SUMMARYThe reconstruction of structurally compromised non-vital posterior teeth may represent one of the most challenging adhesive-based restorative procedures. Several factors may influence the longevity of direct fiber-reinforced resin composite restorations: endodontic procedures prior to post cementation, dentin and/or post surface treatments, selection of the appropriate post design and architecture, resin composite polymerization and layering techniques. Thus, different specialties, such as endodontics and restorative dentistry, should work as a team to improve the longevity of restorations. This article presents three-year clinical results following reconstruction of a severely damaged endodonticallytreated molar using direct fiber reinforced resin composite systems.
INTRODUCTIONEndodontically-treated teeth are weakened because of a decrease in water content and loss of dentin.1 The decay process and/or tooth fracture may be responsible for the structural weakening of non-vital teeth; the tooth preparation required for adequate endodontic treatment may also contribute to the increased fragility.
2After endodontic therapy, selecting the appropriate reconstruction for each non-vital tooth should be based on the remaining hard tooth structure, the number and thickness of the residual cavity walls, the position of the tooth in the arch and the load implied. Resin bonded composite (RBC) restorations showed a strengthening effect on the tooth structure, with fracture resistance similar to that of unaltered teeth.3-5 For many years, direct adhesive restorations have been used for anterior teeth with conservative endodontic access and intact marginal ridges.1,6-7 Posterior non-vital teeth with an intracoronal conservative access only have also been restored with direct RBC. 4 Conversely, for many years, full coverage restorations have been indicated when the teeth are weakened by additional cavities on both the anterior and posterior area. [8][9] With the use of improved adhesive systems in the last decade, clinicians started
Clinical RelevanceThe proper utilization of fiber-reinforced resin composite restorations in endodontically-treated molars may preclude the use of more extensive restorative treatment, possibly delaying the need for expensive indirect restorations.