A CAD/CAM-based strategy for concurrent endodontic and restorative treatment

This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.

Microscopio operatorio en endodoncia: revisión de la literatura / Operating microscope in endodontics: a review of the literature

En la constante búsqueda de mayor calidad en el tratamiento endodóntico, el Microscopio Operatório viene demostrando ser un importante aparato auxiliar, por el hecho de proporcionar al endodoncista mejores condiciones de trabajo, una magnificación visual de hasta 40X, un aumento en la iluminación del campo operatorio, además de permitir la documentación de casos clínicos. Demuestra ser un medio fácil e ideal para la producción de material para registro clínico y fines didácticos. En la literatura, varios son los trabajos y relatos de casos clínicos encontrados que describen la gran ayuda que nos proporciona el uso de este aparato. El objetivo de este trabajo es, por medio de una reseña de la literatura, desmitificar el uso del microscopio operatorio en la práctica endodóntica? describiendo los componentes y lo beneficios proporcionados con su utilización. Después del análisis de los estudios encontrados podemos concluir que la introducción del microscopio operatorio en la endodoncia aumentó significativamente la posibilidad de diagnosticar y muchas veces salvar un diente comprometido, quirúrgicamente o no; casos difíciles pueden ser tratados con alto grado de confianza y éxito clínico. El Microscopio Operatorio será un equipamiento indispensable para El endodoncista Del siglo XXI

In the constant search for better quality endodontic treatments, the operating microscope proved to be an important auxiliary. The endodoncist provides better work conditions by means of a visual magnification up to 40X, increased illumination in the operative area and the documentation of the cases. The objective of this work was demystifying the use of the operating microscope by a review of the literature thereby describing the benefits provided by it in the endondontics practice. After analyzing the existing studies we can conclude that the use of the operating microscope in endodontics has increased significantly the possibility of saving a tooth committed in a traditional or modern way. Difficult cases can be treated with successful clinical results. The operating microscope will become an essential auxiliary appliance for twenty-first century endodoncist