Coronal Destruction Research Articles

Knowledge and Practice of Iranian Dentists Regarding Post Space Preparation and Coronal Reconstruction of Endodontically Treated Teeth

Background: Due to severe coronal destruction in endodontically treated teeth (ETT), the canal space is often utilized to provide retention for the core material. Objectives: This study aimed to assess the knowledge level and practices of Iranian dentists regarding post space preparation and coronal reconstruction of ETT. Methods: This cross-sectional study was conducted with 117 dentists at Kurdistan University of Medical Sciences in 2021. Data were collected using a two-part questionnaire. The first part included 6 questions regarding the demographic information of the participants. The second part comprised 10 questions regarding the methods of post space preparation and coronal reconstruction of ETT. SPSS-20 software was used to analyze the data, calculating frequency (%), mean, and standard deviation. Results: 44.4% of the participants used amalgam along with a prefabricated post, 59% correctly identified the definition of the ferrule effect, and 87.2% believed that the ferrule effect increases fracture resistance. Additionally, 39.3% reported preparing the post space immediately after obturation; 91.5% used rotary instruments for removing root filling material, 93.2% reported cleaning the post space prior to cementation of the intracanal post, and 35.9% used saline for this purpose. Moreover, 72.9% believed that teeth with post and core necessarily require a prosthetic crown, and 94% used full-coverage crowns for ETT. Coronal fracture was reported by 62.4% as the most common cause of failure of ETT. Conclusions: The knowledge level of dental clinicians regarding post space preparation and coronal reconstruction of ETT was moderate, while their practice level was poor. The most common variables that had a significant relationship were age and academic degree.

Digital and Conventional Workflow for Endocrown Fabrication in Pulpotomy Permanent Tooth: Case Report

A higher chance of carrying out a successful full pulpotomy is dependent on the coronal restoration. Preservation of healthy dental structure is essential for providing mechanical stabilization of tooth-restoration integrity and increasing the number of suitable surfaces for adhesion. In this case, endocrown was a suitable restoration due to large coronal destruction. However, the preparation design and material selection affect the manufacturing technique. As shown in this case, the CAD/CAM technique demonstrated technical errors such as marginal chipping and overmilling, for these reasons changing to conventional technique for lithium disilicate endocrown fabrication was adopted. After one week of permanent cementation, the restoration was in good condition and abutment was normal with good gingival health.

Last Generation Bis-GMA Free Composite For Indirect Posterior Restorations: A Case Report

Scientific literature put in evidence the importance to use biocompatible materials, free from any substance that can be toxic for the human body, for this reason a Bis-GMA free composite material is used that shows cytotoxicity equal to zero. Nowadays composite materials can be used with direct and indirect technique. In this case report we decided to provide an indirect composite restoration, this is an excellent option in absence of coronal destruction, as we improve the anatomic contour, and we also increase the physical properties as we also post curing the element in a light curing unit for indirect technique that must not exceed the 80°C /176 °F to avoid to damage the inorganic matrix of the composite.

Autogenous Dental Transplantation: Case Series

Autogenous dental transplantation is defined as the transfer of a tooth to a recipient site of the same individual, whether it is a recently extracted site or surgically prepared bed. This procedure has proven to be a good and cost-effective alternative for replacing teeth with indications for extraction. Depending on the case, it is possible to maintain the vitality of the tooth and the periodontal ligament, ensuring proprioception and physiological dental mobility. The aim of the study is to describe a series of clinical case reports of autogenous dental transplants, in addition to discussing the results obtained based on current literature. The study features with a series of autogenous dental transplant cases conducted at Euro American University Center, where the indication for such a procedure was the extensive coronal destruction of the first molars in young patients. The surgeries were performed in atraumatic manner using a single-stage technique and semi-rigid splinting with occlusive sutures using 4-0 nylon thread. The results demonstrate significant success in the postoperative period, with the absence of symptoms and maintenance of pulp vitality and periodontal ligament. Based on the studies and case reports, it was observed that transplantation remains a safe and economically viable alternative for the replacement of prematurely lost teeth, within its indications and limitations.

Autogenous dental transplantation of the third molar: case report

Autogenous dental transplantation, or autotransplantation, is a technique that gained recognition in the 18th century and involves the transfer of a tooth from one socket to another in the same individual. This practice can be performed with embedded, impacted, or erupted teeth to replace lost or non-restorable teeth, offering a biological alternative that preserves natural teeth. The process of autotransplantation involves steps such as radiographic evaluation, atraumatic extraction, root inspection, extraoral management, and transfer of the tooth to the recipient socket, all carefully followed to ensure clinical success. Currently, dental transplantation is a well-accepted option due to its lower cost, shorter treatment duration, and preservation of tissue and periodontal ligament. However, the lack of knowledge among professionals limits its indication as a rehabilitative alternative. The article presents a literature review followed by a clinical case report of an autogenous dental transplant surgery performed in a Primary Health Care Unit in the municipality of Graça, Ceará, Brazil. A 16-year-old teenager presented with extensive coronary destruction of element 37 due to decay, diagnosed as pulp necrosis. After radiographic evaluation and determining the viability of tooth 38 as a donor, atraumatic extractions of elements 37 and 38 were performed, followed by the autotransplantation of tooth 38 into the socket of tooth 37. The procedure was carried out without scraping or curettage of the recipient bed and without the use of pre-surgical antibiotic therapy. The patient was evaluated after 15 days, 45 days, and 6 months, showing a satisfactory evolution with a response within normal standards for pulp and periodontal health. This work highlights the importance of autotransplantation as an option for dental rehabilitation, especially in contexts where access to endodontic and prosthetic treatments is limited and emphasizes the need for greater dissemination and training for oral health professionals.

Restoration of a Vital Tooth With Extensive Crown Destruction Using Glass Fiber and Polyethylene Fiber-reinforced Composite Resin: A Clinical Case.

Conservative restorative dentistry has been evolving in the last 25 years, focusing mainly on the development of direct restorative materials. Resin-based composites remain an excellent conservative alternative for restoration of teeth with extensive caries lesions. Over time, several strategies have been proposed to improve the mechanical properties of these composites so that they can adequately withstand masticatory forces. Glass fiber-reinforced resin-based composites and their use in situations where there is great loss of tooth structure have gained popularity due to their favorable mechanical properties. Combined techniques with polyethylene fibers can further enhance their clinical performance. This study presents a brief review of their most important qualities and potential use in direct restorative procedures. In addition, a clinical case is described where a vital tooth with extensive coronal destruction was restored using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. The reinforcement of both the remaining tooth structure and the restoration with fibers is a valid treatment option since the network structure formed by the fiber reinforcement can increase the longevity of the direct composite restorations. There are few reports in the literature describing the use of a combined technique using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. Thus, clinical follow-up of this case is required.

Fibre-reinforced Cad/CAM post and cores: The new “gold standard” for anterior teeth with extensive coronal destruction?–A fully digital chairside workflow

ObjectivesSince one-third of persons suffer a dental trauma, treatment of anterior teeth using post and core (PC) is becoming important. In teeth with extensive destruction, cast PC (CPC) remain the “gold standard”, even though they lead to aesthetic impairment and have a mismatching elastic modulus to that of dentin. Prefabricated fibre-reinforced posts have elastic modulus similar to that of dentin but the accuracy of fit and mechanical stability are worse. This study was aimed to evaluate the deviation and mechanical performance of fibre-reinforced CAD/CAM PC (FRPC) fabricated in a fully digital chairside workflow, compared to those of CPC. MethodsOn 30 teeth, a PC preparation was conducted, and a conventional and digital post impression were taken with an intraoral scanner. Fifteen teeth each were treated with CPC and FRPC, respectively. The deviation was evaluated by superimposing the datasets of the digitalised stone models and digital post impressions. Decementation and root fracture during chewing simulation were analysed by microscopy and X-ray. Statistical analysis was performed by pairwise comparison and Kaplan-Meier analysis. ResultsThe median deviation for the “coronal”, “middle” and “apical” were 14.5, 18.0 and 113.7 μm, respectively. The pairwise comparison for “coronal”/“middle” showed no significance (p = 0.465), whereas that for “coronal”/“apical” and “middle”/“apical” showed highly significant differences (p < 0.001). After chewing simulation, five decementations and two root fractures were detected for CPC. For FRPC, neither decementation nor root fracture were documented. SignificanceWithin the limitations of this study, FRPC performed significantly better than CPC.

Conservative Management of Extensively Damaged Endodontically Treated Tooth using Ceramic Endocrown and Deep Margin Elevation: A Clinical Report

Introduction: The restoration of endodontically treated molar continued to be a challenging issue. After endodontic treatment, generally the tooth is exposed to a higher risk of fracture. Endocrown as a minimal invasive restoration could be a wise alternative for restoring molars with large coronal destruction and limited interocclusal space. Observation: Through this work, we present a clinical case report of an endocrown-type restoration, fabricated from lithium disilicate ceramic (IPS e.Max CAD) in a maxillary first molar with extensive coronal destruction associated to cervical margin relocation. Discussion: We discuss the indication and use of endocrown to replace single crowns with intraradicular retention. The supragingival margins of the endocrown preparation simplify rubber dam isolation, and the adhesive procedure that’s why deep marginal elevation in this case was performed.

Current treatment approaches of newly graduated, intern dentists and dentists in doctoral and specialty training to teeth with excessive substance loss (cross-sectional study)

Aim: New treatment options have been developed as alternative post-retaining restorations and crowns that preserve remaining tooth tissue in endodontically treated teeth with excessive substance loss. This study, current treatment approaches newly graduated, intern and doctoral or specialist dentists in teeth excessive coronal destruction were evaluated.&#x0D; Material and Method: This cross-sectional study, online questionnaire consisting of 22 questions, 3 parts was applied. First part consists of demographic information participants, second part consists of questions measuring awareness about preferred indirect restorations, last part consists of current treatment approaches newly graduated, intern and doctoral or specialist dentists. Total 234 voluntary participants questionnaires were evaluated. Obtained data were analyzed with IBM SPSS V23.&#x0D; Results: In restoration of endodontically treated buccal mesial walls (least 2 mm thick) molars, participants all 3 groups preferred posterior adhesive indirect restorations according to their titles. Considering level of awareness, participants high group preferred posterior adhesive indirect restorations more in restorations endodontically treated buccal lingual walled molar teeth. Participants all 3 groups preferred use fiber under composite strengthen teeth in the restoration of teeth with excessive substance loss.&#x0D; Conclusion: According to the results, it was determined that awareness and knowledge level of dentists who received specialty or doctoral training about new current treatments was higher than other newly graduated and intern dentists. It was observed that participants group with high level awareness mostly preferred posterior region indirect adhesive restorations such as endocrown and onlay.

Socioeconomic Determinants and Demand for Dental Avulsions at the Institute of Odontology and Stomatology Clinic in Dakar

Dental avulsion is one of the most common acts performed in dentistry. It concerns both the young population, but its prevalence increases with age. The objective of this work was to study the socio-economic determinants and the demand for dental avulsions at the Institute of Odontology of the Cheikh Anta Diop University of Dakar (UCAD). This was a descriptive cross-sectional study of patients who were seen in the oral surgery department of the UCAD Odontology Clinic. Data were collected from medical records from October 14, 2019 to March 28, 2020. Tools used to collect and process the information were Sphinx software and Excel spreadsheet. From this, it was found that of the 525 patient records, 60% were male and 52.19% were between the ages of 20 and 39 years. More than half (53.14%) of patients lived less than 5 km from the health care facility and 42.7% of patients had a monthly income of between 50,000 and 100,000 FCFA. Clinically, 49.9% of patients came for an odontalgic reason and periodontitis followed by coronal destruction were the most diagnosed pathologies. Also, there is a relation between diagnosis and the variables age and income with respectively P-value 0.023 and 0.001. Closeness to health facilities, income, and cost of treatment are factors that influence accessibility to oral health care. It is important to integrate the health care consumer's profile in the overall approach to care.

Direct Resin Composite Restoration in Anterior Tooth: 10 Years of Clinical Follow-Up

The emergence and development of resin-based materials, such as resin composites and adhesive systems, have shifted the restorative treatment of anterior teeth with caries lesions and/or fractures. Thus, based on the disadvantages of indirect restorations, direct esthetic restorations are restorative options even for anterior teeth with exten sive loss of hard tissues. This study aimed to describe and discuss the direct resin composite restoration performed to solve the esthetic and functional impairments of the upper anterior teeth with diastemas. The upper left central incisor received total crown preparation for indirect restoration. Clinical results after 10 years were recorded. Considering the clinical characteris tics of dental restorations, it is possible to conclude that direct resin composite restorations reestablished the esthetic and functional properties satisfactorily, even in a tooth with extensive coronal destruction. The success of the restorative treatm ent was dependent on factors related to the materials´ properties, oral habits of the patient, and mostly the clinical skills of th e dental clinician.

The advancement of adhesive dentistry with the endocrown technique and its diffusion among professionals: a literature review

Introduction: In the decades with the advancement of materials fabrication, such as restorations with the latest improvements in their dental fabrication process, or as restorations with improvements in their dental fabrication process, or as the latest restorations in their dental fabrication process, dentistry, or as the latest restorations in their restorative materials manufacturing process. Objective: This work aims to demonstrate through a literature review the use of the endocrown technique. Methods: The research was carried out from January to May 2022 and was developed based on PubMed, Scielo, and Google Scholar. Results: There were 11 a total of 13 articles on Endocrowns. In total, 47 articles were complete and 19 were included in this study. Dentistry, contributing to a better resolution of cases, presents little interocclusal space, so the indirect endocrown restoration technique becomes an excellent option, presenting a good alternative and less dental wear for making. Conclusion: It was concluded that the use of the endocrown technique has shown, for the most part, employing clinical results that it is an excellent restorative option for the restoration of molars with great coronary destruction, and its clinical survival rate was comparable to the use of intraradicular posts of fiber.

ENDOCROWN RESTORATION OF THE ENDODONTICALLY TREATED TEETH BY USING CAD/CAM: CASE SERIES

Aim: As a result of large coronal destruction in endodontically treated teeth, significant losses occur in the dentin tissue around the pulp and the need for prosthetic treatment occurs. In this case series, endocrown applications produced in a single session with CAD/CAM system are presented as an alternative to crown restoration traditionally applied to premolar and molar teeth with excessive crown destruction.&#x0D; &#x0D; Case Series: In first case, 38-years-old male patient number 25, 46-years-old female patient number 36 in our second case, 21-years-old female patient number 46 in our third case, 26-years-old male patient number 46 in our fourth case, and in the last case 52-years-old male patient tooth number 15 has been applied to root canal treatment. As a result of the clinical and radiological examinations of the patients, it was observed that there were no systemic diseases. Endocrown restoration was considered appropriate and recommended to patients with less dentin tissue. Firstly, teeth are prepared for endocrown restoration. Afterwards, the impressions were digitalized by scanning the jaws with an intraoral optical scanner (Cerec Omnicam, Dentsply Sirona, USA). The restorations were designed with the help of the CEREC 4.3 software (Dentsply Sirona, USA) and the milling process was carried out using the feldspathic ceramic block (Vita Mark II, Vita Zahnfabrik, Germany) in the same session by CEREC inLab MC XL (Dentsply Sirona, USA). Later, the restorations were glazed and cemented with dual polymerized resin cement (RelyX Ultimate, 3M ESPE, USA).&#x0D; &#x0D; Conclusion: Endocrown restorations are a minimally invasive, conservative treatment approach that provides mechanical adhesion to the pulp chamber and cavity walls with adhesive resin cement and allows the preservation of the remaining tooth structure. For this reason, it is a treatment option that can be preferred instead of post-core and crown application in teeth with root canal treatment.

ENDO CROWN: AN APPROACH FOR RESTORING ENDODONTICALLY TREATED RIGHT MANDIBULAR FIRST MOLARS WITH LARGE CORONAL DESTRUCTION- A CASE REPORT

Rehabilitation of endodontically treated molar stilla challenge. After endodontic management of extensively carious molars, theyhave decreased mechanical characteristics. They became fragile and that is in relation with the removal of pulp and adjacent dentin tissues. Endocrown which is a single partial restoration could be measured as a good alternative for restoring molars having large coronal destruction and presenting endodontic treatment complications. We discuss the indication and use of endocrown to substitute single crowns with intraradicular retention and to present a clinical case report of an endocrown-type restoration, made-up from lithium disilicate ceramic (IPS e.Max CAD) in a mandibular first molar with widespread coronal destruction.

Rehabilitation of severely-destructed endodontically treated premolar teeth with novel endocrown system: Biomechanical behavior assessment through 3D finite element and in vitro analyses

ObjectiveRehabilitation of endodontically treated premolars with extensive coronal destruction through endocrown approach remains a controversial topic in reconstructive dentistry. There is no clear consensus in the literature which endocrown design with which material is the most effective restoration option for severely-destructed endodontically treated premolars. The aim of this study was to assess the biomechanical behavior of endodontically treated maxillary first premolars restored with a novel endocrown system compared to the conventional one varying the applied load type through finite element and in vitro analyses. Materials and methodsFor finite element analysis, two models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: Model C for the conventional monolithic IPS e.max CAD endocrown and Model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). Modified von Mises stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately under axial and oblique loading of 450 N. For in vitro analysis, forty sound human bifurcated maxillary first premolars were collected, endodontically-treated, and divided into 2 main groups (n = 20) according to the system used for endocrown fabrication; Group C: the conventional monolithic endocrowns and Group P: the novel bi-layered endocrowns. All specimens were subjected to an artificial thermomechanical aging protocol. Each main group was subdivided into two subgroups (n = 10) according to the loading type (axial and oblique) applied during the fracture resistance test. Qualitative analysis using Stereomicroscopy and Scanning Electron Microscopy was performed. Data were statistically analyzed at p-value ≤ 0.05. ResultsRegarding stress distribution pattern of remaining tooth structure (enamel and dentin), both endocrown systems and cement lines under both axial and oblique load application, Model P resulted in lower stresses than Model C. The oblique stress values of all analyzed structures were higher than corresponding values resulted axially. Considering failure load, a significantly higher load was recorded for Group P when axial or oblique loading was applied (p = 0.00). A significantly higher failure load was recorded with axial loading for both main groups. With regard to failure mode, a statistically significant difference was observed between main groups (p = 0.033), with more favorable failures detected for Group P axially. ConclusionsCompared to the conventional endocrown system, the studied novel system improved the biomechanical behavior within tooth/restoration complex of the restored severely-destructed endodontically treated maxillary first premolar teeth, whatever the applied load type. Clinical significanceThe novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable promising option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. It can be considered as a conservative alternative option to the conventional treatment modalities not only for normal clinical conditions, but also for parafunctional cases.

Fracture strength of teeth with coronal destruction after core build-up restoration with bulk fill materials.

This study aimed to evaluate the fracture strength and failure modes of different core techniques in teeth with simulated coronal destruction. Forty teeth were endodontically prepared and the specimens were divided into four experimental groups (n= 10) according to the core composition: Filtek One Bulk Fill-FOBF, Filtek Z350 XT-FZ350 (standard group), Filtek Bulk Fill Flow-FBFF, and LuxaCore Z-LCZ. CAD/CAM Monolithic zirconia crowns were obtained and cemented with RelyX U200. After storage in distilled water at 37°C for 48 h, the specimens were subjected to thermal cycling and to compressive strength mechanical tests. Statistical analyses (α= 0.05) were performed by non-parametric Kruskal-Wallis, Dunn post hoc, and Fisher's exact tests. No significant differences (p> 0.05) were observed among FOBF, FZ350, and FBFF (mean ranks=20.30, 12.20, and 23.20, respectively). LCZ (mean rank=26.30) produced results similar to those of FOBF and FBFF (p> 0.05) and higher than those of FZ350 (p= 0.042). The most frequent type of failure was irreparable, regardless of the experimental condition. The lowest percentages of reparable fractures were produced by FOBF group (10%). The use of bulk fill materials, including the "core-and-post" LCZ dual-cure resin composite, did not impair the fracture strength of endodontically treated teeth with coronal destruction. Resin composite bulk fill materials that can be used as a core-and-post cementation in an only stage are interesting, since they enable clinicians to work with one only material, and avoid several materials interfaces, technical sensitivity, and longer chair-time due to multistep procedures.

Modern Applications in Technology of Post and Core Restorations

Abstract Post and core devices are elements that contribute to the complete restoration of the coronary abutment, over which the final prosthetic restoration will be created. Their role is to retain the coronary portion of the restoration and to protect the remaining coronary structures. The retention function is dictated by the major indication of the method, massive coronary destruction that does not provide conditions for coronary aggregation of the restoration. Thus, this material is approaching two unique methods of making post and core devices totally metallic and/or hybrid (metal + totally ceramic component), using both classical technology, modern technologies, but also combinations of them.

English

BACKGROUND Endodontically treated teeth have higher fracture rate due to pronounced coronal destruction. The minimally invasive approach of associating adhesive techniques and posts seems to contribute to a better clinical prognosis for endodontically treated teeth. The purpose of this study was to evaluate the push out bond strength and mode of failure of fiber post using one self-etch resin cement and two selfadhesive resin cements. METHODS Sixty single rooted teeth were selected and decoronated 2 mm coronal to cementoenamel junction (CEJ). The teeth were prepared and obturated, then divided into three groups of 20 samples each. The post spaces were prepared and relyX fiber posts were cemented in group I with multilink N, in group II with relyX U200 and in group III with Maxcem elite luting cements. The specimens were sectioned into three slices of 2 ± 0.1 mm thickness to perform the push out test using universal testing machine. Failure modes were evaluated using scanning electron microscope. Thus, collected data was statistically analysed using one-way analysis of variance test. RESULTS The push out bond strength of group I was significantly higher than that of group II and group III (P &lt; 0.05). No statistically significant difference was found between group II and group III. There was significant difference between coronal, middle and apical thirds in each group. The mode of failures showed 78 % of the samples had adhesive failure while 22 % of the samples had mixed failure. CONCLUSIONS Multilink N was found to be significantly more effective than RelyX U200 and Maxcem elite. Most common type of failure observed was adhesive failure between dentine-cement interface. KEY WORDS Fiber Post, Self-Etch Cement, Self-Adhesive Cement, Bond Strength, Push Out Test

A Thorough Analysis of the Endocrown Restoration: A Literature Review

The aim of this literature review is to determine whether endocrowns are a reliable alternative for endodontically treated teeth with extensive loss of tooth structure, the indications and contraindications of this restorative choice, the principles that should be followed for tooth preparation and which material is most appropriate for endocrown fabrication. Rehabilitation of endodontically treated teeth with severe coronal destruction has always been a challenge for the dental clinician. Until recently, the fabrication of a metal-ceramic or all-ceramic full-coverage crown along with a metal or glass fiber post has been the "gold standard" proving its efficacy via numerous clinical studies. With the development of CAD/CAM technology and the evolution of dental materials, new minimally invasive techniques have been introduced with less need for adjustments and less incorporation of structural defects. One of them, the "monoblock technique," proposed by Pissis in 1995, was the forerunner of endocrown restoration, a term used by Bindl and Mörmann to describe an all-ceramic crown anchored to the internal portion of the pulp chamber and on the cavity margins, thus obtaining macromechanical retention provided by the axial opposing pulpal walls and microretention attained with the use of adhesive cementation. Endocrowns require a decay-oriented preparation taking advantage of both the adhesion and the retention from the pulp-chamber walls, they are strongly indicated in endodontically treated molars in cases where minimal interocclusal space and curved or narrow root canals are present and they should be manufactured from materials that can be bonded to the tooth structure. Endocrowns are a reliable alternative to traditional restorative choices, given that the clinicians respect the requirements and indications describing this technique. Traditional restorative techniques demanding tooth substance removal and minimizing the opportunity for reinterventions should be reconsidered.

Cost-Effectiveness Analysis of Rehabilitation Interventions for Teeth With Extensive Coronary Destruction

ObjectiveTo perform a cost-effectiveness analysis of rehabilitation interventions for management of posterior teeth (molar) with extensive coronary destruction. MethodologyAn economic model by Markov simulated a hypothetical 10-year cohort with 1,000 patients requiring treatment for a molar tooth with pulp necrosis and extensive coronary destruction. This study adopted the perspective of a local manager from Specialized Center in Dentistry, based on the transfer from the Ministry of Health. Treatments were proposed: Tooth Extraction + Removable Partial Denture (TE+RPD); Root Canal Treatment + Intra-Radicular Restoration + Single Crown (RCT+RIR+SC); and Tooth Extraction + Dental Implant + Single Crown (TE+DI+SC). The costs were obtained from the SUS Integrated System of Procedures, Medicines and orthoses; prostheses and special materials table management (SIGTAP). Failure and survival rates were obtained from systematic reviews. The variable “years of survival” was an outcome of effectiveness. The probabilistic simulation considered the confidence interval of 95%, variation of parameters by 5% and annual discount rate of 5%. ResultsTE+RPD intervention presented lower cost and effectiveness. The incremental cost-effectiveness ratio (ICER) of RCT+IRR+SC and TE+DI+SC interventions compared to TE+RPD were $13.06 and $9.92 per year of survival. Compared to RCT+IRR+SC, the TE+DI+SC intervention had an ICER=$26.90 per year of survival. The acceptability curve indicates that the choice of intervention depends on the willingness to pay. ConclusionThe RCT+IRR+SC intervention presented a balance of cost-effectiveness. Rehabilitation with implants can be considered in view of the higher expectation of longevity and, especially, greater willingness to pay.