RECONSTRUCTION OF TEETH WITH SIGNIFICANT STRUCTURAL LOSS AFTER ENDODONTICS

Abstract

Rehabilitation of endodontically treated teeth (ETT) with severe structural loss represents one of the greatest challenges in modern dentistry, requiring a balance between prosthetic retention and biomechanical resistance. This narrative review analyzes the scientific evidence from the last five years on reconstruction protocols. The findings confirm that the amount of remaining tooth structure is the main predictor of success, with the presence of the ferrule effect (1.5 to 2 mm dentin band) being indispensable for stability. In cases of loss of two or more coronal walls, the use of fiberglass or quartz posts is recommended because they have a modulus of elasticity similar to dentin, favoring stress distribution and reducing catastrophic fractures. As contemporary alternatives, endocrowns emerge with performance comparable to conventional crowns, promoting greater tissue preservation. It is concluded that treatment planning should be individualized, prioritizing materials that mimic dental biomechanical behavior and techniques that ensure clinical longevity for 10 years.