Key Points
-
A consideration of the impact of crowning on the dental pulp, and the special issues involved in crowning root-treated teeth.
-
The damaging effects of crown preparation.
-
Assessment and preparation of root-treated and non root-treated teeth to minimize endodontic complications.
-
Special considerations in the temporisation and restoration of root-treated teeth.
Key Points
Crowns and extra-coronal restorations:
-
1
Changing patterns and the need for quality
-
2
Materials considerations
-
3
Pre-operative assessment
-
4
Endodontic considerations
-
5
Jaw registration and articulator selection
-
6
Aesthetic control
-
7
Cores for teeth with vital pulps
-
8
Preparations for full veneer crowns
-
9
Provisional restorations
-
10
Impression materials and technique
-
11
Try-in and cementation of crowns
-
12
Porcelain veneers
-
13
Resin bonded metal restorations
Abstract
Endodontic considerations is the fourth in the series on crowns and other extra-coronal restorations. This article focuses strongly on contemporary biological principles, and is not intended to provide a comprehensive review of commercially available materials and techniques. Principles are illustrated in a variety of clinical case scenarios.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Randlow K, Glanz PO On cantilever loading of vital and non vital teeth: an experimental clinical study. Acta Odontol Scand 1986; 44: 271–277.
Zach L Pulp lability and repair: effect of restorative procedures. Oral Surg 1972; 33: 111–121.
Pashley DH Clinical considerations of microleakage. J Endod 1990; 16: 70–77.
Cox CF, Subay RK, Suzuki S, Suzuki SH, Ostro E Biocompatibility of various dental materials: pulp healing with a surface seal. Int J Periodont Rest Dent 1996; 16: 241–251.
Bergenholtz G Iatrogenic injury to the pulp in dental procedures: aspects of pathogenesis, management and preventive measures. Int Dent J 1991; 41: 99–110.
Seltzer S, Bender IB The Dental Pulp 3rd Edition pp 324–348 Philadelphia: Lippincott 1984.
Abou-Rass M The stressed pulp condition: An endodontic-restorative diagnostic concept. J Prosthet Dent 1986; 48: 264–267.
Bergenholtz G, Nyman S Endodontic complications following periodontal and prosthetic treatment of patients with advanced periodontal disease. J Periodontol 1984; 55: 63–68.
Felton D, Madison S, Kanoy E, Kantor M, Maryniuk G Long term effects of crown preparation on pulp vitality. J Dent Res 1989; 68 (special issue): 1009.
Landolt A, Lang NP Erfolg und misserfolg bei extensionsbrucken. Schweiz Monat Zahnmed 1988; 98: 239–44 [German with English abstract].
Reichen-Graden S, Lang NP Periodontal and pulpal conditions of abutment teeth. Schweiz Monat Zahnmed 1989; 99: 1381–1385.
Gonzalez G, Wier DJ, Helm F, Marshall SJ, Walker L, Stoffer W et al. Incidence of endodontic treatment in teeth with full coverage restorations. J Dent Res 1991; 70 (special issue): 446.
Valderhaug J, Jokstad A, Ambjornsen E, Norheim PW Assessment of the periapical and clinical status of crowned teeth over 25 years. J Dent 1997; 25: 97–105.
McLean JW The Science and Art of Dental Materials. Vol. 1 p59 Chicago: Quintessence 1979.
Madison S, Jordan RD, Krell KV The effect of rubber dam retainers on porcelain fused-to-metal restorations. J Endod 1986; 12: 183–186.
Dental Protection Annual Report of the Board 1996; 8: 22.
Cohen S In Cohen S, Burns R C. (eds). Pathways of the Pulp. 6th edn pp 2–24 St Louis: Mosby 1994.
Khayat A, Lee SJ, Torabinejad M Human saliva penetration of coronally unsealed obturated root canals. J Endod 1993; 19: 458–461.
Walton R, Torabinejad M Principles and Practice of Endodontics 2nd edn. Baltimore: Saunders 1996.
Pitt-Ford TR Harty's Endodontics in Clinical Practice 4th edn. Oxford: Wright 1997.
Clements RE, Gilboe DB Labial endodontic access opening for mandibular incisors: Endodontic and restorative considerations. J Can Dent Assoc 1991; 57: 587–589.
Langeland K, Langeland LK Pulp reactions to cavity and crown preparation. Aust Dent J 1970; 15: 261–276.
Langeland K, Langeland LK Cutting procedures with minimized trauma. J Am Dent Assoc 1968; 76: 991–1005.
Bergenholtz G, Cox C, Loesche WJ, Syed SA Bacterial leakage around dental restorations: its effect on the dental pulp. J Oral Pathol 1982; 11: 439–450.
Goldman M, Laosonthorn P, White RR Microleakage: full crowns and the dental pulp. J Endod 1992; 18: 473–475.
Cox CF, Suzuki S Re-evaluating pulp protection: Calcium hydroxide liners vs. cohesive hybridization. J Am Dent Assoc 1994; 125: 823–831.
Sorensen JA, Martinoff JT Intracoronal reinforcement and coronal coverage: a study of endodontically treated teeth. J Prosthet Dent 1984; 51: 781–784.
Morgano SM Restoration of pulpless teeth: an application of traditional principles in present and future contexts. J Prosth Dent 1996; 75: 375–380.
Edmunds DH, Dummer PM H Root canal retained restorations: 1. General considerations and custom-made cast posts and cores. Dent Update 1990 June 183–188.
Dummer PMH, Edmunds DH Root canal retained restorations: 2. Prefabricated post and core systems – (i) Non-threaded posts. Dent Update 1990; July/August; 244–249.
Dummer PMH, Edmunds DH Root canal retained restorations: 2. Prefabricated post and core systems – (ii) Threaded posts. Dent Update 1990; September; 286–289.
Edmunds DH, Dummer PM H Root canal retained restorations revisited. Dent Update 1993 January/February 14–19.
de Cleen M J H The relationship between the root canal filling and post space preparation. Int Endod J 1993; 26: 53–58.
Torbjorner A, Karlsson S, Odman PA Survival rate and failure characteristics for two post designs. J Prosthet Dent 1995; 73: 439–444.
Standlee JP, Caputo AA, Collard EW, Pollack MH Analysis of stress distribution by endodontic posts. Oral Surg 1972; 33: 952–960.
Weine FS, Wax AH, Wencus CS Retrospective study of tapered smooth post systems in place for 10 years or more. J Endodont 1991; 17: 293–297.
Creugers NHJ, Mentink AGB, Kayser AF An analysis of durability data on post and core restorations. J Dent 1993; 21: 281–284.
Deutsch AS, Cavallari J, Musikant BL et al. Root fracture and the design of prefabricated posts. J Prosthet Dent 1985; 53: 637–640.
Cohen BI, Musikant BL, Deutsch AS A 10-year literature review of a split-shanked threaded post. Compend Cont Educ Dent 1995 16: 630–631.
Saunders WP, Saunders EM Coronal leakage as a cause of failure in root-canal therapy: a review. Endod Dent Traumatol 1994; 10: 105–108.
Tjan AHL, Nemetz H Effect of eugenol-containing endodontic sealer on retention of prefabricated posts luted with adhesive composite resin cement. Quintessence Int 1992; 23: 839–844.
Haddix JE, Mattison GD, Shulmann CA et al. Post preparation techniques and their effect on the apical seal. J Prosth Dent 1990; 64: 515–519.
Fox K, Gutteridge DL An in vitro study of coronal microleakage in root-canal-treated teeth restored by the post and core technique. Int Endod J 1997; 30: 361–368.
Ferrari M, Vichi A, Mannocci F, Mason PN Retrospective study of the performance of fiber posts. Amer J Dent 2000; 13 (special issue): 9B–13B.
Nayyar A, Walton RE, Leonard LA An amalgam coronal-radicular dowel and core technique for endodontically treated posterior teeth. J Pros Dent 1980; 43: 511–515.
Saupe WA, Gluskin AH, Radke RA A comparative study of fracture resistance between morphologic dowel and cores and a resin-reinforced dowel system in the intraradicular restoration of structurally compromised roots. Quintessence Int 1996 27: 483–491.
Author information
Authors and Affiliations
Corresponding author
Additional information
Refereed paper
Rights and permissions
About this article
Cite this article
Whitworth, J., Walls, A. & Wassell, R. Crowns and extra-coronal restorations: Endodontic considerations: the pulp, the root-treated tooth and the crown. Br Dent J 192, 315–327 (2002). https://doi.org/10.1038/sj.bdj.4801365
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.bdj.4801365
This article is cited by
-
Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis
BMC Oral Health (2023)
-
Onlays/partial crowns versus full crowns in restoring posterior teeth: a systematic review and meta-analysis
Head & Face Medicine (2022)
-
Radiographic periapical healing associated with root-treated teeth accessed through existing crowns: a historical controlled cohort study
Clinical Oral Investigations (2021)
-
The Dental Practicality Index – assessing the restorability of teeth
British Dental Journal (2017)
-
Contemporary issues in the provision of restorative dentistry
British Dental Journal (2012)
