All about Dowels - A Review Part I. Considerations before Cementation

Area of Science:

• Dentistry
• Endodontics
• Restorative Dentistry

Background:

• Restoration of non-vital teeth using the dowel-core technique is a complex and debated topic.
• Successful outcomes depend on various factors influencing the stability and longevity of the restoration.

Purpose of the Study:

• To review and assess factors impacting the successful restoration of root-filled teeth with root canal dowels.
• To discuss indications and physical parameters of dowel systems used in endodontic treatment.

Main Methods:

• A comprehensive literature search was conducted in the PubMed/Medline database.
• Keywords related to dowels and endodontic restorations were used to identify relevant articles.
• Selected articles were reviewed for their relevance to dowel systems in reconstructing endodontically treated teeth.

Main Results:

• The review included 51 articles, predominantly in vitro studies (49), with only two clinical studies.
• Literature suggests dowels primarily aid in core material retention, not structural reinforcement.
• Optimal dowel length is limited to 4-6 mm from the apical seal, and dowel width should be minimized.

Conclusions:

• Clinical data on dowel systems for restoring endodontically treated teeth is currently insufficient.
• Canal configuration influences the choice between prefabricated and custom cast dowels.
• Fiber-based dowels show potential for anterior teeth, but require further clinical validation.