Clinical practice guidelines for choice of post-endodontic restorations

Abstract

The survival of the tooth after endodontic treatment is extremely important for the overall success and improvement of quality of life of the patient. This depends on the choice of the post-endodontic restoration. In the past, post-endodontics, it was advised to crown all teeth with full coverage restorations. Over the years, minimally invasive dentistry has become more popular among restorative dentists. Evidence has made clinicians and researchers realize that full coverage restorations are not advisable and that tremendous amounts of healthy tooth structure may be lost in the process. Recently, many more minimally invasive options are available to restore endodontically treated teeth. They include, partial coverage restorations, inlays, onlays, overlays, and even simple resin composite cores. Although this minimal approach is quite tempting, some teeth do require more coverage. There are numerous factors that must be studied before a choice of post-endodontic restoration is made including, the type of tooth, the occlusal load on the tooth, number of missing teeth, the amount of remaining healthy tooth structure, position of the tooth, etc. Apart from this, newer materials have been introduced by manufacturers like zirconias, lithium disilicate, leucite ceramics, etc. that provide better properties to the restorations The clinical decision making process might become quite confusing due to these reasons. A proper guideline is thus required, which includes all the parameters that need to be assessed before making a choice of post-endodontic restoration. Hence, this paper aims at reviewing the various options available today for post-endodontic restorations as well as formulating clinical practice guidelines to aid clinicians in making the correct choice of restoration of endodontically treated teeth.