Strategies for the Restoration of Minimally Invasive Endodontically Treated Teeth

Abstract

The amount of residual tooth structure is considered as the main factor to determine the survival of an endodontically treated tooth. Over the last years all the efforts in endodontics and restorative dentistry have been directed toward a paradigm shift from the traditional rules to a more conservative and minimally invasive approach, in order to preserve as much tooth structure as possible in all the procedures: from the access cavity preparation to the choice of the type of coronal restoration. In this perspective new trends in access cavity opening, the introduction of heat-treated NiTi alloys for root canal preparation and fiber-reinforcement for post fabrication have represented a great achievement. The restorative choice should be assessed even taking into high consideration the occlusion rules that still remain crucial to guide the clinician in a correct management of coronal restorations. Furthermore, most destructive decays can be detrimental for periodontal health: biological width and crown-root ratio become important concepts to be focused and orthodontic extrusion and surgical crown lengthening can be performed to provide a favorable ferrule effect and improve biomechanical behavior of the restored tooth.