Abstract
Endodontic treatment is usually required because of significant coronal disease or traumatic tissue loss. The restoration of the subsequently endodontically treated tooth is also complicated by the reduction in its structural strength consequent to accessing the pulp chamber and the removal of radicular dentine during root canal instrumentation, alongside some alteration of dentinal properties during disinfection by chemical agents, prior to obturation. A loss of proprioceptive feedback, which may lead to increased loading, can place further stress on the already very compromised structure. This article considers the principles of restoring endodontically treated teeth: assessing restorability, providing a coronal seal to prevent reinfection, and gaining retention for a core where necessary, to restore aesthetics and function. Consideration is given to the patient and material factors that influence the decision to restore the treated tooth using direct or indirect restorations. Specific attention is given to anterior or posterior teeth and the various materials which may be used in their overall restoration with their associated, probable, longevity.
Key points
- After determining restorability and subsequently endodontically treating teeth, the clinician should determine the likely forces that will be exerted on the tooth in function and, potentially, parafunction.
- A restorative material should be selected based on these forces, the remaining tooth structure, and patient acceptability, to provide an antimicrobial seal for the root canal filling and provide protection to the underlying tooth structure.
- A direct or indirect restoration constructed from an appropriately selected material, based on patient and material factors, should restore aesthetics and function with a reasonably predictable longevity.