Build-up restorations after extensive loss of tooth tissue
After (extensive) loss of tooth tissue, vital teeth can be built up completely with composite restoration material. Sometimes, the application of additional retentive preparations is indicated. In exceptional cases, a root canal treatment is indicated, following which a root canal post is applied if necessary. Endodontically treated multi-rooted teeth can be built up entirely with composite, utilizing the pulp chamber and root canal accesses for retention. However, in single-rooted teeth a root canal post is necessary, in which case a prefabricated root post is used. Traditionally, metal posts were used in combination with a cast, indirect build-up restoration. Subsequently, directly fabricated cores, combining metal posts with amalgam or, at the present time, composite restoration material, became customary. The present trend is to use prefabricated or individually fabricated fibre-reinforced posts. After restoring a tooth with a build-up restoration, a combined build-up restoration can be chosen, or a direct or indirect crown single tooth prosthesis.