Restoring endodontically treated teeth with posts and cores--a review.

Area of Science:

• Restorative Dentistry
• Endodontics
• Prosthodontics

Background:

• The long-term success of endodontically treated teeth relies heavily on both the endodontic procedure and the subsequent restorative approach.
• The decision to utilize posts for core retention is a critical factor influencing prognosis.

Purpose of the Study:

• To establish evidence-based guidelines for the prosthetic rehabilitation of endodontically treated teeth using posts and cores.
• To clarify indications, material selection, and critical dimensions for post-retained restorations.

Main Methods:

• A comprehensive literature review was conducted to synthesize current evidence.
• Guidelines were formulated based on findings from in vitro studies and limited clinical data.

Main Results:

• Posts are indicated for core retention primarily when one or no coronal walls remain.
• A minimum 2mm ferrule preparation is essential, and post length should ensure a 4-6mm apical seal.
• Fiber posts are preferred over ceramic posts due to lower fracture risk and retrievability; adhesive fixation is recommended for shorter posts.
• Composite resins are suitable core materials. Posts are advised when endodontically treated teeth serve as abutments for removable partial dentures.

Conclusions:

• Current guidelines are primarily derived from in vitro evidence (IIa/IIb), highlighting a need for more robust randomized clinical trials.
• The significance of remaining tooth structure in post and core indications is often underestimated in research and practice.
• Further prospective clinical studies are necessary to refine treatment protocols for endodontically treated teeth.