Restoration of Endodontically Treated Teeth Review and Treatment Recommendations

Abstract

Coronal restorations and posts can positively influence the long-term prognosis of teeth following root canal therapy. Final sealing the canal by placing an appropriate post and core will minimize leakage of oral fluids and bacteria into the periradicular area and is recommended as soon as possible after completion of root canal filling. Glass ionomer or MTA placed over the residual root canal filling after post space preparation may be effective to prevent bacterial leakage. A ferrule of 1-2 mm of tooth tissue coronal to the finish line of the crown significantly improves the fracture resistance of the tooth and is more important than the type of the material the core and post are made of.

Stability of endodontically treated teeth with differently invasive restorations: Adhesive vs. non-adhesive cusp stabilization

“…Although recent reports were not able to confirm this, it is still widely accepted that ETT are still more prone to fracture than vital teeth [15,25,26,28]. Therefore it can be concluded that the reason for increased fracture risk of ETT is based on the often dramatical loss of sound tooth hard tissue during preparation of the endodontic access cavity, the root canal, and often additionally of a post space [19,20,30,52]. This is the reason why -in contrast to restorative aspects of vital teeth -crown preparations are often recommended for ETT, and to be honest, clinical findings are really encouraging, especially when being compared to reports about direct restorations of ETT with inacceptably high annual failure rates [23,37,41,[53][54][55][56].…”

“…It is proven that the biomechanical stability of posterior teeth after access cavity and even further preparation is dramatically decreased with a high risk of vertical root fracture [13][14][15][16][17][18]. Thus, it is logical that clinical studies focusing on endodontically treated teeth (ETT) reveal inferior outcomes compared to vital teeth [19][20][21][22][23][24], although recent studies could not find less tactile sensitivity of ETT compared to vital teeth which makes the "cherry stone" theory questionable, i.e. that the opening reflex for ETT is be delayed, involving heavier load input during routine mastication of hard items [25].…”

Vertical fracture resistance of endodontically treated teeth restored with four sets of obturation and filling materials

“…1e3 Two major reasons may contribute to this, including weakening of the tooth structures following preparation of radicular canals, 4e6 and weakening of coronal structures following preparation of the access cavity. 6,7 The latter seems to be more critical than the former. 6,7 The prognosis of such teeth might be correlated to the radicular/coronal preparation techniques and the amount of tooth tissues removed.…”

Fracture Resistance and Microleakage of Endocrowns Utilizing Three CAD-CAM Blocks

“…However, many clinical and laboratory studies have reported that placing a post will contribute to the retention of the core portion of the restoration but may have a weakening effect on the root. [1][2][3][4][5] The use of intraradicular post and cores is complicated by the necessity to prepare an adequate ferrule, which reduces the risk of failure through root fracture. 6 Failure of post and core systems may be due to different mechanical behaviors relative to tooth structure in response to intraoral cyclic stresses.…”