Root canal treatment is a procedure performed on teeth which have become dead or when the pulp tissue gets infected due to Dental caries or any trauma leading to inflammation of the periapical tissue. Check this to know the in detail procedure of Root Canal Procedure. RCT involves multiple steps starting from access preparation which involves cutting of the enamel and dentin to give straight line access to the pulp chambers or pulp cavity. BMP or Bio mechanical preparation and then Obturation ( filling of the prepared root canals with GP points.
One of the important aspect is the post obturation filling or restoration which is very important to make sure that the Root Canal treatment is successful preventing any leakage of oral cavity fluids into the root canal, which can lead to failure of RCT and re infection. The next step after a restoration is to give the treated tooth an onlay or a Dental Crown (Metal, Metal Ceramic, Zirconia). So the restorative material should bond to the tooth structure which is possible in restorative materials like GIC and Composite.
Most preferred Restorative material after Root canal treatment:
- Composite (first choice)
- Glass Ionomer Cement (second choice)
- Amalgam (third choice)
The ideal restorative material is Composite as it micro mechanically bonds to tooth structure and this prevents any micro leakage later on. GIC also bonds to the tooth structure but the Compressive strength of GIC is less and it is soluble in saliva. In comparison, Composite has more compressive strength and it is not soluble in saliva.
A Layer of GIC on the Pulpal Floor followed by Composite restoration to fill the rest of the cavity is the Ideal way to restore a tooth after completing Root Canal Treatment.
Contraindications of Root canal treatment
Hence Composite can be used to either directly restore the tooth without any need for a crown or onlay. Amalgam is the third choice because it does not bond to the tooth structure and there are chances of micro leakage in the long run along with discoloration of the restored tooth.
hello doctor,
I dont agree with you that composite has chemically bonds to the tooth structure. Composite has micromechanical bonding to tooth structure, thats why we do etching, as far as I know. And about the statement that composite it the best material for restoration after root canal, I dont agree. According to me as you say the material should have chemical bonding which is not there in composite and so when we do crown preparation the restoration may get dislodged. So in my opinion GIC is the best material.
But as you see with GIC, it is soluble in Saliva over a period of time and can lead to marginal leakage. Hence I have mentioned that GIC should be used initially as a layer on the Pulpal Floor and later the cavity (Flowable GIC is available which is easy to use) should be filled with Composite to get the ideal restoration after Root Canal Treatment.
Thanks for sharing its really helpful the rool canel treatment
To prolong your teeth after root canal treatment a dental crown is necessary to put over it. Successfully preventing any leakage of oral cavity fluids into the root canal filling or restoration is very important. So the restorative material should bond to the tooth structure. As the ideal restorative material is composite as it micro mechanically bonds to tooth structure this prevents any micro leakage later on. It is always preferable do oral treatment by a good dentist who used good quality of material for your root canal treatment.
After I had my root canal, my dentist in Alpharetta recommended a porcelain crown for my tooth, he said that composite can actually stain whereas porcelain is known to be stain resistant. I haven’t had any issues with mine so far, it matches the rest of my smile perfectly!
Should we use a specific obturation method (e.g. GuttaCore, vertical compaction, cold lateral ..) when there is a post to place afterwards?
Vertical Compaction or Gutta Core is more preferable in cases where you want to use a Post as this helps in getting proper vertical height for the Post to be places. Cold lateral is least preferred in cases with Post.
What is the reason why we put first GIC before the composite?