CLINICAL EVALUATION OF RESTORATIONS OF ENDODONTICALLY TREATED TEETH
Authors: Udod O.A. , Kostenko R.S. 
Published: June 2020

For endodontically treated lateral teeth, direct restoration made of photocomposites is most often used, and indirect ceramic restoration appears to be more promising, for which, however, additional retention is required.

The aim of the study was the clinical evaluation of direct photocomposite and indirect ceramic restorations of endodontically treated lateral teeth.

The object and methods of the research. We examined 118 people aged from 24 to 53 years, in whom 249 lateral teeth with cavities were endodontically treated according to the 2nd class by Black. Group 1 included 38 patients (32.2% of the total number of subjects) who underwent direct restoration of 89 molars (35.7% of the total number of restorations) made of photocomposite; 41 patients (34.7%) with 81 indirect ceramic restorations (32.5%) were included in group 2 according to the generally accepted requirements; group 3 consisted of 39 people (33.1%), who underwent 79 indirect ceramic restorations (31.7%) with the formation of cavities with additional retention elements.

Direct restorations in the subjects from group 1 were performed with a photocomposite using a 5th generation adhesive system in a layered technique with light polymerization by “soft start”. In the molars of persons from groups 2 and 3, cavities were prepared taking into account the generally accepted requirements, while in the cavities of the molars in patients from group 3, we formed retention elements in dentin in the form of depressions. Intraoral optoelectronic scanner CEREC AC Connect Omnicam, Dentsply Sirona was used for scanning, restorations were modeled in Exocad software and made of ceramic CAD-blocks based on lithium disilicate using an inLab MC X5 assembler, Dentsply Sirona. The restoration was fixed on a self-adhesive composite cement of double hardening. Clinical evaluation of restoration was performed in 18 and 24 months. Impairments and the number of restorations with them were registered.

Research results and their discussion. In the period of 18 months, out of 70 direct photocomposite restorations (78.7% of the initial number) in persons of group 1, 2 restorations (2.2%) were partially absent, in 4 restorations (4.5%) anatomical impairments were revealed, in 5 (5.6%) – impairments of the marginal adaptation, in 8 (9.0%) – marginal color, also in 8 cases (9.0%) there were impairments of contact points. All impairments were identified in 12 restorations (13.5%). In patients of 2 groups, in 78 indirect ceramic restorations (96.3%) we revealed a partial destruction and shift of 1 restoration (1.2%), disturbance of an anatomic form – in 2 restorations (2.5%), in 3 restorations (3.7% each) there were defects of marginal adaptation and marginal color, contact points were impaired in 4 cases (4.9%). In total, impairments were detected in 5 restorations (6.2%). In 77 indirect ceramic restorations (97.5%) in patients of group 3, 1 restoration (1.3% each) had impairments of anatomical shape, marginal adaptation and contact points, 2 restorations (2.5%) had marginal color. Impairments pertained to only 2 restorations (2.5%).

In 24 months, out of 58 direct restorations (62.5%) of patients in group 1, 3 restorations (3.4%) were partially or completely absent, anatomical impairments were found in 6 restorations (6.7%), and marginal defects were found in 7 (7.9%), marginal color – in 11 (12.4%), 15 contact points (16.9%) were with impairments. The number of direct restorations with impairments was 20 (22.5%). In 77 indirect restorations (90.1%) in persons of the 2nd group, we revealed a partial destruction and displacement of 3 restorations (3.7%), 2 restorations (2.5% each) had impairments of anatomical shape and marginal adaptation, 4 each (4 , 9%) – marginal color and defects of contact points. In total, there were 7 indirect restorations (8.6%) with impairments. In patients of group 3, among 75 indirect restorations (94.9%) 1 restoration (1.3% each) had disturbances of anatomic shape and marginal adaptation, 2 restorations (2.5%) were with marginal coloring, 3 (3.8 %) – with defects of contact points. There were 3 indirect restorations with impairments (3.8%).

Conclusion. During both terms with impairments, we detected 32 direct photocomposite restorations (36.0%), 12 indirect ceramic restorations (14.8%) and only 5 indirect ceramic restorations (6.3%) made with additional retention elements.