CAD/CAM Customized Glass Fiber Post and Core With Digital Intraoral Impression: A Case Report

Abstract

Background: After endodontic treatment, a proper restorative technique is necessary to ensure coronal seal and protection of residual dental structure; teeth which have lost two or more walls need to be restored with posts to increase retention and stability of final restoration. Posts can be distinguished in prefabricated and customized, which are manufactured by lost wax technique or CAD-CAM.

Purpose: Digital dentistry has been developed to increase workflow precision and to accelerate production process; use of CAD-CAM to realize customized posts was limited to scanning plaster models obtained from traditional impressions.

Patients and methods: In the reported case an intraoral scan was used to mill a post and core restoration on an endodontically treated inferior premolar; this operative protocol was based on previous in vitro experiments that confirmed the ability of 3shape Trios scanner to read post-space up to 9 mm in depth.

Results: The digital technique allows us to convert the concave surface of the root canal into the convex surface of the post, and realize an anatomical post and core that improves the biomechanics of the endodontically treated tooth reducing the possibility of root fractures.

Conclusion: The use of an intraoral digital scanner represents an opportunity for the clinician as it speeds up the production of an anatomical post and core restorations.

Keywords: digital dentistry; digital intraoral impression; endodontic; post and core; post-space.

Figure 1

Preoperative periapical radiography, inappropriate root canal treatment of 4.5 and a periapical lesion.

Figure 2

The post-space was prepared 9 mm in depth. It has been scanned by Trios 3shape scanner: 3D software images.

Figure 3

Photography of post and core.

Figure 4

Photography of post and core, and provisional composite resin crown.

Figure 5

Intraoral vision of post and core after adhesive cementation.

Figure 6

Postoperative periapical radiography, the endodontic retreatment was performed, and the post and core have been luted.

Figure 7

Intraoral photography after provisional composite resin crown cementation.

Figure 8

Intraoral photography after digital impression with Trios 3shape scanner.

Figure 9

Final digital impression with Trios 3shape scanner.

Figure 10

Final digital impression with Trios 3shape scanner, right bite.

Figure 11

Intraoral photography of monolithic zirconia crown after cementation.

Figure 12

Periapical radiography, the monolithic zirconia crown has been luted definitively.

Figure 13

Intraoral final photography with a removable partial prosthetic.

Figure 14

Two years control periapical radiography of the functional and clinically successful treated tooth.