Restoration of the Endodontically Treated Tooth

            1) Patient-Health Related Factors:

a)      Systemic and local health factors: Poorly or uncontrolled diabetes, immune-suppressed, smokers have elevated risk of developing complications after implant placement.

b)      Patient Comfort and Perceptions

 

a)      Limited remaining tooth structure

-         Fatigue resistance is crucial to long-term success

-         Success requires a tooth be able to accept repeated forces at a lower level to succeed rather than be resistant to one maximal traumatic event

-         Importance of using adhesive resin regardless of post and core build-up used

-         In additional to ferrule, thickness of remaining walls of the tooth will impact success (need for studies)

-         Bruzism (ideal ferrule) 

b)      Crown-to-Root Ratio

c)      Preparation for resistance and retention form

d)      Ability to perform oral hygiene

e)      Quantity and quality of bone (type IV worst)

f)        Soft tissue anatomy or esthetic issues (papilla, periodontal biotype (if thin avoid implants)

-         No more need for heroic treatment to save isolated single tooth because of predictability and success rate of single implant

-         Implant close to natural teeth better papilla