DIRECT CLINICAL PERSPECTIVE: ADDRESSING THE CHALLENGES IN THE REHABILITATION OF ENDODONTICALLY TREATED TEETH
DOI:
https://doi.org/10.56238/levv17n57-074Keywords:
Non-Vital Tooth, Intraradicular Post, Ferrule, Finite Element Analysis, Fracture Resistance, Dental MaterialsAbstract
Objective: To critically analyze contemporary scientific evidence related to rehabilitation strategies for endodontically treated teeth, comparing intraradicular post systems and adhesive restorative approaches, with emphasis on the influence of the remaining coronal structure, ferrule effect, biomechanical behavior, and failure patterns. Methodology: Integrative literature review using the PubMed database, employing descriptors related to endodontically treated teeth, intraradicular posts, endocrowns, and fracture resistance. Longitudinal clinical studies, finite element analyses, in vitro investigations, and systematic reviews addressing biomechanical performance, functional fatigue, clinical survival, and restorative behavior were included. Data analysis was performed qualitatively and thematically. Results: The amount of remaining tooth structure and the presence of a cervical ferrule were shown to be the main prognostic factors for restorative longevity. Fiberglass posts presented more favorable biomechanical behavior when compared to metallic systems, promoting a more homogeneous stress distribution and predominantly repairable failure patterns. Clinical evidence indicates a higher survival rate in teeth with carefully considered post placement. Indirect adhesive restorations and endocrowns have demonstrated promising functional performance after cyclic fatigue simulation, especially when associated with appropriate adhesive protocols and structural preservation. Conclusion: Restorative decision-making in endodontically treated teeth should prioritize tissue preservation and analysis of the remaining coronal structure, considering that intraradicular posts act primarily as retention elements and not as structural reinforcement. Endocrowns represent a minimally invasive therapeutic alternative in selected cases, exhibiting favorable biomechanical behavior and more conservative failure patterns.
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References
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