Does an intracanal composite anchorage replace posts?

OBJECTIVES: This study aims to assess the effectiveness of an intracanal composite anchorage to replace conventionally cemented titanium or bonded glass fibre posts. MATERIALS AND METHODS: Post space preparation was performed up to depths of 6 mm (groups 1 and 2) and 3 mm (group 3) in root filled mandibular premolars. In group 1, titanium posts were cemented with zinc phosphate cement. Glass fibre posts were adhesively cemented in group 2 using a dual-cure composite resin. In group 3, intracanal anchorage was solely performed with a dual-cure composite. All teeth were restored with standardised direct composite crowns without a ferrule. After thermo-mechanical loading, static load was applied until failure. Fracture patterns were assessed, and a microscopic analysis was performed to analyse the occurrence of additional cracks. RESULTS: Group 2 revealed a significantly higher median fracture value (408 N) than groups 1 and 3, while no difference was detected between group 1 (290 N) and group 3 (234 N) (p = .1417). In group 3, the more favourable fracture patterns were observed. However, the majority of teeth within this fracture category revealed additional minor cracks of the root. CONCLUSIONS: Within the limitations of this study, adhesive intracanal anchorage to a depth of 3 mm with resin composite only has the same fracture resistance as titanium posts conventionally cemented to a depth of 6 mm. Even teeth with repairable main fractures exhibited additional dentinal cracks on the root. CLINICAL RELEVANCE: Additional dentinal root cracks in the teeth with repairable main fractures may considerably impair their longevity.

[Repair of a root perforation with MTA: a case report]. / Reparatur einer Wurzelperforation mit MTA: ein Fallbericht.

Root perforations as a possible complication during a root canal treatment may increase the risk of failure for the affected tooth. The influencing factors include: the location and the size of the perforation, a potential microbial colonization of the endodontic system, the time lapse between the occurrence of the perforation and repair, and the filling material. Decontamination at the perforation site and in the remaining root canal system is essential for long-term success. For most cases, an orthograde retreatment with perforation repair represents a reasonable causal-based approach. This case report documents the treatment of a maxillary incisor with extensive apical periodontitis and iatrogenic root perforation in a 14-year-old patient. Three years after retreatment, perforation repair and coronal restoration with composite the follow-up shows a successful treatment outcome.

Localized alveolar ridge augmentation using a two-step approach with different soft tissue grafts: a clinical report.

AIM: The purpose of this report is to present the use of different soft tissue grafting procedures for surgical ridge augmentation. BACKGROUND: Multiple augmentative procedures may be indicated for the esthetic reconstruction of edentulous alveolar ridge deformities due to unpredictable shrinkage of augmented tissues. REPORT: A 38-year-old woman with a moderate Class III alveolar ridge defect received periodontal plastic surgery treatment using a combined onlay-interpositional graft procedure and a subepithelial connective tissue graft. SUMMARY: This case illustrates the aesthetic reconstruction of a moderate alveolar ridge defect using a two-step approach. CLINICAL SIGNIFICANCE: Using different soft tissue grafting procedures might be helpful in planning and treating moderate alveolar ridge defects. The time for remodelling of the augmented tissues needs to be respected before the final prosthesis is placed.