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Aesthetic Restoration of Endodontically Treated Teeth

The utilization of all-ceramic anterior restorations has been widely advocated by dental clinicians for the creation of a natural appearance, even in teeth that have undergone endodontic treatment. A suitable aesthetic level is generally more difficult to achieve, however, when a post and core system is required in the absense of adequate dental structure. In particular, conventional cast-metallic posts negate light transmission, which has long been considered a vital component in the creation of optimal aesthetics. This podcast provides an overview of the materials, fabrication methods, and procedures involved in anterior reconstruction using aesthetic alternative systems and solutions.

*Special lecturer, Department of Prosthodontics, Louisiana State University, New Orleans, Louisiana; private practice, Pesaro and Milano, Italy.

 

Learning Objectives:

This podcast describes aesthetic anterior restoration of endodontically treated teeth with a post and core system. Upon completing this podcast, the listener should:

  • Have an understanding of the materials, methods, and procedures involved in anterior restorations using alternative systems and solutions.
  • Recognize concerns for aesthetic restorations of endodontically treated teeth in compromised aesthetic conditions.

 

Related Reading:

  1. Cohen S, Burns R. Pathways of the Pulp. 4th ed. St. Louis, MO: Mosby; 1987:640-684.
  2. Shillingburg HT, Hobo S, Whitsett LD, et al. Fundametals of Fixed Prosthodontics. 2nd ed. Carol Stream, IL: Quintessence Publishing; 1981:147-159.
  3. Shillingburg HT, Kessler JC. Restoration of the Endodontically Treated Tooth. Carol Stream, IL: Quintessence Publishing; 1982:13-203.
  4. Malone WFP, Koth DL, Cavazos E, et al. Tylman's Theory and Practice of Fixed Prosthodontics. 8th ed. St. Louis, MO: Ishiyaku EuroAmerica Inc.; 1989:410-415.
  5. Guzy GE, Nicholls JI. In vitro comparison on intact endodontically treated teeth with and without endo-post reinforcement. J Prosthet Dent 1979;42(1):39-44.
  6. Rud J, Omnell KA. Root fractures due to corrosion. Diagnostic aspects. Scand J Dent Res 1970;78(5):397-403.
  7. Sorensen JA, Martinoff JT. Intracoronal reinforcement and coronal coverage: A study of endodontically treated teeth. J Prosthet Dent 1984;51(6):780-784.
  8. Sorensen JA, Martinoff JT. Clinically significant factors in dowel design. J Prosthet Dent 1984;52(1):28-35.
  9. Caputo AA, Standlee JP. Biomechanics in Clinical Dentistry. Carol Stream, IL: Quintessence Publishing; 1987:185-186.
  10. Trabert CK, Caputo AA, Abou Ross M. Tooth fracture - A comparison of endodontic and restorative treatments. J Endod 1978;4(11):341-345.
  11. Lovdahl PE, Nicholls JI. Pin-retained amalgam cores vs. cast-gold dowel-cores. J Prosthet Dent 1977;38(5):507-514.
  12. Gelfand M, Goldman M, Sunderman EJ. Effects of complete veneer crowns on the compressive strength of endodontically treated teeth. J Prosthet Dent 1984;52:635-638.
  13. Libman WJ, Nicholls JI. Load fatigue of teeth restored with cast posts and cores and complete crowns. Int J Prosthodont 1995;8(2):155-161.
  14. Kurer HG, Combe EC, Grant AA. Factors influencing the retention of dowels. J Prosthet Dent 1997;38:515-525.
  15. Ruemping DR, Lund MR, Schnell RJ. Retention of dowels subjected to tensile and torsional forces. J Prosthet Dent 1979;41:159-162.
  16. Zmener O. Effect of dowel preparation on the apical seal of endodontically treated teeth. J Endod 1980;6(8):687-690.
  17. Mattison GD, Delivanis PD, Thacker RW Jr, Hassell KJ. Effect of post preparation on the apical seal. J Prosthet Dent 1984;51(6):785-789.
  18. Wirz J, Christ R. In vitro study of the occurrence of screw and pin corrosion in dental prosthesis structures. SSO Schweiz Monatsschr Zahnheilkd 1982;92(5):408-428.
  19. Eliasson S, Bergström J, Sanda A. Periodontal bone levels of teeth with posts. A radiographic study. J Clin Periodontol 1995;22(11):850-853.
  20. Duret B, Reynaud M, Duret F. New concept of coronoradicular reconstruction: The Composipost (1). Chir Dent France 1990;60(540):131-141.
  21. Engelman MJ, Sorensen JA, Avera SP, Lew D. Effect of luting agents on corrosion resistance of metal posts. J Dent Res 1990;69(Abstract No. 913):223.
  22. Arvidson K, Wroblewski R. Migration of metallic ions from screwposts into dentin and surrounding tissues. Scand J Dent Res 1978;86(3):200-205.
  23. Assif D, Oren E, Marshak BL, Aviv I. Photoelastic analysis of stress transfer by endodontically treated teeth to the supporting structure using different restorative techniques. J Prosthet Dent 1993;69:36-40.
  24. King PA, Setchell DJ. An in vitro evaluation of a prototype CPRC prefabricated post developed for the restoration of pulpless teeth. J Oral Rehabil 1990;17(6):599-609.
  25. Sorensen JA, Mito WT. Rational and clinical technique for esthetic restoration of endodontically treated teeth with the Cosmopost and IPS Empress Post System. Quint Dent Technol 1998;81-90.
  26. Hormati AA, Denehy GE. Microleakage of pin-retained amalgam and composite resin bases. J Prosthet Dent 1980;44(5):526-530.
  27. Dishman MV, Covey DA, Baughan LW. The effects of peroxide bleaching on composite to enamel bond strength. Dent Mater 1994;10(1):33-36.
  28. Barkhordar RA, Kempler D, Plesh O. Effect of nonvital bleaching on microleakage of resin composite restorations. Quint Int 1997;28(5):341-344.
  29. Meyenberg HK, Lüthy H, Schärer P. Zirconia posts: A new all-ceramic concept for nonvital abutment teeth. J Esthet Dent 1995;7(2):73-80.
  30. Dietschi D, Romelli M, Goretti A. Adaptation of adhesive posts and cores to dentin after fatigue testing. Int J Prosthodont 1997;10(6):498-507.
  31. Schweiger M, Frank M, Cramer von Clausbruch S, et al. Mechanical properties of a pressed ceramic core to a zirconia post. Quint Dent Technol 1998;21:71-77.
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