The restoration of endodontically treated teeth: An update

Abstract

W ith increasing numbers of teeth being retained by endodontic therapy there is a concomitant need for the dentist to have the knowledge and skills to restore them. The restorative method depends on the amount’ of supported coronal tooth structure that remains. If a substantial part of the crown is intact, a conservative approach may be used. If little or no coronal tooth structure remains, provision must be made for creating a core, a synthetic crown preparation such as gold, amalgam, composite, or glass ionomer, over which a crown can be placed. Ideally a post inserted in a preparation within the confines of the root by using the canal as a guide provides optimum support for the core. This post may be supplemented with one or more TMS pins (Whaledent International, New York, N.Y.) to increase retention. However, there are instances when the use of a retentive post may be prohibited by (1) a curve in the root that prevents the placement of a post of adequate length to provide necessary retention, (2) the presence of a silver point that cannot be removed to the desired depth, and (3) the presence of a previous post that cannot be removed. In these instances, if sufficient horizontal root face is present, pins may be used to support the core. If neither a post nor pins can be used, the restorative effort is nullified and extraction is necessary.