27 Choice of intracoronal restorations


Choice of Intracoronal Restorations


Intracoronal restorations are defined as those surrounded by one or more natural tooth surface(s) and can broadly be categorised according to Black’s cavity classification; classes I, II, III, IV and V, and the newly added class VI.

Treatment for intracoronal lesions depends on a variety of factors, and for optimal clinical decisionmaking, it is necessary to accurately diagnose pathology, determine aetiology, identify risk factors and assess prognosis for various treatment options.

Non-Cavitated Carious Lesions

Current research has highlight the ability for enamel to remineralise following carious attack. Therefore, a non-cavitated carious lesion extending into dentine, with appropriate treatment, has the potential to be arrested by remineralisation of the demineralised enamel hard tissues. The factors to consider for non-cavitated lesions are:

  • Aetiology – cariogenic bacteria;
  • Clinical presentation – discolouration below surface of an unrestored tooth; caution is necessary when using sharp probes, in order to avoid piecing the delicate demineralised surface enamel;
  • Symptoms – none or sporadic sensitivity;
  • Risk assessment – patients with poor oral hygiene, inadequate diet control, or individuals with high caries susceptibility require restorative intervention;
  • Treatment options – minimally invasive, monitor for low-risk patients, or restore for high-risk patients;
  • Type of restoration – chlorhexidine (CHX) and fluoride (F) varnishes, fissure sealing, direct restorations;
  • Choice of restorative materials – bioactive restorative materials (glass ionomers, resin-based composites), or amalgam;
  • Prognosis/outcome:
    a) Halted carious lesion with or without remineralisation of enamel – monitor with periodic application of varnishes and/or fissure sealants;
    b) Reparative ‘healing’ with bioactive restorative materials – monitor;
    Only gold members can continue reading. Log In or Register to continue

Jan 20, 2015 | Posted by in Prosthodontics | Comments Off on 27 Choice of intracoronal restorations
Premium Wordpress Themes by UFO Themes