RESTORATIVE STRATEGIES IN ENDODONTICALLY TREATED TEETH: IMPACT ON MECHANICAL RESISTANCE

Abstract

Teeth that have undergone endodontic treatment exhibit biomechanical behavior distinct from vital teeth, requiring restorative approaches capable of compensating for the structural fragility acquired after root canal therapy. Inadequate choice of coronal rehabilitation can result in early failures, extensive fractures, and tooth loss. Therefore, this study aimed to synthesize and analyze the most recent scientific evidence on restorative strategies in endodontically treated teeth and their impact on mechanical resistance. Searches were conducted in the PubMed, SciELO (Scientific Electronic Library Online), and Google Scholar databases, using the terms "non-vital tooth," "dental restoration," "endodontics," "fracture resistance," and "dental materials." The studies showed that the clinical survival of these teeth depends mainly on the remaining structural integrity and the restoration's ability to redistribute occlusal stresses. It has been observed that conservative restorative interventions can be satisfactory when there is significant maintenance of coronal structure, while indirect adhesive approaches with cusp coverage tend to perform better in teeth with large cavities. Additionally, fiber-reinforced restorative materials have shown potential in modifying the fracture pattern, favoring less destructive failures. However, reports of failure related to excessive cuspid flexion, root fractures, and deficiencies in coronal sealing persist. Thus, it can be considered that the definition of the restorative strategy should be based on biomechanical and conservative criteria, considering the particularities of each clinical case, although the absence of standardized protocols and the limitation of long-term clinical studies indicate the need for further investigations to strengthen evidence-based decision-making.