Endodontic success is not only dependent on obtaining a proper apical seal but also a coronal seal, as coronal leakage is one of the primary reasons for the long-term failure of endodontically treated teeth. After completing endodontic treatment, it is necessary to perform a coronal restoration to obtain an adequate coronal seal. A pulpless tooth differs from a vital tooth mainly in terms of the remaining tooth structure. Therefore, the residual dentinal tissue and its preservation primarily dictate the restoration, especially for severely compromised teeth, where we must choose the best restoration accurately.
Various techniques are available for the reconstruction and restoration of pulpless decayed teeth. Is a root canal post absolutely necessary? Which core materials should be used? Should a crown be placed after root canal therapy? With modern adhesive dentistry, there are two treatment possibilities for anterior and posterior teeth: placement of a direct restoration or placement of an indirect restoration.
Adhesive techniques can be used in either approach to achieve a proper coronal restoration that will seal effectively. To obtain favorable long-term results, the restoration must protect the tooth against excessive load. The cervical region of the restored tooth is subject to the most stress, and thus, we should restore an endodontically treated tooth in the most conservative way possible, minimizing any further tooth structure loss. Adhesive techniques offer potential advantages in this regard.
To give indications in this presentation why we will choose either direct or indirect restoration in different clinical situations and the type of coronal-radicular restoration procedure that should be adopted
- Understand what is important to achieve the Endodontic Success
- Understand which adhesive material to choose
- Understand how is important to clean and prepare the chamber and post space
- Understand how to restore anterior and posterior teeth
- Understand when using the post and which post