Patel Shanil R, Youngson Callum, Jarad Fadi
Specialist in Endodontics, Endo 61 Dental Practice, 61 Church Road, Gately, Cheshire, SK8 4NG, United Kingdom.
Emeritus Professor, Liverpool Dental School, Faculty of Health and Life Sciences, University of Liverpool, L3 5PS, United Kingdom.
Br Dent J. 2025 Apr;238(7):508-516. doi: 10.1038/s41415-025-8401-4. Epub 2025 Apr 11.
Endodontic treatment is usually required because of significant coronal disease or traumatic tissue loss. The restoration of the subsequently endodontically treated tooth is also complicated by the reduction in its structural strength consequent to accessing the pulp chamber and the removal of radicular dentine during root canal instrumentation, alongside some alteration of dentinal properties during disinfection by chemical agents, prior to obturation. A loss of proprioceptive feedback, which may lead to increased loading, can place further stress on the already very compromised structure. This article considers the principles of restoring endodontically treated teeth: assessing restorability, providing a coronal seal to prevent reinfection, and gaining retention for a core where necessary, to restore aesthetics and function. Consideration is given to the patient and material factors that influence the decision to restore the treated tooth using direct or indirect restorations. Specific attention is given to anterior or posterior teeth and the various materials which may be used in their overall restoration with their associated, probable, longevity.
由于严重的冠部疾病或创伤性组织缺损，通常需要进行牙髓治疗。后续接受牙髓治疗的牙齿进行修复时，也会因进入髓腔和根管预备过程中去除根中牙本质导致结构强度降低而变得复杂，同时在根管充填前使用化学药剂消毒期间牙本质性质也会发生一些改变。本体感觉反馈的丧失可能导致负荷增加，这会给已经非常脆弱的结构带来进一步的压力。本文探讨了牙髓治疗后牙齿修复的原则：评估可修复性、提供冠部封闭以防止再次感染，以及在必要时为核获得固位，以恢复美观和功能。还考虑了影响使用直接或间接修复体修复治疗后牙齿决策的患者和材料因素。特别关注前牙或后牙以及可用于其整体修复的各种材料及其可能的使用寿命。
