Restorative Strategies for Endodontically Treated Teeth with Extensive Structural Loss: A Narrative Review

The mechanical characteristics of damaged anterior teeth that have received endodontic treatment procedures may ultimately be impacted by intra-radicular restoration. With significant structural loss, fiber-reinforced composite (FRC) posts are frequently recommended as an alternative to metal posts because they possess a higher elasticity modulus, thus tending to increase the chances of root fractures. However, with continual advancements in adhesive restorations, reinforced resin composite materials have recently been offered as possible substitutes for FRC or metal posts. These alternatives provide improved bonding capabilities and can further enhance the longevity of the restoration. This narrative review aimed to accumulate data on various post and core buildup protocols as well as the effect they have on anterior teeth’s fracture resistance following endodontic treatment. The findings suggest that the choice of post and core materials significantly influences the longevity and durability of the restored teeth. By evaluating different protocols, clinicians can make informed decisions to optimize treatment outcomes. We concluded that while each approach has benefits and drawbacks, all can be used effectively for post-endodontic reinforcement. Despite this, traditional fiber posts and composite cores provide higher fracture strength in comparison with the reinforced composite core material alone, particularly in situations when the coronal portion of the tooth has been severely destructed.