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Restabelecimento estético utilizando um cimento reforçado por carga – quatro anos de acompanhamento

Relato de caso descreve o bom comportamento clínico de abordagem restauradora com uso de cimento resinoso reforçado por carga para cimentação do retentor.


AUTORES

Douglas Silva de Almeida
Graduando em Odontologia – Universidade Federal de Pelotas.
Orcid: 0000-0002-2297-7715.

Carolina Schuster Ouriques
Graduanda em Odontologia – Universidade Federal de Pelotas.
Orcid: 0000-0001-6644-4278.

Mateus Bertolini Fernandes dos Santos
Doutor em Clínica Odontológica, área de Prótese Dental – Universidade Estadual de Campinas; Professor adjunto – Faculdade de Odontologia da Universidade Federal de Pelotas.
Orcid: 0000-0001-5477-4077.

Noéli Boscato
Doutora em Clínica Odontológica, área de Prótese Dental – FOP-Unicamp; Professora associada – Faculdade de Odontologia da Universidade Federal de Pelotas.
Orcid: 0000-0002-3817-1732.

César Dalmolin Bergoli
Doutor em Prótese Dentária – Unesp; Professor adjunto – Faculdade de Odontologia da Universidade Federal de Pelotas.
Orcid: 0000-0003-4835-8477.


RESUMO

A reabilitação restauradora de fraturas coronárias em dentes anteriores demanda o restabelecimento tanto da funcionalidade quanto da estética do elemento traumatizado. Esse processo fica ainda mais complexo à medida que necessitamos usar um retentor intrarradicular para a retenção da restauração, pois a técnica de cimentação e reconstrução do núcleo apresenta sensibilidade técnica. No presente relato, o paciente apresentou fraturas de esmalte e dentina dos elementos 13 e 31, que foram restaurados com resina composta, e fraturas de maior extensão no 11 e 12. Para esses, foi realizada a cimentação de pinos de fibra de vidro (PFV), construção do núcleo de preenchimento e cimentação de coroa bilayer em dissilicato de lítio, destacando que para todas essas etapas foi utilizado um cimento resinoso reforçado por carga. Após quatro anos, o paciente retornou para uma consulta de acompanhamento e verificou-se que tanto as restaurações cerâmicas como as de resina composta haviam sobrevivido e não apresentavam nenhuma alteração estética ou de forma (escore 1 para todos critérios de Hickel). Assim, entendemos que a utilização de um cimento resinoso reforçado por fibra mostra-se uma ótima opção a curto prazo para as etapas de cimentação de pinos, construção de núcleos de preenchimento e cimentação de coroas metal free. Além disso, os pinos de fibra e coroas cerâmicas confirmaram seu bom comportamento, conforme já apresentado em outros estudos clínicos.

Palavras-chave – Prótese dentária; Cimentos dentários; Estética dentária; Reabilitação bucal.


ABSTRACT

Restorative rehabilitation of coronary fractures in anterior teeth demands the reestablishment of functionality and aesthetics of the damaged tooth. This process becomes more complex as we need to use an intraradicular retainer for the retention of the restoration, since the cementation technique and core reconstruction steps are prone to errors. In the present report, a patient presents fractures of enamel and dentin on upper right canine and lower left central incisor, which were restored using composite resin, and fractures of several extension on upper right central and lateral incisors. For these, it was planned to use glass fiber posts (GFPs), construction of the core and cementation of the bilayer crown in lithium disilicate with the use of a single reinforced resin cement Allcem Core. The ceramic and composite resin restorations had a score 1 for all Hickel criteria, showing survival and success in 4 years follow-up. Therefore, we understand that reinforced resin cement proves to be an excellent material in the short term for the steps of cementation of posts, core build-up and cementation of metal-free crowns. In addition, GFPs and ceramic crowns confirmed their good clinical performance, as shown by other clinical studies.

Key words – Dental prosthesis; Dental cements; Esthetics dental; Mouth reabilitation.

Recebido em ago/2021
Aprovado em out/2021

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