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Restorations of Endodontically Treated Teeth

Concepts, Materials, and Aesthetics

The care of endodontically treated teeth has been one of the greatest challenges in restorative dentistry. Left unrestored, endodontically treated teeth have complications that include coronal leakage and subsequent reinfection of the root canal system. These teeth are at risk for fracture, since they become predisposed to structural compromise when compared to their properly restored counterparts. As demonstrated herein, caries, previous restorations, fractures, wear, erosion, and endodontic procedures each require careful consideration and timely tooth reconstruction to ensure a favorable prognosis.

*Clinical Assistant Professor, Graduate Prosthodontics, University of Southern California, School of Dentistry, Los Angeles, California; private practice, Los Angeles, California.


Learning Objectives:

This podcast highlights advances in endodontic dowels and explains their use in aesthetic restorative dental procedures. Upon completing this podcast, the listener should:

  • Recognize the importance of the ferrule effect on the outcome of an endodontically treated tooth.
  • Understand the current research and use of endodontic dowels.


Related Reading:

  1. Freedman GA. Esthetic post-and-core treatment. Dent Clin North Am 2001;45(1):103-116.
  2. Gluskin AH, Ahmad I, Herrero DB. The aesthetic post and core: Unifying radicular form and structure. Pract Proced Aesthet Dent 2002;14(4):313-321.
  3. Morgano SM, Milot P.Clinical success of cast metal posts and cores. J Prosthet Dent 1993;70:11-16.
  4. Heydecke G, Butz F, Hussein A, Strub JR. Fracture strength after dynamic loading of endodontically treated teeth restored with different post-and -core systems. J Prosthet Dent 2002;87(4):438-445.
  5. Quintas AF, Dinato JC, Bottino MA. Aesthetic post and cores for metal free restoration of endodontically treated teeth. Pract Periodont Aesthet Dent 2000;12(9):875-884.
  6. Ferrari M, Scotti R. Fiber posts: Characteristics and clinical applications. Milano, Italy: Masson SpA;. 2002.
  7. Asmussen E, Peutzfeldt A, Heitmann T. Stiffness, elastic limit, and strength of newer types of endodontic posts J Dent 1999;27(4):275-278.
  8. Duret B, Reynaud M, Duret F. Long life physical property preservation and post endodontic rehabilitation with the Composipost.  Compend Cont Educ Dent 1996;20(Suppl): S50-S56.
  9. Sidoli GE, King PA, Setchell DJ. An in vitro evaluation of a carbon fiber-based post and core system. J Prosthet Dent 1997;78(1):5-9.
  10. Fredriksson M, Astback J, Pamenius M, Arvidson K.. A retrospective study of 236 patients with teeth restored by carbon fiber-reinforced epoxy resin posts. J Prosthet Dent 1998;80(2):151-157.
  11. Martelli R. Fourth-generation intraradicular posts for the aesthetic restoration of anterior teeth. Pract Periodont Aesthet Dent 2000;12(6):579-584.
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  14. Koutayas SO, Kern M. All-ceramic posts and cores: The state of the art. Quint Int 1999; 30(6):383-392.
  15. Akkayan B, Gulmez T. Resistance to fracture of endodontically treated teeth restored with different post systems. J Prosthet Dent 2002;87(4):431-437.
  16. Fradeani M, Aquilano A, Barducci G. Aesthetic restoration of endodontically treated teeth. Pract Periodont Aesthet Dent 1999;11(7):761-768.
  17. Dietschi D, Romelli M, Goretti A. Adaptation of adhesive post and cores to dentin after fatigue testing. Int J Prosthodont 1997;10(6):498-507.
  18. Goodacre CJ, Spolnik KJ. The prosthodontic management of endodontically treated teeth: A literature review. Part II. Maintaining the apical seal. J Prosthodont 1995;4:(1)51-53.
  19. McLean A. Criteria for the predictably restorable endodontically treated tooth. J Canad Dent Assoc 1998;64(9):652-656.
  20. Tjan AH, Whang SB. Resistance to root fracture of dowel channels with various thicknesses of buccal dentin walls. J Prosthet Dent 1985;53(4):496-500.
  21. Assif D, Bitenski A, Pilo E, Oren E. Effect of post design on resistance to fracture of endodontically treated teeth with complete crowns. J Prosthet Dent 1993;69(1):36-40.
  22. Sorensen JA, Engleman MJ. Ferrule design and fracture resistance of endodontically treated teeth. J Prosthet Dent 1990;63(5):529-536.
  23. Eissman HF, Radke RA. Postendodontic restoration. In: Cohen and Burns, eds. Pathways of the Pulp. 4th Ed. St Louis, MO: CV Mosby;1987:640-643.
  24. Libman WJ, Nicholls JI. Local fatigue of teeth restored with cast posts and cores and complete crowns. Int J Prosthodont 1995;8:155-161.
  25. Torbjorner A, Karlsson S, Odman PA. Survival rate and failure characteristics for two post designs. J Prosthet Dent 1995;73(5):439-444.
  26. Newcomb GM..The relationship between the location of subgingival crown margins and gingival inflammation. J Periodontol. 1974;5(3):151-154.
  27. Koslovsky A, Tal H, Lieberman M. Forced eruption combined with gingival fiberotomy. A technique for clinical crown lengthening. J Clin Periodontol 1988;15(9):534-538.
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