Research & Patents

Endodontically Treated Teeth

Endodontic Veneers EV ©®

An innovative alternative procedure using a ceramic porcelain veneer to restore intact anterior teeth after endodontic treatment.

This product veneer offers metal free esthetics, an ideal alternative to porcelain fused to metal (PFM).

This is a prosthetic endodontic solution(pros-endo solution) to prepare an Endodontic Veneer product after treating the tooth with root canal therapy.

"A porcelain veneer is a thin layer of ceramic material placed over a tooth, used to improve the esthetics (i.e. increased translucency, color, shape, length, width) and fracture strength of a tooth."

Powder/Liquid Ceramics, Glass-Based Pressed, Machinable Materials, High Strength Crystalline Ceramics, can be used as an anterior veneer product.

Materials indicated for the anterior region require optimal esthetics and strength.

The product veneer should have wear resistance, guard against chipping, erosion of the restoration, and fracturing.

The compressive strength of ceramic is 10X higher than its tensile strength.

The Endodontic Veneer product has a stronger bond when it is bonded to enamel.

IPS e.max(lithium disilicate) with 400 MPa flexural strength and Zirconia can be used to make Endodontic Veneers EV ©®.

RNC (resin nano ceramic) is a combination of resin, composite and pure ceramic. This new ceramic contains 20nm diameter silica and 4nm to 11nm diameter Zirconia nanomers.The combination of these nanoparticles produces increased wear resistance and lasting esthetics to that of the Glass Based Machinable ceramics.

A porcelain veneer product is usually indirectly fabricated.

The RNC (Lava, Ultimate,3M ESPE) nano ceramics offers an alternative when choosing an indirect material. This material is used for CAD/CAM veneer product fabrication.

This material is reported to mill exceptionally well. Marginal integrity is excellent.

The Veneer product restoration is cemented with the Scotchbond Universal Adhesive and Rely X Ultimate Resin Cement.

Endodontic Veneers EV ©® 3

Treating teeth that require endodontic treatment requires a multidisciplinary approach. One must use endodontic, periodontal, restorative and esthetic evaluations. Many times trauma and caries devitalize the pulp, necessitating root canal therapy.

Anterior teeth treated with endodontic treatment lose tooth structure that has been undermined and damaged by caries, by fracture and endodontic manipulation, making the tooth more susceptible to fracture. These teeth are prone to fracture because of the loss of important intracoronal and intraradicular dentin.

After root canal treatment is completed there should be careful selection of a restorative procedure that will be minimally invasive and not remove excess tooth structure. The restorative material selected should be esthetic, strong and supportive with increased fracture strength. The new porcelains, Zirconia, and Emax. are excellent restorative materials that contain these properties. They replace cast and prefabricated metal posts that lead to micro fractures.

Using Endodontic Veneers EV ©®

Intact endodontically teeth do not need complete coverage unless they are weakened by large and /or multiple restorations. An innovative and alternative approach to restoring these teeth using a composite access seal or a metallic post core and crown is the use of a porcelain veneer. Further support from the lingual surface,(access opening) using the same material would give additional backing to the clinical crown. Using a Zirconia like porcelain veneer with a minimally invasive preparation would exceed the fracture strength of intact teeth without any facial restoration. It has been reported that (Andreasen FM ) " using cast ceramic (Dicor) laminate veneers, the fracture strength of the restored incisors was significantly increased . (21.0 +/- 3.7 MPa), exceeding that of intact teeth". J.Pros Dent

Preparation of the Endodontic Veneer EV ©®

By constructing a minimal chamfer veneer preparation of 0.5 mm or less with a slight lingual wrap in enamel, we can reduce the amount of tooth structure and restore it with a strong porcelain veneer. The entire lingual wall is not reduced. The access opening is restored with the same porcelain material to prevent shearing of the clinical crown at the cervical.(this is a patent pending procedure) The beauty of the endodontic veneer surpasses the intact tooth without a facial restoration. Consideration of restoring the adjacent tooth and or the six anteriors can be made to improve function and esthetics .Although stress tests were not conducted, in a study a review of the literature would support the use of Zirconia or EMax like Endodontic Veneers EV ©® to be a useful alternative in restoring endodontically treated teeth. Zirconia lends itself to be used without removing excess tooth structure.

PE Pros Endo Solutions

Pros-"Prosthodontics" Endo-"Endodontics" Using the State of the Art Solutions

Prosthetic dentistry can diagnose, and plan a treatment plan for teeth which have been treated with endodontics, enhancing the rehabilitation, maintenance of oral function, appearance and comfort of patients. The coronal portion of endodontically treated teeth are weakened and teeth become more susceptible to fracture.

Posterior Teeth: Onlay, Full Crown, Post and Core, Three Quarter Crown. When exposed cusps are weakened and have no support.

Anterior Teeth: Full Crown Restorations when too much of the tooth structure has been undernined.

With less tooth loss:, placement of a composite restoration on the lingual access

Use of Veneers to Restore Intact Endodontically Treated Teeth:

Endodontically treated teeth most often require access openings on the lingual, and occlusal surfaces of teeth. Tooth structure is removed and a hollow portion is created inside the tooth, undermining the tooth's structural integrity. The teeth need some form of protective covering. The construction of metal posts and core have lead to microfractures, resulting in tooth extraction and implant replacement

a porcelain veneer is a thin layer of ceramic material placed over a tooth, used to improve the esthetics (i.e. increased translucency, color, shape, length, width) and fracture strength of a tooth"

An innovative alternative procedure using a ceramic porcelain veneer to restore intact anterior teeth after endodontic treatment.

This is a prosthetic endodontic solution(pros-endo solution) to prepare an endodontic veneer product after treating the tooth with root canal therapy

The lingual access opening is sealed with composite or with the same porcelain material.

This product veneer offers metal free esthetics, an ideal alternative to porcelain fused to metal (PFM) "

Powder/Liquid Ceramics, Glass-Based Pressed, Machinable Materials,

High Strength Crystalline Ceramics, can be used as an anterior veneer product.

The Endodontic Veneer product has a stronger bond when it is bonded to enamel.

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