Restoration of endodontically treated teeth/Build-ups, posts & pins

Factors to consider when deciding to restore a tooth with a core build-up

• Extent of the carious involvement.
• Restoration/remaining tooth structure..
• Success of endodontic treatment.
• Periodontal health status.
• Occlusion/function requirements.
• To resist fracture restorative techniques.
• Should conserve as much dentin as possible.
  
• Provide cuspal protection.

''Reagan concluded that a properly completed amalgam restoration with cuspal coverage has the same.''

Resistance to fracture as an unrestored tooth

• Composite and glass ionomer lack the physical and mechanical properties necessary to function as cusp coverage restorations and load bearing restorations in posterior teeth.
  

• Excellent results have been obtained in using composite to restore root canal treated teeth with minimal access preparation and most coronal tooth structure remaining.

• Cuspal coverage restorations of endodontically treated posterior teeth can be either a core material followed by a casting; or an amalgam core combination amalgam crown.

• Adequate retention can be achieved from the pulp chamber alone if its height is 4mm or greater.

• Condensing amalgam into canals, slots, amalgapins, and boxes improves retention.

• Self threaded pins are an option to increase retention but have inherent risks of crazing and cracking of the dentin or perforation into the PDL.

• Premolar teeth require post retention more often due to the smaller pulp chamber and dentin available for other internal retentive features.

Category: Conservative and Endodontics Notes