Clinical Recommendation for Coronal Restoration of Endodontically Treated Teeth: Direct Resin Composite or Crown/Onlay?
Keywords:clinical guideline, coronal restoration, dental crown, endodontically treated teeth, resin composite
A post-endodontic coronal restoration is important to increase the success of endodontic treatment by providing a coronal seal and protection from fracture. The weakening of endodontically treated teeth is caused by significant loss of tooth structure, not from root canal procedures. In other words, the fracture resistance of endodontically treated teeth mainly depends on remaining tooth structure. The teeth with mild to moderate loss of tooth structure may be successfully restored with a bonded restoration (e.g. direct resin composite). In contrast, a more protective restoration such as a crown or onlay/overlay should be placed in the teeth with severely damaged tooth structure. In addition, other risk factors such as tooth type, parafunctional force, or function as abutment for prosthesis should also be considered. In this review, updated clinical guidelines for coronal restoration of endodontically treated anterior and posterior teeth were proposed, based on tooth type and other risk factors.
Chotvorrarak K, Suksaphar W, Banomyong D. A retrospective study of survival from unrestorable fracture in endodontically treated molars: the effect of single-unit full-coverage crowns vs. direct resin composite restorations. Restor Dent Endod. 2021; 46: e29.
Jirathanyanatt T, Suksaphar W, Banomyong D, Ngoenwiwatkul Y. Endodontically treated posterior teeth restored with or without crown restorations: A 5-year retrospective study of survival rates from fracture. J Investig Clinl Dent. 2019; 10: e12426.
Naumann M, Schmitter M, Krastl G. Postendodontic Restoration: Endodontic Post-and-Core or No Post At All? J Adhes Dent. 2018; 20: 19-24.
Suksaphar W, Banomyong D, Jirathanyanatt T, Ngoenwiwatkul Y. Survival Rates from Fracture of Endodontically Treated Premolars Restored with Full-coverage Crowns or Direct Resin Composite Restorations: A Retrospective Study. J Endod. 2018; 44: 233-8.
Phengudom P, Banomyong D, Jirathanyanatt T, Ngoenwiwatkul Y, Suksaphar W. Survival Rates of Unrestorable Fracture of Endodontically Treated Anterior Teeth Restored with Resin Composites or Crowns: A Retrospective Cohort Study. Iran Endod J. 2021; 16: 176-83.
Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 1995; 28: 12-8.
Tronstad L, Asbjørnsen K, Døving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol. 2000; 16: 218-21.
Gillen BM, Looney SW, Gu L-S, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod. 2011; 37: 895-902.
Taha NA, Messer HH. Restoration of the Root-Filled Tooth. Prim Dent J. 2016; 5: 29-35.
Papa J, Cain C, Messer HH. Moisture content of vital vs endodontically treated teeth. Endod Dent Traumatol. 1994; 10: 91-3.
Sedgley CM, Messer HH. Are endodontically treated teeth more brittle? J Endod. 1992; 18: 332-5.
Cheron RA, Marshall SJ, Goodis HE, Peters OA. Nanomechanical properties of endodontically treated teeth. J Endod. 2011; 37: 1562-5.
Awawdeh L, Hemaidat K, Al-Omari W. Higher Maximal Occlusal Bite Force in Endodontically Treated Teeth Versus Vital Contralateral Counterparts. J Endod. 2017; 43: 871-5.
Reeh ES, Messer HH, Douglas WH. Reduction in tooth stiffness as a result of endodontic and restorative procedures. J Endod. 1989; 15: 512-6.
Panitvisai P, Messer HH. Cuspal deflection in molars in relation to endodontic and restorative procedures. J Endod. 1995; 21: 57-61.
Adolphi G, Zehnder M, Bachmann LM, Göhring TN. Direct resin composite restorations in vital versus root-filled posterior teeth: a controlled comparative long-term follow-up. Oper Dent. 2007; 32: 437-42.
Atlas A, Grandini S, Martignoni M. Evidence-based treatment planning for the restoration of endodontically treated single teeth: importance of coronal seal, post vs no post, and indirect vs direct restoration. Quintessence Int. 2019; 50: 772-81.
Ibrahim AM, Richards LC, Berekally TL. Effect of remaining tooth structure on the fracture resistance of endodontically-treated maxillary premolars: An in vitro study. J Prosthet Dent. 2016; 115: 290-5.
Reeh ES, Douglas WH, Messer HH. Stiffness of endodontically-treated teeth related to restoration technique. J Dent Res. 1989; 68: 1540-4.
Al Amri MD, Al-Johany S, Sherfudhin H, Al Shammari B, Al Mohefer S, Al Saloum M, et al. Fracture resistance of endodontically treated mandibular first molars with conservative access cavity and different restorative techniques: An in vitro study. Aust Endod J. 2016; 42: 124-31.
Dioguardi M, Alovisi M, Troiano G, Caponio CVA, Baldi A, Rocca GT, et al. Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: a systematic review and meta-analysis. Clin Oral Investig. 2021; 25: 6597-621.
Frankenberger R, Winter J, Dudek MC, Naumann M, Amend S, Braun A, et al. Post-Fatigue Fracture and Marginal Behavior of Endodontically Treated Teeth: Partial Crown vs. Full Crown vs. Endocrown vs. Fiber-Reinforced Resin Composite. Materials (Basel). 2021; 14: 7733.
Taha NA, Palamara JE, Messer HH. Fracture strength and fracture patterns of root filled teeth restored with direct resin restorations. J Dent. 2011; 39: 527-35.
Thongbai-On N, Chotvorrarak K, Banomyong D, Burrow MF, Osiri S, Pattaravisitsate N. Fracture resistance, gap and void formation in root-filled mandibular molars restored with bulk-fill resin composites and glass-ionomer cement base. J Investig Clinl Dent. 2019; 10: e12435.
Banomyong D, Palamara JE, Messer HH, Burrow MF. Sealing ability of occlusal resin composite restoration using four restorative procedures. Eur J Oral Sci. 2008; 116: 571-8.
Schwartz RS, Robbins JW. Post placement and restoration of endodontically treated teeth: a literature review. J Endod. 2004; 30: 289-301.
Veríssimo C, Simamoto Júnior PC, Soares CJ, Noritomi PY, Santos-Filho PC. Effect of the crown, post, and remaining coronal dentin on the biomechanical behavior of endodontically treated maxillary central incisors. J Prosthet Dent. 2014; 111: 234-46.
Jurema ALB, Filgueiras AT, Santos KA, Bresciani E, Caneppele TMF. Effect of intraradicular fiber post on the fracture resistance of endodontically treated and restored anterior teeth: A systematic review and meta-analysis. J Prosthet Dent. 2022; 128: 13-24.
Furuya Y, Huang SH, Takeda Y, Fok A, Hayashi M. Fracture strength and stress distributions of pulpless premolars restored with fiber posts. Dent Mater J. 2014; 33: 852-8.
Magne P, Goldberg J, Edelhoff D, Güth J-F. Composite Resin Core Buildups With and Without Post for the Restoration of Endodontically Treated Molars Without Ferrule. Oper Dent. 2016; 41: 64-75.
Ramírez-Sebastià A, Bortolotto T, Cattani-Lorente M, Giner L, Roig M, Krejci I. Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Investig. 2014; 18: 545-54.
Valdivia AD, Raposo LH, Simamoto-Júnior PC, Novais VR, Soares CJ. The effect of fiber post presence and restorative technique on the biomechanical behavior of endodontically treated maxillary incisors: an in vitro study. J Prosthet Dent. 2012; 108: 147-57.
Magne P, Lazari PC, Carvalho MA, Johnson T, Del Bel Cury AA. Ferrule-Effect Dominates Over Use of a Fiber Post When Restoring Endodontically Treated Incisors: An In Vitro Study. Oper Dent. 2017; 42: 396-406.
Aurélio IL, Fraga S, Rippe MP, Valandro LF. Are posts necessary for the restoration of root filled teeth with limited tissue loss? A structured review of laboratory and clinical studies. Int Endod J. 2016; 49: 827-35.
Naumann M, Schmitter M, Frankenberger R, Krastl G. "Ferrule Comes First. Post Is Second!" Fake News and Alternative Facts? A Systematic Review. J Endod 2018; 44: 212-9.
Ferrier S, Sekhon BS, Brunton PA. A study of the fracture resistance of nyyar cores of three restorative materials. Oper Dent. 2008; 33(3): 305-11.
Kane JJ, Burgess JO, Summitt JB. Fracture resistance of amalgam coronal-radicular restorations. J Prosthet Dent. 1990; 63: 607-13.
Tangsripongkul P, Jearanaiphaisarn T. Resin Composite Core and Fiber Post Improved the Fracture Parameters of Endodontically Treated Maxillary Premolars with Wedge-shaped Cervical Lesions. J Endod. 2020; 46: 1733-7.
Ferrari M, Pontoriero DIK, Ferrari Cagidiaco E, Carboncini F. Restorative difficulty evaluation system of endodontically treated teeth. J Esthet Restor Dent. 2022; 34: 65-80.
Sorensen JA, Martinoff JT. Intracoronal reinforcement and coronal coverage: a study of endodontically treated teeth. J Prosthet Dent. 1984; 51: 780-4.
Mannocci F, Bertelli E, Sherriff M, Watson TF, Ford TR. Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration. J Prosthet Dent. 2002; 88: 297-301.
Suksaphar W, Banomyong D, Jirathanyanatt T, Ngoenwiwatkul Y. Survival rates against fracture of endodontically treated posterior teeth restored with full-coverage crowns or resin composite restorations: a systematic review. Restor Dent Endod. 2017; 42(3): 157-67.
Kaewchomphoo K, Banomyong D, Ngoenwiwatkul Y, Pumpaluk P. Comparison of the Survival Rate Against Fracture of Endodontically Treated Premolars with Exposed Cervical Lesions Restored with Crowns and Resin Composites: A Retrospective Study. Eur Endod J. 2022; 7: 27-32.
Fathi A, Ebadian B, Dezaki SN, Mardasi N, Mosharraf R, Isler S, et al. An Umbrella Review of Systematic Reviews and Meta-Analyses Evaluating the Success Rate of Prosthetic Restorations on Endodontically Treated Teeth. Int J Dent. 2022; 2022: 4748291.
Mario D, Mario A, Allegra C, Andrea B, Giuseppe T, Milena C, et al. The influence of indirect bonded restorations on clinical prognosis of endodontically treated teeth: A systematic review and meta-analysis. Dent Mater. 2022; 38: e203-e19.
Kassis C, Khoury P, Mehanna CZ, Baba NZ, Bou Chebel F, Daou M, et al. Effect of Inlays, Onlays and Endocrown Cavity Design Preparation on Fracture Resistance and Fracture Mode of Endodontically Treated Teeth: An In Vitro Study. J Prosthodont. 2021; 30: 625-31.
Govare N, Contrepois M. Endocrowns: A systematic review. J Prosthet Dent. 2020; 123: 411-8.
Thomas RM, Kelly A, Tagiyeva N, Kanagasingam S. Comparing endocrown restorations on permanent molars and premolars: a systematic review and meta-analysis. Br Dent J. 2020; https://doi.org/10.1038/s41415-020-2279-y.
Al-Dabbagh RA. Survival and success of endocrowns: A systematic review and meta-analysis. J Prosthet Dent. 2021; 125: 415 e1-e9.
Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J. 2022; 55 (Suppl 4): 1059-84.
Sorensen JA, Martinoff JT. Endodontically treated teeth as abutments. J Prosthet Dent. 1985; 53: 631-6.
Aquilino SA, Caplan DJ. Relationship between crown placement and the survival of endodontically treated teeth. J Prosthet Dent. 2002; 87: 256-63.
Nagasiri R, Chitmongkolsuk S. Long-term survival of endodontically treated molars without crown coverage: a retrospective cohort study. J Prosthet Dent.. 2005; 93: 164-70.
El-Ma'aita A, M AA-Ra, Abu-Awwad M, Hattar S, Devlin H. Endocrowns Clinical Performance and Patient Satisfaction: A Randomized Clinical Trial of Three Monolithic Ceramic Restorations. J Prosthodont. 2022; 31: 30-7.
da Silva PB, Duarte SF, Alcalde MP, Duarte MAH, Vivan RR, da Rosa RA, et al. Influence of cervical preflaring and root canal preparation on the fracture resistance of endodontically treated teeth. BMC Oral Health. 2020; 20: 111.
Atlas AM, Behrooz E, Barzilay I. Can bite-force measurement play a role in dental treatment planning, clinical trials, and survival outcomes? A literature review and clinical recommendations. Quintessence Int. 2022; 53: 632-42.
Banomyong D. Clinical considerations for non-vital tooth walking bleaching. Thai Endod J. 2022; 1: 33-42.
Copyright (c) 2023 Thai Endodontic Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Thai Endod Journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license, unless otherwise stated. Please read our Policies in Copyright for more information.