In any procedure, the central goal is to satisfy the patient’s aesthetic and functional needs by successfully treating cases in the most conservative way possible, with ease, and in a time efficient manner. This is particularly true in endodontically treated teeth, as it depends not only on meticulous root canal treatment, but also on the quality of the restorative treatment that follows.
Although endodontics and restorative dentistry are two different procedures they need to combine together, and the compatibility of products used in each contributes significantly to overall outcomes. Properties of materials from different manufacturers can vary, therefore choosing a one-system approach by selecting products from the same manufacturer is a reassuring way to know that everything will work together for a successful clinical outcome.
Direct and indirect restorative choices
In recent years major advancements in the methods and techniques surrounding direct and indirect materials used for endodontic restorations have combined to transform the way clinicians can achieve the best results. Nevertheless, deciding which materials and techniques to adopt can be complex as the industry is faced with an array of solutions being offered on the market at any one time.
Accurate diagnosis and treatment planning is essential. Successful root canal and restorative treatment depends not only on the materials used but also on the strength and condition of the remaining tooth structure. The location of treatment (either the anterior or posterior region) means consideration is needed of the different forces on the tooth that will affect the final restoration. The ability to provide accurate colour matching is also an essential consideration, particularly for anterior teeth.
From root…
When performing root canal procedures strength, flexibility and cutting efficiency need to combine to provide the ultimate shaping of the canals and removal of debris, and to also minimise any risk of file separation and harm to the patient.
The preparation of the root canal in shaping, cleaning and obturation is essential to the quality of the final coronal restoration. To achieve the best results, single file NiTi systems have been the instruments of choice for endodontists worldwide for many years now, especially for those moving from hand files to a rotary-based system, or for those just starting out in endodontic treatments. WaveOne Gold, from Dentsply, is an example of the latest
generation of reciprocating single-files. It features improved strength and flexibility enabling a wider range of canal
morphologies to be shaped efficiently and safely.
…to crown
Once the root canal system has been properly shaped and obturated, the effectiveness of the materials used to quickly build a tight fitting coronal seal is essential to prevent any risk of possible coronal micro-leakage. The final
restoration is to restore function, form and aesthetics and should commence as soon as possible after treatment to
prevent contamination and risk of tooth fracture.
By using compatible materials, the effectiveness of the coronal seal will be heightened as it prevents micro-leakage
of bacteria from the mouth into the canals. To do this the floor of the pulp chamber can be effectively sealed using
either a resin-modified glass ionomer or with a composite.
The use of SDR (Smart Dentine Replacement) in such cases will successfully allow an effective seal of the pulpal floor and quick build up of a core restoration. It can be used in conjunction with an adhesive composite system to
perform a tried and trusted procedure that is a practical alternative to the laborious incremental filling technique.
Whether a restoration requires a core build up as preparation for a crown or a restoration of the access cavity, a user friendly material that can successfully complete the procedure in a short amount of time is a priority.
Continuing research and clinical evidence undertaken by manufacturers has shown that the compatibility of products can have a significant impact on overall clinical outcomes. A onesystem approach, using materials and equipment from the same manufacturer, from initial treatment to final restoration, ensures every stage is compatible with the next, combining to give optimum aesthetic results.