hrvatski

Zbrinjavanje subgingivne komplicirane frakture krune : prikaz slučaja

Pacijent (26) je došao na Zavod za endodonciju i restaurativnu stomatologiju zbog bolnosti i pomičnosti zuba 21. Anamnestički je utvrđeno da je 2 dana ranije pacijent bio fizički napadnut, pri čemu je primio udarac u području lica. Pacijent je bio zdrav, pušač (10 cigareta dnevno). Kliničkim pregledom utvrđeni su višestruki hematomi i manje laceracije lica. Intraoralnim pregledom utvrđena je nekomplicirana fraktura zubi 11, 31 i 41, te komplicirana fraktura zuba 21 s pomičnim koronarnim fragmentom. U konzultaciji s pacijentom odlučeno je endodontski liječiti zub 21, opskrbiti ga intrakanalnim kolčićem od vlaknima ojačanog kompozita, te ovako ojačane fragmente spojiti kompozitnim cementom u svrhu privremenog estetsko – funkcijskog rješenja. Koronarni fragment je uklonjen i proširen, a korijenski kanal instrumentiran (#40) i napunjen (hladna lateralna kondenzacija). Kanal je prepariran za postavljanje intrakanalnog kolčića (Cytec blanco, Hahnenkratt), a kolčić je silaniziran Monobond Plus-om (Ivoclar Vivadent). Korijenski kanal i koronarni fragment tretirani su AdheSe DC samojetkajućim adhezivom. Pri cementiranju kolčića i spajanju fragmenata korišten je Multicore Flow (Ivoclar vivadent) kompozitni cement. Okluzija je provjerena. Na kontrolnom pregledu nakon 6 mj. restauracija je bila u zadovoljavajućem estetskom i funkcionalnom stanju. Parodont zuba je bio bez znakova upale. Nakon 2, 5 godine restauracija je i dalje zadovoljavajuća, a parodont bez znakova upale. Zaključak: Koronarni fragment zuba moguće je stabilizirati korištenjem adhezivne tehnike i estetskih intrakanalnih kolčića i u slučaju subgingivne frakture. Patient (26) arrived at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Zagreb due to pain and mobility of tooth 21. Anamnesis revealed that patient was physically attacked and hit in the facial area 2 days before. Patient was healthy, smoking up to 10 cigarettes a day. During clinical examination multiple hematomas and lesser lacerations were observed. Intraoral examination revealed uncomplicated fractures of teeth 11, 31 and 41 and complicated fracture of tooth 21 with mobile coronary fragment. After informing patient about treatment options, it was decided to endodonticaly treat tooth 21 and connect the fragments using an intracanal fiber reinforced post and composite cement in order to achieve short-term aesthetic and functional solution. Coronary fragment was extracted and prepared and root canal was instrumented (#40) and filled (cold lateral condensation). Post space preparation was done, while the post (Cytec blanco, Hahnenkratt) was treated with Monobond S (Ivoclar Vivadent). In the next step, root canal and coronary fragment were treated with AdheSE DC adhesive. Multicore flow was used for cementing the post and re-attaching the fragments. Oclusion was checked. Recall after 6 months revealed adequate esthetic and functional aspects of the restoration. Periodontal tissue was without signs of inflammation. After 2.5 years restoration is still esthetically and functionally acceptable with healthy periodontium. Conclusion: Coronary tooth fragment can be reattached using adhesive technique and fiber reinforced intracanal posts even in case of sub – gingival fracture.

fraktura krune zuba; intrakanalni kolčić; estetska restauracija; parodont

nije evidentirano

engleski

Treatment of subgingival complicated crown fracture : a case report

Pacijent (26) je došao na Zavod za endodonciju i restaurativnu stomatologiju zbog bolnosti i pomičnosti zuba 21. Anamnestički je utvrđeno da je 2 dana ranije pacijent bio fizički napadnut, pri čemu je primio udarac u području lica. Pacijent je bio zdrav, pušač (10 cigareta dnevno). Kliničkim pregledom utvrđeni su višestruki hematomi i manje laceracije lica. Intraoralnim pregledom utvrđena je nekomplicirana fraktura zubi 11, 31 i 41, te komplicirana fraktura zuba 21 s pomičnim koronarnim fragmentom. U konzultaciji s pacijentom odlučeno je endodontski liječiti zub 21, opskrbiti ga intrakanalnim kolčićem od vlaknima ojačanog kompozita, te ovako ojačane fragmente spojiti kompozitnim cementom u svrhu privremenog estetsko – funkcijskog rješenja. Koronarni fragment je uklonjen i proširen, a korijenski kanal instrumentiran (#40) i napunjen (hladna lateralna kondenzacija). Kanal je prepariran za postavljanje intrakanalnog kolčića (Cytec blanco, Hahnenkratt), a kolčić je silaniziran Monobond Plus-om (Ivoclar Vivadent). Korijenski kanal i koronarni fragment tretirani su AdheSe DC samojetkajućim adhezivom. Pri cementiranju kolčića i spajanju fragmenata korišten je Multicore Flow (Ivoclar vivadent) kompozitni cement. Okluzija je provjerena. Na kontrolnom pregledu nakon 6 mj. restauracija je bila u zadovoljavajućem estetskom i funkcionalnom stanju. Parodont zuba je bio bez znakova upale. Nakon 2, 5 godine restauracija je i dalje zadovoljavajuća, a parodont bez znakova upale. Zaključak: Koronarni fragment zuba moguće je stabilizirati korištenjem adhezivne tehnike i estetskih intrakanalnih kolčića i u slučaju subgingivne frakture. Patient (26) arrived at the Department of Endodontics and Restorative Dentistry, School of Dental Medicine, Zagreb due to pain and mobility of tooth 21. Anamnesis revealed that patient was physically attacked and hit in the facial area 2 days before. Patient was healthy, smoking up to 10 cigarettes a day. During clinical examination multiple hematomas and lesser lacerations were observed. Intraoral examination revealed uncomplicated fractures of teeth 11, 31 and 41 and complicated fracture of tooth 21 with mobile coronary fragment. After informing patient about treatment options, it was decided to endodonticaly treat tooth 21 and connect the fragments using an intracanal fiber reinforced post and composite cement in order to achieve short-term aesthetic and functional solution. Coronary fragment was extracted and prepared and root canal was instrumented (#40) and filled (cold lateral condensation). Post space preparation was done, while the post (Cytec blanco, Hahnenkratt) was treated with Monobond S (Ivoclar Vivadent). In the next step, root canal and coronary fragment were treated with AdheSE DC adhesive. Multicore flow was used for cementing the post and re-attaching the fragments. Oclusion was checked. Recall after 6 months revealed adequate esthetic and functional aspects of the restoration. Periodontal tissue was without signs of inflammation. After 2.5 years restoration is still esthetically and functionally acceptable with healthy periodontium. Conclusion: Coronary tooth fragment can be reattached using adhesive technique and fiber reinforced intracanal posts even in case of sub – gingival fracture.

tooth crown fracture; intracanal post; esthetic restoration; periodontium

nije evidentirano