When to use fillers, build-ups or posts and cores

Area of Science:

• Dentistry
• Restorative Dentistry
• Prosthodontics

Background:

• Tooth preparation for crowns requires meticulous removal of existing restorative materials.
• Proper management of missing tooth structure is crucial for successful crown placement.
• Endodontically treated teeth with significant coronal loss present unique restorative challenges.

Purpose of the Study:

• To outline the recommended procedures for managing existing restorative materials and missing tooth structure prior to final crown preparation.
• To provide guidelines for selecting appropriate restorative materials for different extents of tooth loss.
• To detail the restorative protocols for endodontically treated teeth requiring significant coronal reconstruction.

Main Methods:

• Review of established dental restorative protocols.
• Analysis of material properties for fillers, build-ups, and post-and-core systems.
• Clinical recommendations based on the extent of tooth structure loss and endodontic status.

Main Results:

• Complete removal of old restorative materials is essential before final tooth preparation.
• Compomers are suitable for small areas of missing tooth structure.
• Bonded composite resin or amalgam build-ups are recommended for larger missing areas.
• Endodontically treated teeth with substantial coronal structure loss necessitate a titanium or titanium alloy post and core with a bonded build-up.

Conclusions:

• Adherence to these restorative guidelines ensures optimal foundation for dental crowns.
• Appropriate material selection and technique are critical for long-term restorative success.
• These protocols address common challenges in pre-prosthodontic tooth management.