[Build-up restorations after extensive loss of tooth tissue]

After (extensive) loss of tooth tissue, vital teeth can be built up completely with composite restoration material. Sometimes, the application of additional retentive preparations is indicated. In exceptional cases, a root canal treatment is indicated, following which a root canal post is applied if necessary. Endodontically treated multi-rooted teeth can be built up entirely with composite, utilizing the pulp chamber and root canal accesses for retention. However, in single-rooted teeth a root canal post is necessary, in which case a prefabricated root post is used. Traditionally, metal posts were used in combination with a cast, indirect build-up restoration. Subsequently, directly fabricated cores, combining metal posts with amalgam or, at the present time, composite restoration material, became customary. The present trend is to use prefabricated or individually fabricated fibre-reinforced posts. After restoring a tooth with a build-up restoration, a combined build-up restoration can be chosen, or a direct or indirect crown single tooth prosthesis.