Friday, January 24, 2020
Essay --
In the present case scenario, 19year old patient with crown fracture of #10 with 1.5mm of tooth structure remaining. However, the nature of pulp (vital or nonvital), history of pain, If any pulp exposure - time spent with exposed pulp, diameter of the pulp exposure and number of tooth walls remaining are not discussed. These factors are considered as key elements in the diagnosis and treatment plan. However within the limited findings, the present case can be diagnosed as complicated crown fracture #10 with pulp exposure involving enamel and dentin fracture. The success rate in vital pulp therapy of carious lesion has been reported in the range of 72.9-92.9%. However, further studies of high quality need to be conducted to evaluate the factors influencing the treatment outcome. 1 The classic Toronto study shown 92%, 93% of success in endodontically treated teeth without periapical radiolucency.2,3 The outcome of non surgical endodntic therapy reported a success rate of 86-93%. 4 It is seen that the success rate of pulp therapy is predictably inferior to the nonsurgical endodontic therapy. Also failure of pulp therapy due to persistent bacterial infection, leaky restoration has severe painful condition. Treating failed pulp therapy is further more complex and difficult as there is narrowing of pulp chamber due to calcification.5 Hence in this case, endodontic therapy #10 was planned. The primary aim of RCT is to chemomechanical preparation of root canal spaces followed by obturating with material, which is chemically inert and provides hermetic seal. Guttapercha is one of the oldest obturating materials and is considered still as gold standard. However, guttapercha has shown inadequate seal and presence of voids when lateral ... ...build-up material, which is formed after cementation of the post. Composites, being more esthetic material gives favourable outcome. It is well bonded to the tooth through micromechanical retention creating a monobloc effect. However, microleakage, secondary caries factors should be considered. Resin luting cements played a major role in the modern dentistry. High compressive and tensile strength, low dissolution, adhesive mechanism and high esthetic qualities have made the material of choice in luting cements.13,14 All Ceramic crowns has shown increased fracture resistance and improved esthetics. Hence, the material of choice in the current clinical case. How ever the type of material with ceramic has not shown any significant difference. Every treatment plan should be based on the updated clinical evidence at highest level for the long term success of the therapy. Essay -- In the present case scenario, 19year old patient with crown fracture of #10 with 1.5mm of tooth structure remaining. However, the nature of pulp (vital or nonvital), history of pain, If any pulp exposure - time spent with exposed pulp, diameter of the pulp exposure and number of tooth walls remaining are not discussed. These factors are considered as key elements in the diagnosis and treatment plan. However within the limited findings, the present case can be diagnosed as complicated crown fracture #10 with pulp exposure involving enamel and dentin fracture. The success rate in vital pulp therapy of carious lesion has been reported in the range of 72.9-92.9%. However, further studies of high quality need to be conducted to evaluate the factors influencing the treatment outcome. 1 The classic Toronto study shown 92%, 93% of success in endodontically treated teeth without periapical radiolucency.2,3 The outcome of non surgical endodntic therapy reported a success rate of 86-93%. 4 It is seen that the success rate of pulp therapy is predictably inferior to the nonsurgical endodontic therapy. Also failure of pulp therapy due to persistent bacterial infection, leaky restoration has severe painful condition. Treating failed pulp therapy is further more complex and difficult as there is narrowing of pulp chamber due to calcification.5 Hence in this case, endodontic therapy #10 was planned. The primary aim of RCT is to chemomechanical preparation of root canal spaces followed by obturating with material, which is chemically inert and provides hermetic seal. Guttapercha is one of the oldest obturating materials and is considered still as gold standard. However, guttapercha has shown inadequate seal and presence of voids when lateral ... ...build-up material, which is formed after cementation of the post. Composites, being more esthetic material gives favourable outcome. It is well bonded to the tooth through micromechanical retention creating a monobloc effect. However, microleakage, secondary caries factors should be considered. Resin luting cements played a major role in the modern dentistry. High compressive and tensile strength, low dissolution, adhesive mechanism and high esthetic qualities have made the material of choice in luting cements.13,14 All Ceramic crowns has shown increased fracture resistance and improved esthetics. Hence, the material of choice in the current clinical case. How ever the type of material with ceramic has not shown any significant difference. Every treatment plan should be based on the updated clinical evidence at highest level for the long term success of the therapy.
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