Page 15 - Dental Practice August 2022

FIG 7a FIG 7b FIG 7c FIG 7d

execute more definitive solution
, namely implants. even if a few
years a gained, the treatment
rendered is better for the patient
as clinician himself too has
shown growth in his/her clinical
skills and knowledge.
in cases where the destruc-
tion is so much that one of the
criteria [bondable tissues, crown
to length ratio, occlusal para-
function will be compromised,
FIG 7e FIG 7f alternative treatment planning
must be considered and tooth be
extracted.
5. enDODOnTiC COnDiTiOn cations
The remaining tooth should be evaluated relat- • Prognosis: good
ed to the extent of endodontic treatment
required: can treatment be performed without Class ii
predictable complications are complications • Ferrule effect: height of remaining tooth 0.5–2
likely and, thus, treatment outcome is uncertain mm or width of remaining tooth walls 1.6–2.2
or are complications irreversible and cannot be mm with visible margins or 1.2–1.6 mm with
resolved with endodontic treatment. Root frac- non-visible margins
tures are for extraction. • Remaining root length: less than crown height About the
For a severely damaged tooth, some elements plus 5 mm but equal or greater than crown AUTHOR
of a treatment plan are mandatory: height plus 3 mm
• Removal of all caries and old restorations to • endodontic condition: Without predictable
achieve access to the remaining tooth structure. complications or with uncertain results
• elimination of all periodontal infection and • Prognosis: moderate
control of plaque.
• Predetermination of the value of the tooth, e.g., Class iii
is it important for occlusion or esthetics. • Ferrule effect: height of remaining tooth < 0.5
A useful classification has been proposed by mm or width of remaining tooth wall < 1.2 mm
helder esteves, André Correia and Filipe Araújo at future margin level
• Remaining root length: less than crown height
Class i plus 3 mm Dr Sachin Deep Singh did his graduation
• Ferrule effect: height of remaining tooth ≥ 2 • endodontic condition: With irreversible com- from G.D.C & H, Mumbai, followed by post
mm at 4 locations (mesial, distal, buccal, pala- plications graduation in Prosthodontics from K.G.M.C,
tine or lingual) and thickness of remaining tooth • Prognosis: Poor Lucknow. He currently runs courses on
walls ≥ 2.2 mm for an esthetic restoration or ≥ dental implants and full mouth rehabilita-
1.6 mm for non-esthetic restorations CONCLUSION tion at Four Dimensions Dental, Gurgaon.
• Remaining root length: At least as long as the in cases of badly decayed tooth/teeth one should He maintains a private practice in New
Delhi focusing on Implantology and
future crown height plus 5 mm for the apical use all the knowledge and techniques in order to Aesthetic Dentistry. He has been active in
seal give that tooth a life, albeit short. in this way not CDE for more than 15 years now and has
• endodontic condition: endodontic treatment only one gains time to evaluate the forces in that lectured extensively in national and inter-
may be performed without predictable compli- particular mouth but also gets to better plan and national platforms.

Dental Practice // July-August 2022 // Vol 18 No 4 15