Clinical Case Report: Coronal reconstruction with a glass fiber post, sleeve, and composite resin

Renato Girelli Coelho
Caroline Felipe Magalhães Girelli
Andrea Barbosa do Valle Coelho
Wyllyanna Ferreira dos Reis

Introduction

The decision of which material and technique to use to restore fractured and endodontically treated teeth continues to be a controversial issue in the dental profession. Pulped teeth need to be restored with techniques and materials that reinforce and protect the remaining tooth structure (Albuquerque, 1996). Each fractured and endodontically treated tooth has a unique root anatomy and coronal remnant, making it difficult to establish a specific protocol for restoration.

Literature Review

When compared to non-anatomized posts, anatomized glass fiber posts demonstrated higher bond strength, superior fracture resistance, less crack formation, lower stress levels, and superior performance (LEAL et al, 2017). Glass fiber posts do not fully resemble the anatomy of the root canal and adapt imprecisely to it, necessitating the use of excessive resin cement to fill the gap between the tooth remnant and the post. The addition of composite resin to the glass fiber post improves its mechanical properties and reduces the cement line.

The SPLENDOR system (Angelus) is a single-post system that can be adapted to any canal size: narrow, medium, or wide. They are suitable for supporting restorations and prosthetic crowns. They are universal and anatomical, with high retentivity and a low risk of root fracture. They have several advantages, including a one-size-fits-all design for narrow, medium, and wide canals, adaptability to canal shape from apical to cervical, chemical adhesion, mechanical embedding, no need for excessive tooth structure wear, and a modulus of elasticity comparable to dentin.

Clinical Case

Patient G. S. presented element 21 (Fig. 1) with a coronal fracture and was referred for endodontic treatment. After endodontic treatment, a glass fiber post and sleeve were cemented and the crown was reconstructed with composite resins. The Splendor system (Angelus) (Fig. 2) was chosen for its ease of cementation, single size for narrow, medium, and wide canals, and ability to adjust to the shape of the conduit from apical to cervical.

The canal was prepared using wide-type drills, followed by testing of the glass fiber post and sleeve (Fig. 3). The posts were then prepared and disinfected with alcohol, and silane was applied to the post and sleeve (outside and inside) (Fig. 4). The self-adhesive cement was inserted into the canal (Fig. 6), then the glass fiber post and sleeve (Figs. 7 and 8). The excess cement was removed and photoactivated for 30 seconds. The Forma composite resin (Ultradent) was then bonded (see Figure 9).

Conclusion

The use of glass fiber posts combined with composite resins for the restoration of partially or completely destroyed teeth, where endodontic treatment was required, has shown satisfactory aesthetic and functional results, leading to their regular use in dental clinics.