Coronal Restoration of Endodontically Treated Teeth: Current Trends and Predictable Outcomes

Restoring endodontically treated teeth represents a major challenge in dental practice, with the primary goal of restoring functionality and preventing long-term complications. Current studies highlight that the success of endodontic treatment is closely correlated not only with the quality of the root canal filling but especially with that of the crown restoration.

Depending on the extent of tooth structure loss, direct or indirect restorations (inlays, onlays, endocrowns) may be used, with the selection guided by biomechanical and aesthetic criteria. The use of root posts remains controversial, with the literature indicating that they do not directly increase tooth strength but may contribute to restoration retention in cases of extensive crown loss. In this context, the ferrule effect is considered crucial for a favourable prognosis.

Advances in adhesive materials and techniques have enabled the development of modern solutions, such as universal adhesives and dual-cure resin cements, that provide a stable, durable adhesive interface. Additionally, short-fibre-reinforced composites offer superior biomechanical properties, mimicking dentin behaviour and reducing fracture risk.

Restorative failures are frequently associated with the degradation of adhesion and the organic dentin matrix. To counteract these processes, rigorous clinical protocols are recommended, including effective root canal cleaning, the use of conditioning agents (EDTA), the application of chlorhexidine, and optimised adhesive techniques.

In conclusion, the success of restorations in endodontically treated teeth depends on integrating the principles of adhesive dentistry, preserving the remaining tooth structure, and selecting appropriate materials and techniques, with the aim of improving durability and clinical performance.