(PO-159) New Treatment Approach Utilizing CAD-CAM Restorations for Endo-treated Permanent Anterior and Posterior Teeth in Pediatric Patients

Author: Ana Keohane, D.M.D. – Clinical Assistant Professor, Boston University Henry M. Goldman School of Dental Medicine
Author: Gladys Carrasco, D.D.S. CAGS – Pediatric Dentist Clinical Lecturer, Boston University Henry M. Goldman School of Dental Medicine
Submitter: Ana Keohane, D.M.D. – Clinical Assistant Professor, Boston University Henry M. Goldman School of Dental Medicine

Objective:

The aim of this case report is to describe an alternative treatment of severely damaged upper permanent central incisors by endodontic root-canal therapy and placement of E.MAX endocrowns utilizing digital workflow with an intraoral scanner (IOS) and computer-aided design/computer-assisted manufacturing (CAD/CAM) .This approach can be included in the pediatric department for the pre and post-doctoral curriculum as a treatment option to maintain permanent teeth until full development.

Methods:

A 13-year-old female patient presented to the pre-doctoral clinic during pediatric rotation with severe caries in teeth #8 and #9, after root canal therapy performed 3 years ago and with chief complain that she wants restorations that will not fall off or break again. After diagnosis and treatment planning evaluation, endo re-treatment and placement of endocrowns on teeth #8 and #9 were planned as the final treatment. After discussing treatment options with the patient’s mother, CAD/CAM lithium desilicated ceramic (IPS E.MAX CAD) blocks were chosen. Digital impressions of arches and bite registration were obtained utilizing the Omnicam intraoral scanner, and the endocrowns were designed digitally. Endocrowns were cemented with self-cured adhesive resin cement.

Results:

Over the 3-month follow-up period, no changes of the periradicular area of teeth #8 and #9 was observed on radiographs. Clinically, there was not discoloration and the marginal seal was intact and the anatomical forms remained.


Conclusion:

CAD/CAM endocrowns demonstrated to be a good material for the short-to long-term treatment of endo-treated permanent teeth with large coronal destruction in children. There is still an important challenge for the rehabilitation of endodontically treated teeth with extensive coronal destruction in pediatric patients and more clinical cases and follow-up are required to investigate the long-term effects. The Pre and Post-doctoral pediatric departments include this approach in the curriculum as an alternative treatment option to maintain permanent teeth until full development.