Restorative difficulty evaluation system of endodontically treated teeth

Abstract

This article provides an updated overview of restorative procedures of endodontically treated teeth. The different techniques and procedures to restore an endodontic treated tooth were considered in the last decades. While they are generally performed using bonding procedures in combination with or without the placement of a post into the root to build up the abutment, there has been a lack of interest in restorative difficulties that can be faced. Failures are represented such as debonding of the post, fracture of the root, decementation, and/or fracture of the restoration, microleakage of the margins. Essentially, the presence of a sufficient failure is considered a key point of a long prognosis. Different clinical factors can directly influence the type of restoration and the longevity of the treatment. The restorative difficulty evaluation system (RDES) is proposed in this article. This new system is composed of eight different clinical factors that are divided into six levels of difficulties. The RDES is composed of 1. Endodontic complexity and outcome, 2. Vertical amount of coronal residual structure and dimension of the pulp chamber, 3. Horizontal amount of coronal residual structure, 4. Restoration marginal seal, 5. Local interdisciplinary conditions, 6. the complexity of the treatment planning, 7. Functional need, 8. Dental wear and esthetic need. This article reviews the RDES and outlines critical steps and tips for clinical success. The RDES allows to any clinician to evaluate restorative difficulties when an endodontic treated tooth must be restored, combines clinical aspects that can involve from the single tooth to a full mouth rehabilitation.