Prof. Dr. Füsun Özer - Özet

Prof. Dr. Füsun Özer | Özet

Prof. Dr. Füsun Özer

Prof. Dr. Füsun Özer
Prof. Dr. Füsun Özer

Restoration of Endodontically Treated Teeth
Endodontically treated teeth are more susceptible to fracture than vital teeth mainly because of the reduction of tooth structure, changes in the chemical composition of dentine due to loss of water. Depending on the remaining tooth structure, different treatment planning can be applied to this kind of teeth. However, the treatment planning and materials to restore them is yet controversial. This presentation reviews recent restoration options of endodontically treated teeth. 
Cuspal coverage restorations appear to provide higher longevity to posterior teeth with root canal treatment; according to some recent studies, bonded restorations thought to preclude the need for cuspal coverage in such teeth, might provide a short-term strengthening. Actually, bonded restorations represent the main choice for conservatively restoring anterior teeth with minimal loss of tooth structure. When a tooth has more than 50% of its coronal structure missing, the use of a post–and–core foundation is recommended prior to prosthetic restoration. The main purpose of a post is to retain a core buildup in a tooth with extensive loss of coronal tooth structure. However, endodontic posts are indicated only when there is inadequate tooth structure to retain a core; preparation of a post space adds a certain degree of risk to a restorative procedure
Until the mid-1980s, the cast metal post, made indirectly in the laboratory, was considered the best way to restore an endodontically treated tooth. Fiber-reinforced composite (FRC) posts were introduced as an alternative to traditional custom made cast post and prefabricated metal posts in the 1990’s. It has been confirmed that FRC posts have the potential to lower the risk of vertical root fracture due to their lower modulus of elasticity, whilst providing adequate aesthetics. The availability of fiber posts with different shapes reflects the different morphologies of human root canals that they need to fit. If the post does not fit well, there will be an excessively thick layer of cement, especially at the coronal level, where air bubbles or voids could be incorporated, predisposing to debonding of the posts. Initially FRC posts were quartz or carbon fiber but now most are glass fibers, possessing a translucency that makes an esthetic restoration more easily obtainable. They also allow some degree of light transmission so that dual-cure cement can be used as the translucency helps to provide adequate polymerization of cements. But it should be kept in mind that, no post is ideal for all clinical situations and the selection of a post should depend on the tooth position in the arch, possible abutment, and occlusion. The post should provide all the mechanical requirements to restore the tooth.
It is difficult to give a clear recommendation when considering the ideal way to restore endodontically treated teeth. Awareness of the biological needs of the teeth, long term prognosis and understand¬ing of the limitations of available materi¬als goes a long way to providing the ideal restoration for endodontically treated teeth.