Abstract | Endodontskom se terapijom, koja uključuje širenje, čišćenje, dezinfekciju i punjenje
korijenskih kanala, uz uklanjanje karijesom zahvaćenih tvrdih zubnih struktura, oslabljuje
struktura zuba. Cilj postendodontske opskrbe je adekvatna nadoknada tvrdih zubnih tkiva kako
bi se umanjio rizik od rubnog propuštanja i fraktura te na taj način sačuvao zub. Prilikom
donošenja odluke o planu terapije potrebno je postaviti pravilnu dijagnozu koja uključuje
uzimanje anamneze, intra- i ekstraoralni pregled te procjenu periapikalne rendgenske snimke.
Ovisno o kvaliteti punjenja ponekad je prije postendodontske opskrbe potrebno napraviti
reviziju punjenja.
Manji krunski defekti uspješno se nadoknađuju kompozitnim ili staklenoionomernim
materijalima, dok su kod većih gubitaka indicirani indirektni nadomjesci i prema potrebi
intrakanalne nadogradnje. Inlayi, onlayi i overlayi se izrađuju izvan pacijentovih usta, a
razlikuju se po plohama i broju kvržica koje prekrivaju. Za njihovu se izradu koriste keramički
i kompozitni materijali.
Dvije su velike skupine nadogradnji: individualne i konfekcijske. Najčešće se primjenjuju
intrakanalni kolčići ojačani staklenim vlaknima radi dobrih mehaničkih svojstava sličnih
dentinu, ali i zato što osiguravaju retenciju budućeg nadomjeska, krunice ili mosta. Kod velikih
krunskih defekata indicirano je zub opskrbiti krunicom.
Glavni ciljevi postendodontske opskrbe i adekvatnog endodontskog liječenja su onemogućiti
prodor mikroorganizama, rekonstruirati izgubljena tvrda zubna tkiva te zadovoljiti estetske
zahtjeve pacijenta. Na uspješnost terapije utječe pravilno postavljanje dijagnoze, poštovanje
svih koraka tijekom provođenja terapije, suradnja s pacijentom i njegova briga o oralnoj higijeni. |
Abstract (english) | Endodontic therapy, which includes spreading, cleaning, disinfection, and filling root canals,
while eliminating the hard dental tissue affected by caries, weakens the tooth's structure. The
aim of post-endodontic therapy is adequate compensation for hard dental tissues in order to
reduce the risk of marginal leakage and fractures, thereby preserving the tooth. When deciding
on a therapy plan, it is necessary to make a correct diagnosis which includes taking an
anamnesis, intra- and extraoral examination, and evaluation of the periapical X-ray. Depending
on the filling quality, it is sometimes necessary to make the revision of the filling before postendodontic therapy.
Smaller crown defects are successfully compensated by composite or glass ionomer materials,
while indirect restorations and, if necessary, intracanal restorations are indicated for bigger
dental tissue losses. Inlays, onlays and overlays are made outside the patient's mouth, and differ
from each other by the surfaces and number of cusps they cover. They are made out of ceramic
and composite materials.
There are two large groups of post and core: individual and confectionary. The most commonly
used intracanal restorations are posts reinforced by glass fibers because of their of good
mechanical properties similar to dentine, but also because they ensure the retention of the future
restoration, crown or bridge. In case of the large crown defects it is indicated to restore a tooth
with the crown.
The main objectives of post-endodontic therapy and adequate endodontic treatment are to
prevent the penetration of microorganisms, to reconstruct lost hard dental tissues and to meet
the patient's aesthetic requirements. The success of therapy is influenced by proper diagnosis,
respect for all steps during the therapy, collaboration with the patient and his or her care of oral
hygiene. |