Q U I N T E S S E N C E I N T E R N AT I O N A L

ENDODONTICS

Richard D.
Trushkowsky

Restoration of endodontically treated teeth:

Criteria and technique considerations
Richard D. Trushkowsky, DDS1
The restoration of endodontically treated teeth is often
required and may represent a challenge as there is no consensus on ideal treatment. The failure of endodontically treated
teeth is usually not a consequence of endodontic treatment,
but inadequate restorative therapy or periodontal reasons.
Prior to the initiation of endodontic treatment the restorability,
occlusal function, periodontal health, biologic width, and
crown-to-root ratio need to be assessed. If acceptable, the
appropriate technique, material, and type of restoration to re-

store function need to be considered. Posts are used to provide

retention for the core material and to replace missing tooth
structure. The residual amount of tooth structure will determine its stability for restoration. The creation of adequate ferrule (approaching 2 mm circumferentially is ideal) minimizes
the damaging eects of lateral and rotational forces on the
restoration and post. (Quintessence Int 2014;45:557567;
doi: 10.3290/j.qi.a31964)

Key words: core, endodontically treated tooth, post

Caries and trauma are the most frequent causes of irreversible pulp damage resulting in root canal therapy. The
restoration of these endodontically treated teeth is often
required and may represent a challenge as there is no
consensus on ideal treatment. However, endodontically
treated teeth have been reported to have a reduced
survival rate compared to vital teeth.1 The failure of endodontically treated teeth is usually not a consequence of
endodontic treatment, but inadequate restorative therapy or periodontal reasons.2 Excessive removal of tooth
structure during mechanical instrumentation of the root
canal system, mechanical pressures during obturation,
lack of cuspal protection, and large restorations can
1

Clinical Associate Professor, Associate Director, The Advanced Program for

International Dentists in Esthetic Dentistry, New York University College of Dentistry, New York, USA.

Correspondence: Dr Richard D. Trushkowsky, The Advanced Program

for International Dentists in Esthetic Dentistry, New York University College of Dentistry, 345 E 24th St, New York, NY 10010, USA. Email: rt587@
nyu.edu

VOLUME 45 NUMBER 7 JULY / AUGUST 2014

weaken the tooth. The prognosis of endodontically

treated teeth is contingent not only on apical seal but
also on the coronal sealing of the canal thereby reducing
leakage of oral uids and bacteria into the periradicular
areas (Fig 1).3 The neurosensory response apparatus is
impaired with the removal of the pulpal tissue, which
may result in decreased protection of the endodontically

bacteria

Fig 1 The coronal seal is

important to prevent microleakage. Decementation and
micromovement produce
microleakage. Where there is
presumed shrinkage, the bacteria can inltrate, causing
secondary decay.

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treated tooth during mastication.4 Prior to the initiation

of endodontic treatment the restorability, occlusal function, periodontal health, biologic width, and crown-toroot ratio need to be assessed. If acceptable, the appropriate technique, material, and type of restoration to restore function need to be considered.5 An ideal
permanent restoration should restore esthetics and function, and protect the endodontically weakened tooth.6

Class V teeth have no remaining walls, and a post

will be required to provide retention for core material. A ferrule, which is characterized by a
360-degree metal crown collar surrounding parallel
walls of dentin and extending coronal to the shoulder of the preparation, would greatly increase the
fracture resistance of the tooth.14 If a ferrule cannot
be obtained, surgical crown lengthening or forced
eruption may be required.

INDICATIONS FOR A POST

The indications for a post have been modied in recent
years based on the advantages of adhesive restorations, which may obviate the need for posts.7 Posts are
used to provide retention for the core material and to
replace missing tooth structure. The residual amount of
tooth structure will determine its stability for restoration. Preparation for pulpal access diminishes mechanical strength by about 5%, but a mesio-occlusal-distal
(MOD) cavity will result in a 63% reduction in strength.7
The importance of the marginal ridge was specied by
Strand et al.8 The loss of tooth vitality does not result in
a substantial change in moisture content compared to
vital teeth.9 Unfortunately, the degree of remaining
tooth structure left to require a post has not been delineated. Preoz et al7 established ve classes depending
on the number of axial cavity walls remaining:
Class 1 teeth have four remaining cavity walls, with
a thickness greater than 1 mm. In this case, it was
felt a post is not necessary and any nal restoration
can be utilized.10
Class II and Class III have two or three remaining
cavity walls. These teeth can possibly be restored
without a post. The use of an adhesive core can
provide adequate fracture resistance without the
need for a post.11
Class IV teeth have one remaining wall, and the core
material will provide minimal or no eect on the
fracture resistance of the endodontically treated
tooth.12 The use of the tooth as an abutment for a
xed or removable partial denture will result in
reduced fracture resistance as a consequence of
crown preparation.13

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INDICATIONS FOR A CROWN

Baba and Goodacre15 suggest that most endodontically
treated posterior teeth require a crown for longevity.
However, although crowns improve the success of posterior teeth, this was not demonstrated for anterior
teeth.16 Anterior teeth with minimal loss of tooth structure can be conservatively restored with composite in
the lingual access opening and no post.17 A post provides
minimal or no benet for a structurally sound tooth.18
Many classical indications for the use of a crown
have also been questioned.19 Unfortunately, the literature is equivocal as to the requirement for full coverage, although cuspal coverage is often recommended.
Rocca and Krejci20 report that currently available
adhesive techniques permit the use of direct composites
and an endocrown (a circular butt-joint margin and a
central retention cavity inside the pulp chamber, lacking
intraradicular anchorage). The basis of this technique is
to use the surface available in the pulpal chamber to
assume the stability and retention of the restoration
through adhesive procedures. The endocrowns provide
full occlusal coverage and the use of the pulp chamber
increases the available surfaces for adhesion.
A variety of materials can be used including feldspathic porcelain, glass ceramic (eg, IPS e.max, Ivoclar
Vivadent), or CAD/CAM blocks of either ceramic or
composite or combinations of the two (Lava Ultimate
Restorative, 3M ESPE). Molars can more readily be utilized in this fashion. Premolars are more in danger if
canine guidance is absent as group function may permit a combination of both axial and shear forces on the
premolar cusps.

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Fig 2

Fig 3

A wide variety of post shapes and materials is available.

An anatomic glass ber post conforms to the root shape.

DESIGN AND TYPE OF POSTS

Posts can be active (most retentive, eg, ParaPost XT,
Coltne Whaledent; Flexipost, Essential Dental Systems), passive parallel or passive tapered (least retentive, eg, ParaPost Taper Lux, Coltne Whaledent), double tapered (DT Light-Post Illusion X-RO, Bisco), or parallel tapered (TENAX Fiber White, Coltne Whaledent;
ParaPostXP No-Ox, Coltne Whaledent). Regarding post
shape, parallel-sided posts provide better retention,
less stress formation, and increased fracture resistance
than tapered posts.21
Regarding surface design, serrated posts provide
better retention than smooth-sided posts, and
threaded posts provide even better retention (Fig 2).22
An increase in post length has also been shown to
be benecial, but an apical seal of approximately 5 mm
of gutta-percha is required.23 Excessive length can also
become detrimental as the dentin in the apical third is
very thin and perforation or increasing root fracture can
become a possibility. The length of custom metal posts
is usually recommended as two-thirds to three-quarters

VOLUME 45 NUMBER 7 JULY / AUGUST 2014

Fig 4 A glass ber post provides a degree of light conduction

into the canal and allows more complete polymerization. (Courtesy of Coltne Whaledent.)

of root length, and equal to or more than the length of

the crown to be fabricated.24
Posts can be metallic (either custom cast posts or
prefabricated) or ber (custom [Fig 3] or prefabricated).
Since their introduction in 1990,25 ber posts have
changed in shape and mechanical physical properties.
Initially the posts were quartz or carbon ber but now
most are glass bers, possessing a translucency that
makes an esthetic restoration more easily obtainable.
They also allow some degree of light transmission so
that dual-cure cement can be used (Fig 4),26 as the
translucency helps to provide adequate polymerization
of dual-cure cements. However, the light intensity at
the apical portion may be inadequate because of the
distance from the light source and the light-scattering
nature of the resin cement and the post. The quantity of
light that is absorbed, reected, and transmitted seems
to be related to the resin matrix, the ber composition
of each post, and the intensity of the light source.27
Post shapes have been modied from a retentive
shape to cylindrical or oval, which is more anatomical.
Posts of this type provide better adaptation and
remove less remaining root dentin.28

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Fractured Post
and Crown

Fractured
root

Fractured Post
and Crown

Vector of
Force

Fractured
root

Vector of
Force
Vector of Force

Vector of Force
b

Figs 5a and 5b Failure can be more catastrophic with a metal post than a glass ber post. (a) Potential fracture location with glass
berreinforced composite posts. (b) Potential fracture location with metal posts.

parallel
post
space

1+ mm

1+ mm

Teeth restored with metal posts many times fail

catastrophically with root fracture (Fig 5). The most
frequent cause of failure in teeth reconstructed with
ber posts is not root fracture but debonding of the
post, which can occur at the post-cement interface
and/or between cement and root dentin.29
Boschian et al30 underscored the eect of elastic
modulus of the post material on stresses transferred to
tooth structures as an important factor. They reported
that post materials that have a higher elastic modulus
than dentin are capable of causing dangerous and nonhomogenous stresses in root dentin. The authors concluded that the arrangement that best preserves the
integrity of the root, post, and core unit is when ber
posts are used for restoration. Unlike cast posts, post

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narrow
walls

<1 mm

Fig 6 An ideal post should t the

morphology of the canal and not
remove unnecessary tooth structure.

length, post diameter, or taper of the post do not meaningfully aect the adhesion and the long-term behavior
of glass ber posts. However, the low modulus of elasticity of ber posts (which is similar to dentin) creates a
root strain similar to that of an intact tooth at 8 to
10 mm, and a shorter length (5 mm) causes reduction of
the absorptive forces of the post system. This creates a
transfer of forces to the less rigid dentin in the cervical
area and possible fracture.31 In addition, glass ber
posts are biocompatible and their esthetic appearance
does not cause discoloration at the gingival margin.32
Endodontically treated teeth that are used as abutments for xed partial dentures (FPDs) have a higher
failure rate than vital abutment teeth.33 The FPD can
consist of a short span, long span, or be cantilevered.

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These abutment teeth undergo both horizontal and

torqueing forces when used for FPDs or removable
partial dentures (RPDs).33,34

CEMENTS AND CEMENTATION

The main reason for failure of glass ber posts is
debonding, which occurs mainly because of the diculties in achieving proper adhesion to intraradicular
dentin and to the post.35 Posts cemented with composite cements exhibit enhanced retention, and the roots
are more fracture-resistant because of more uniform
stress distribution.36
Dual-cured resin cements and adhesive systems are
usually suggested as merging self-curing and lightcuring. Despite the use of two initiation systems by
some products, adequate light transmission is required
to get light activation and the best results.37
Self-adhesive cements have been promoted as
being simpler and less technique-sensitive, but some of
them demineralize the dentin, and the depth of resin
penetration is not equivalent. In addition, residual
acidic monomers may be present, reducing adhesion
capabilities.38 However, some studies favor the use of
self-adhesive cements.39 The retention of glass ber
posts that had been pretreated with silane has been
reported to be higher compared with posts that were
not pretreated or that were pretreated with other products.40 However, ber-reinforced posts that have highly
cross-linked polymers in the matrix do not have functional groups that can chemically interact with silane.
Microabrasion with 50-mm aluminum oxide at 2.8
bar (0.28 MPa) pressure for 5 seconds has also been
shown to increase surface area and minimize damage.41
Another problem is the bond to intraradicular dentin,
as it is variable. The number of tubules declines toward
the apical region, and the ratio between the peritubular
and intertubular dentin changes signicantly from the
apical to the coronal third.42
An ideal adaptation of the post is a crucial factor for
an adequate cement thickness, as the clinical success of
a tooth rebuilt with a glass ber post is given mainly by
its ability to limit root dentin removal and to t to it.

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Fig 7 Fiber post with surrounding Quartz Splint Unidirectional. (Courtesy of RTD
Dental.)

Fig 8 Fiber post with accessory Fibercones. (Courtesy of

RTD Dental.)

The availability of ber posts with dierent shapes

reects the dierent morphologies of human root
canals that they need to t (Fig 6). Root canal crosssectional shapes can be classied as round, oval, long
oval, attened, or irregular. Among these, the oval and
long oval shapes are the most common. Recently, a
new type of ber post and ber mesh (Fibercone, a
small, slender ber post, and pre-cut sections of Quartz
Splint Unidirectional; RTD) that address the problem of
restoring wide, oval, ared, or otherwise large or irregularly shaped root treatment spaces in combination with
a master ber post and any resin cement and core composite, has been introduced to avoid excessive removal
of residual dentin and to obtain a more uniform
cement layer (Figs 7 and 8).43 If the post does not t
well, there will be an excessively thick layer of cement,
especially at the coronal level, where air bubbles or
voids could be incorporated, predisposing to debonding. Many authors have investigated the inuence of
cement thickness on the bond strength of ber posts.
As yet, there is no agreement in the literature on the
ideal cement thickness or on the inuence of voids
(gaps, air bubbles, emptiness within the cement layer,
or at the post-cement and cavity-wallcement interface) on the bond strength of ber posts and their clinical consequence.

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The application of NaOCl could act as a polymerization inhibitor of resin materials due to the formation of
an oxygen-enriched dentin surface.44 However, NaOCl
is the most commonly used irrigant because it has the
ability to remove the smear layer, which is created on
the dentin surface during the post space preparation.
The removal of the smear layer, which contains organic
and inorganic components, sealer and gutta-percha
remnants, microorganisms, and infectious deteriorated
dentin is necessary for the penetration of the adhesive
system and resin cement into the dentin tubules.45 Ideally the root canal should be irrigated with chlorhexidine (eg, Endo-CHX, Essential Dental Systems) or sterile
saline solution before post cementation in order to
eliminate the negative eect of NaOCl on the adhesive
bond to dentin. The smear layer, consisting of sealer
and gutta-percha remnants, is plasticized by the heat of
the drill bur during the post space preparation, and can
act as insulation against any kind of adhesive material
intended to bond to the root canal dentin.46 In addition,
this smear layer can also reduce the chemical action of
orthophosphoric acid to provide an ideal bonding substrate. GuttaFlow (Coltne Whaledent) can be used to
ll the canal, and this contains a silicone that can also
make the smear layer more resistant to acid etching.47

FERRULE
A dental ferrule is an encompassing band of cast metal
around the coronal surface of the tooth. The ferrule may
resist stresses such as functional lever forces, the wedging eect of tapered posts, and the lateral forces exerted
during the post insertion.48 Some clinicians interpret the
ferrule as the amount of dentin above the nish line but
it is the denite bracing of the crown encompassing the
tooth structure that establishes the ferrule.
Eissmann and Radke49 discussed the importance of
the ferrule eect for preventing tooth fracture and recommended a ferrule height of at least 2 mm. Libman
and Nicholls50 compared the eect of dierent ferrule
heights (0.5, 1.0, 1.5, and 2.0 mm) of a maxillary incisor
under fatigue loading. They found the minimum
1.5-mm ferrule height meaningfully improved crown

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resistance. This in vitro study tested the breakage of

cement seal (which can lead to secondary caries, crown
dislodgement, or tooth fracture) in a clinically pertinent
manner using dynamic repetitive loading.50 In addition,
ferrule eect increases the post/core ratio and prevents
the luting cement from being washed away, in turn
improving post retention. Hsu et al51 demonstrated that
the total bonding area between dowel-core and tooth
structure meaningfully inuenced crown resistance. It
was demonstrated that the type of cement used for
both the dowel-core and crown can signicantly aect
the durability of the restoration and the tooth.51 Unfortunately, many of these studies were done on maxillary
central incisors and may not pertain to posterior teeth.
There are many factors that have to be considered in
the eectiveness of the ferrule: ferrule height, ferrule
width, number of walls, ferrule location, type of tooth,
lateral loads, type of post, and type of core material.52

Ferrule height
Most studies have indicated that a ferrule height of 1.5
to 2 mm of vertical tooth structure would be the most
benecial.53 The crown should encompass at least
2 mm past the tooth core connection to achieve the
most protective ferrule eect.54

Ferrule width
Esthetic restorations often require fairly aggressive
preparations at the gingival margin and sometimes
buccal defects such as abfraction may compromise the
buccal dentin wall. Generally it has been accepted that
the walls are considered too thin if they are less than
1 mm in thickness, and would negate the ferrule eect.
Therefore crown lengthening on teeth with conical
roots may add dentin height but the dentin width at
the margin may not be adequate.

Number of walls and ferrule location

A circumferential ferrule would be optimal but caries
may aect the interproximal areas and abrasion or erosion the buccal walls. A crown preparation will further
reduce the wall thickness and only a partial ferrule will
remain. Al-Wahadni and Gutteridge55 found having a

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3-mm ferrule on the buccal aspect was better than having no ferrule at all. It created a signicantly higher
resistance to fracture.55 Ng et al56 proposed that the
location of the sound tooth structure to resist occlusal
forces is more signicant than having a circumferential
dentin wall. The authors demonstrated that the presence of a palatal wall allowed resistance of forces
applied in function to a maxillary incisor. A maxillary
incisor with three walls present but no palatal wall
demonstrated poor fracture resistance.56 This may indicate that a partial ferrule provides a degree of fracture
resistance, although it is not as ideal as a 360-degree,
2-mm ferrule.

TYPE OF TOOTH AND

DIRECTION OF LOAD
Anterior teeth are loaded non-axially while posterior
teeth usually are loaded in an occluso-gingival direction. Lateral forces usually are more detrimental to the
tooth restoration interface. The restoration of anterior
or posterior teeth may require an altered approach.
Anterior teeth with a deep overbite and parafunction
are at a higher risk of failure. Posterior teeth with dierent occlusal arrangements and cuspal heights aect
the direction and nature of the load applied to each
tooth. Teeth that are in group function with long maxillary buccal cusps produce higher lateral forces than if
there was canine guidance. As the cusps wear, lateral
forces may be converted to vertical trajectories.57

TYPE OF POST
Clear guidelines for the selection of the type of post are
lacking.7 However, the existence of a 1.5- to 2-mm ferrule of sound coronal tooth structure is more important
than the post itself.58 Cast posts have been used for
many years for the support of the nal restoration.
However, in recent years this type of restoration has
been progressively replaced by composite cores with a
glass ber post or metal post.59 Fiber-reinforced posts
have found favorable use, notwithstanding their signicantly lower bearing values. Their performance is

VOLUME 45 NUMBER 7 JULY / AUGUST 2014

favorable because this type of post is shielding the

remaining tooth structure by failing in a more noncatastrophic form (Fig 5).

FIBER POST CEMENTATION AND

CORE BUILDUP
The literature on when to prepare the post space is
inconclusive. Gutta-percha or Resilon (eg, Epiphany,
Pentron Clinical Technologies) are removed with heat
(eg, System B, Sybron Endo) or with rotary instruments.60 Ideally there should be minimal enlargement
of the canal past that incurred during endodontic
instrumentation.
1. Select prefabricated post suitable for both the tooth
and the restoration being utilized.
2. Prepare the coronal residual tooth structure to
accommodate the crown with a minimal wall thickness 1.5 mm and determine if the post is going to
be fabricated by direct or indirect means depending
on residual tooth structure.
3. Determine the prerequisite preparation depth and
mark this length on the corresponding instruments
with silicone stoppers.
a. The remaining root canal lling from the post
terminus to the apex should be no shorter than
4 mm.
b. The length of the post within the canal should
be at least equal to coronal length of the nal
restoration.
4. Remove the root canal lling with a Gates-Glidden
or Peeso reamer to the desired length.
5. Prepare the post space to the same depth with the
appropriate size drill that corresponds to the size
post selected.
6. If necessary apply antirotation protection.
7. Rinse the canal and ush with alcohol.
8. Clean the canal with a CanalBrush (Coltne Whaledent) or similar.
9. Check proper t of the post
10. Shorten the post as necessary with rotary diamonds.
11. Fiber posts should be cleaned with phosphoric acid
for 60 seconds then washed and dried. Metal posts

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Fig 9 After etching with phosphoric acid,

the canal should be rinsed and dried with
high volume suction. (Courtesy of Premier
Dental.)

Fig 10 A dual-cured bonding agent

should be mixed and placed in the canal.
(Courtesy of Premier Dental.)

Fig 11 The bonding agent is placed in

the canal with a cylindrical microbrush.
(Courtesy of Premier Dental.)

Fig 12 An endo-tip allows the dual cure

cement to be placed in the canal without
bubble formation if it is kept immersed.
The post is placed immediately. (Courtesy
of 3M ESPE.)

Fig 13 An automix syringe with two different diameter tips expedites both placement of cement into the canal and the
core build-up. The cement is then allowed
to self-cure or it can be light-cured for 20
seconds. (Courtesy of Premier Dental.)

Fig 14 The nal core build is cured for 40

seconds. (Courtesy of Premier Dental.)

can be micro-etched and a metal primer applied

(eg, Alloy Primer, Kuraray).
12. Some ber posts benet from silane application (eg,
Monobond-S, Ivoclar Vivadent) for 60 seconds.
13. Air dry and do not touch with ngers.
14. Adhesive cementation of the post can be with
either a dual- or self-curing luting composite (eg,
Multilink Automix or Variolink II, Ivoclar Vivadent). A
total etch, self-etch, or an adhesive cement can be
used (eg, RelyX Ultimate Adhesive Resin Cement,
3M ESPE). If a total etch is used, place 37% phosphoric acid in the canal for 10 to 15 seconds. Irrigate
with water in an irrigating syringe, then use the
high volume vacuum and a paper point to dry the
canal (Fig 9).
15. Use the specic instructions of the cementation
system. If an adhesive is used (Fig 10), a paper point

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or preferably an endo brush is used to place the

dual-cured adhesive in the canal and remove excess
(longer cylindrical shape) (Fig 11).
16. If available, use an endo-tip to place the cement into
the canal (Fig 12). Immediately place the tted post.
17. If a dual-cure luting cement is used, polymerize for
20 seconds from the occlusal aspect of the post and
as near to the post as possible, or wait 5 minutes to
allow self-curing initially and then light cure (Fig 13).
18. Ideally the core can be built up using the same luting material. After proper contour is achieved of the
dual-cure material, light cure for a nal 40 seconds
(Fig 14). A highly lled core such as MultiCore Flow
or MultiCore HB (Ivoclar Vivadent) can be sculpted
as it is placed.
19. The tooth is then prepared for the nal restoration
located on 2 to 3 mm of natural tooth structure.

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11 mm
9 mm
7 mm

1.5 mm
(min.)

5 mm

Fig 16 A plastic post with GC Pattern

Resin is used to shape the post and
core.

11 mm
9 mm
7 mm

Fig 17 The pattern

is removed from the
mouth to be cast.

Fig 18 The cast post

duplicates the pattern
previously formed.

1.5 mm
(min.)

5 mm

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Figs 15a to 15e The ParaPost direct

technique for a cast post. (a) Post space
preparation. (b) Keyway. (c) Direct waxup on burnout post. (d) Provisional
crown with temporary post. (e) Final
cast post and core. (Courtesy of Coltne
Whaledent.)

Fig 19 The cast post is then cemented

and the preparation rened.

Figs 20a to 20e The ParaPost indirect

casting system will allow the laboratory
to create the post pattern. This is especially useful if multiple teeth are
involved. (a) Post space preparation. (b)
Impression with impression post. (c)
Provisional crown with temporary post.
(d) Wax-up with burnout post. (e) Final
cast post and core. (Courtesy of Coltne
Whaledent.)

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Alternatively a cast post can be fabricated directly

(Figs 15 to 19) using Pattern Resin LS (GC America) and
ParaPost Burnout Posts - Serrated and Vented (ParaPost
XP Casting System-Plastic Burnout, Coltne Whaledent), or an indirect casting technique with an impression post (ParaPost XP Casting System) (Fig 20).

CONCLUSION
The restoration of endodontically treated teeth encompasses many dierent materials and techniques. There
is no consensus of opinion on the need for a crown,
and in the anterior with only a lingual access a composite restoration will suce. Posts are only indicated
where inadequate tooth exists to retain a core if a
crown is required. Preparation for a post should wherever possible maintain coronal and radicular tooth
structure. No post is ideal for all clinical situations and
the selection of a post should depend on the tooth position in the arch, possible abutment, and occlusion. The
post should provide all the mechanical requirements to
restore the tooth. The creation of adequate ferrule
approaching 2 mm circumferentially would be ideal
and minimize the damaging eects of lateral and rotational forces on the restoration and post.

REFERENCES
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Long-term analysis of biologic and technical aspects of xed partial dentures
with cantilevers. Int J Prosthodont 2000;13:409415.
2. Vire DE. Failure of endodontically treated teeth: classication and evaluation.
J Endod 1991;17:338342.
3. Heling I, Gorl C, Slutzky H, Kopolovic K, Zalkind M, Slutzky-Goldberg I. Endodontic failure caused by inadequate restorative procedures: review and
treatment recommendations. J Prosthet Dent 2002;87:674678.
4. Randow K, Glantz P. On cantilever loading of vital and non-vital teeth. Acta
Odontol Scand 1986;44:271277.
5. Gulabivala K. Restoration of the root-treated tooth. In: Stock CJR, Gulabivala K,
Walker RT (eds). Endodontics, 3rd edition. Edinburgh: Elsevier Mosby,
2004:279305.
6. Goldman M, DeVitre R, Tenca J. A fresh look at posts and cores in multirooted
teeth. Compend Contin Educ Dent 1984;5:711715.
7. Preoz I, Blankenstein F, Lange K-P, Naumann M. Restoring endodontically
treated teeth with posts and cores: a review. Quintessence Int 2005;36;
737746.
8. Strand GV, Tvelt AB, Gjerdet NR, Bergen GE. Marginal ridge strength of teeth
with tunnel preparations. Int Dent J 1995;45:117123.
9. Papa J, Cain C, Messer HH. Moisture content of vital vs endodontically treated
teeth. Endod Dent Traumatol 1994;10:9193.

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