Methods and techniques of morpho-functional restorations of endodontically treated teeth

Abstract

Background. The preservation of the natural tooth represents one of the fundamental objectives of contemporary dental medicine. In this context, endodontic treatment constitutes an essential therapeutic intervention for maintaining the functionality of dental units affected by inflammatory or pulpal necrotic processes. The evolution of endodontic instrumentation techniques, obturation materials, and disinfection protocols has led to a significant increase in the biological success rate of endodontic treatment [1,2]. However, the long-term survival of the endodontically treated tooth is not determined solely by the elimination of infection from the root canal system. Numerous clinical studies indicate that the prognosis of these teeth largely depends on the coronal restoration performed after endodontic treatment. In the absence of an adequate restoration, the endodontically treated tooth becomes susceptible to coronal or radicular fractures, even when the endodontic treatment is correctly performed [3]. Endodontically treated teeth present significant structural changes resulting from the loss of dental tissue caused by carious processes, previous restorations, and the preparation of the endodontic access cavity. These changes lead to altered biomechanical behavior of the tooth, causing a different redistribution of occlusal forces and increased vulnerability to functional stresses [4]. Specialized literature highlights that the mechanical resistance of the endodontically treated tooth is primarily influenced by the amount and distribution of the remaining dental tissue. Loss of coronal structural integrity leads to the occurrence of stress concentration areas, especially in the cervical region, where the transition between crown and root occurs [5]. In this context, the morpho-functional restoration of endodontically treated teeth should aim to restore structural integrity, achieve favorable redistribution of occlusal stresses, and ensure functional reintegration of the tooth within the stomatognathic system. The choice of restorative method must be based on the analysis of biomechanical factors such as the amount of remaining dental tissue, tooth position on the dental arch, occlusal stresses, and the properties of the restorative materials used [6,7].