva N, Moreira AN, et al. Conservative treatment of a complicated crown-root fracture using adhesive fragment reattachment and composite resin restoration: two year follow-up. Oper Dent. 2018;43(3):E102-E9. [Crossref] [PubMed]
- Diangelis AJ, Andreasen JO, Ebeleseder KA, Kenny DJ, Trope M, Sigurdsson A, et al. International association of dental traumatology guidelines for the management of traumatic dental injuries: 1. fractures and luxations of permanent teeth. Dent Traumatol. 2012;28(1):2-12. [Crossref] [PubMed]
- Vilela Maia EA, Baratieri LN, de Andrada MAC, Jr Monteiro S, Jr de Araújo EM. Tooth fragment reattachment: fundamentals of the technique and two case reports. Quintessence Int. 2003;34(2):99-107. [PubMed]
- Fong CD, Davis MJ. Partial pulpotomy for immature permanent teeth, its present and future. Pediatr Dent. 2002;24(1):29-32. [PubMed]
- Güngör HC. Management of crown-related fractures in children: an update review. Dent Traumatol. 2014;30(2):88-99. [Crossref] [PubMed]
- Bakland LK. Revisiting traumatic pulpal exposure: materials, management principles, and techniques. Dent Clin North Am. 2009;53(4):661-73, v-vi. [Crossref] [PubMed]
- Solomon RV, Faizuddin U, Karunakar P, Deepthi Sarvani G, Sree Soumya S. Coronal pulpotomy technique analysis as an alternative to pulpectomy for preserving the tooth vitality, in the context of tissue regeneration: a correlated clinical study across 4 adult permanent molars. Case Rep Dent. 2015;2015:916060. [Crossref] [PubMed] [PMC]
- Olsson H, Davies JR, Holst KE, Schröder U, Petersson K. Dental pulp capping: effect of emdogain gel on experimentally exposed human pulps. Int Endod J. 2005;38(3):186-94. [Crossref] [PubMed]
- Pereira JC, Segala AD, Costa CA. Human pulpal response to direct pulp capping with an adhesive system. Am J Dent. 2000;13(3):139-47. [PubMed]
- Giraud T, Jeanneau C, Rombouts C, Bakhtiar H, Laurent P, About I, et al. Pulp capping materials modulate the balance between inflammation and regeneration. Dent Mater. 2019;35(1):24-35. [Crossref] [PubMed]
- Camilleri J, Laurent P, About I. Hydration of biodentine, theracal LC, and a prototype tricalcium silicate-based dentin replacement material after pulp capping in entire tooth cultures. J Endod. 2014;40(11):1846-54. [Crossref] [PubMed]
- Prati C, Gandolfi MG. Calcium silicate bioactive cements: biological perspectives and clinical applications. Dent Mater. 2015;31(4):351-70. [Crossref] [PubMed]
- Torabinejad M, Watson TF, Pitt Ford TR. Sealing ability of a mineral trioxide aggregate when used as a root end filling material. J Endod. 1993;19(12):591-5. [Crossref] [PubMed]
- Tziafa C, Koliniotou-Koumpia E, Papadimitriou S, Tziafas D. Dentinogenic responses after direct pulp capping of miniature swine teeth with biodentine. J Endod. 2014;40(12):1967-71. [Crossref] [PubMed]
- Camilleri J. Staining potential of neo MTA plus, MTA plus, and biodentine used for pulpotomy procedures. J Endod. 2015;41(7):1139-45. [Crossref] [PubMed]
- Rajasekharan S, Martens LC, Cauwels RGEC, Anthonappa RP. Biodentine? material characteristics and clinical applications: a 3 year literature review and update. Eur Arch Paediatr Dent. 2018;19(1):1-22. [Crossref] [PubMed]
- Nowicka A, Lipski M, Parafiniuk M, Sporniak-Tutak K, Lichota D, Kosierkiewicz A, et al. Response of human dental pulp capped with biodentine and mineral trioxide aggregate. J Endod. 2013;39(6):743-7. [Crossref] [PubMed]
- Parinyaprom N, Nirunsittirat A, Chuveera P, Na Lampang S, Srisuwan T, Sastraruji T, et al. Outcomes of direct pulp capping by using either proroot mineral trioxide aggregate or biodentine in permanent teeth with carious pulp exposure in 6- to 18-year-old patients: a randomized controlled trial. J Endod. 2018;44(3):341-8. [Crossref] [PubMed]
- Brizuela C, Orme-o A, Cabrera C, Cabezas R, Silva CI, Ramírez V, et al. Direct Pulp Capping with Calcium Hydroxide, Mineral Trioxide Aggregate, and Biodentine in Permanent Young Teeth with Caries: A Randomized Clinical Trial. J Endod. 2017;43(11):1776-80. [Crossref] [PubMed]
- Katge FA, Patil DP. Comparative analysis of 2 calcium silicate-based cements (biodentine and mineral trioxide aggregate) as direct pulp-capping agent in young permanent molars: a split mouth study. J Endod. 2017;43(4):507-13. [Crossref] [PubMed]
- Martens L, Rajasekharan S, Cauwels R. Pulp management after traumatic injuries with a tricalcium silicate-based cement (Biodentine?): a report of two cases, up to 48 months follow-up. Eur Arch Paediatr Dent. 2015;16(6):491-6. [Crossref] [PubMed]
- Olsburgh S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dental Traumatol. 2002;18(3):103-15. [Crossref] [PubMed]
- Lin CL, Chang YH, Chang CY, Pai CA, Huang SF. Finite element and weibull analyses to estimate failure risks in the ceramic endocrown and classical crown for endodontically treated maxillary premolar. Eur J Oral Sci. 2010;118(1):87-93. [Crossref] [PubMed]
- Chen C, Trindade FZ, de Jager N, Kleverlaan CJ, Feilzer AJ. The fracture resistance of a CAD/CAM Resin Nano Ceramic (RNC) and a CAD ceramic at different thicknesses. Dent Mater. 2014;30(9):954-62. [Crossref] [PubMed]
- Strub JR, Rekow ED, Witkowski S. Computer-aided design and fabrication of dental restorations: current systems and future possibilities. J Am Dent Assoc. 2006;137(9):1289-96. [Crossref] [PubMed]
- Buldur B, Carti O, Mutaf Hİ, Unal Y. Multidisciplinary treatment approach to a complicated crown fracture: a case report. J Pediatr Dent. 2016;4(3):72-6. [Crossref]
- Vanoorbeek S, Vandamme K, Lijnen I, Naert I. Computer-aided designed/computer-assisted manufactured composite resin versus ceramic single-tooth restorations: a 3-year clinical study. Int J Prosthodont. 2010;23(3):223-30. [PubMed]
- Awada A, Nathanson D. Mechanical properties of resin-ceramic CAD/CAM restorative materials. J Prosthet Dent. 2015;114(4):587-93. [Crossref] [PubMed]
- Ramírez-Sebastià A, Bortolotto T, Cattani-Lorente M, Giner L, Roig M, Krejci I, et al. Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Investig. 2014;18(2):545-54. [Crossref] [PubMed]
- Ruse ND, Sadoun MJ. Resin-composite blocks for dental CAD/CAM applications. J Dent Res. 2014;93(12):1232-4. [Crossref] [PubMed] [PMC]
- Karakoca Nemli S, Bankoğlu Güngör M. [Single visit restoration of an endodontically treated tooth with a cad/cam resin nano ceramic endocrown: case report]. Turkiye Klinikleri J Dental Sci Cases. 2015;1(2):94-100. [Crossref]
- Yaşa E, Yaşa B, Yıldızeli D, Aral CA. [Esthetic rehabilitation of traumatized teeth with adolescent: a case report]. Selcuk Dent J. 2016;3(1):27-33. [Crossref]
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