Strengthening of fractured devitalized teeth by casted core

Introduction: Essential suggestion of fixed prosthodontics is positioning of casted cores owing to strengthening of devitalized tooth's root. In this manner, fortified roots should be successfully loaded by crowns and bridges. Objective: Objective of this study was to present success of strengthening of infrabony fractured roots of devitalized teeth by particularly designed metal cores. Material and Methods: 3 patients (2 men and1 women, aged 31 to 47 yrs.) having devitalized fractured teeth with infrabony lack of a part of root-dentin substance were selected for fabrication of fixed restoration. ¾ of root filling were removed in root canal preparations. Mock-up of cores was formed directly in the mouths using self-curing resin (Palavit G, Kultzer, Germany) Bounding surface and borders were prepared in resin material as a shoulder surface of core in supragingival i.e. subgingival areas of dentin-root defects, using retraction cord (Ultrapack #1 and #2, U.S.A.), but as the form of chamfer respecting remained coronal surface of devitalized teeth. After casting, 4 cores made of precious alloys (Golden alloy type III, Zlatara Majdanpek; M-Palador cast, Galenika, Serbia) were decidedly polished and cemented, using normal-set zinc-phosphate cement (Cegal-N, Galenika, Serbia). Temporary crowns were not positioned onto cemented cores and these teeth. After finishing of bounding surface (Fine diamond burs NTI-Kahla rotary dental instruments, Germany), dental arches were impressed (Oranwash L, Zhermack). Metal-ceramic fixed restorations (Vita, Europe) were fabricated and positioned. Results: Restored teeth with surrounding tissues showed favorable appearance of gingival margins, and functional stability in static occlusion, dynamic occlusion and mastication. There were not bleeding during probing or dispositions of fixed restorations to horizontal functional loading. There was not pain during 1,2 and 5 year controls. Conclusion: Ultimate providing of shoulder in subgingival metal core surface, decided core polishing and good quality of alveolar bone withstand fractured root and core completing the capability of functional loading and rehabilitation by fixed restoration. Keywords: fixed restoration, core, post and core, devitalized tooth, fracture, dowel