Clinical Observations on Postless Fiber-Reinforced Composite Restorations in Endodontically Treated Teeth with Immediate Pre-Endodontic Dentin Sealing and an Internal Adhesive Ferrule: A Case Series

TL;DR

This case series explores a new dental restoration method for root-filled teeth using a special sealing technique and fiber-reinforced composites without traditional posts.

Contribution

The study introduces a novel postless restoration approach combining immediate pre-endodontic dentin sealing with fiber-reinforced composites and internal adhesive ferrules.

Findings

All treated teeth remained asymptomatic with stable periodontal and periapical conditions for up to 2.5 years.

The restorations maintained structural integrity and showed favorable adhesive performance.

The technique appears promising but requires further long-term controlled studies for validation.

Abstract

Background: Traditional reliance on intraradicular posts for the restoration of root-filled teeth is decreasing due to advances in adhesive dentistry. Immediate pre-endodontic dentin sealing (IPDS) aims to protect dentin during endodontic procedures and improve adhesive outcomes. For teeth with minimal remaining structure and absent ferrule, internal adhesive ferrule approaches using fiber-reinforced composites or fiber mesh offer an alternative to posts. Methods: Four endodontically treated teeth with severely reduced coronal structure were restored using the IPDS protocol, reinforcement with an internal adhesive ferrule ring and fiber composites, and postless adhesive build-ups. Clinical and radiographic assessments were performed up to 2.5 years post-treatment. Results: All teeth remained asymptomatic, with stable periodontal and periapical conditions. Restorations maintained structural integrity and favorable adhesive performance. Conclusions: Within the limitations of this small case series, the IPDS approach combined with fiber-reinforced postless restorations showed favorable short-term clinical outcomes. Given the small sample size, case heterogeneity, and lack of a control group, these observations should be considered preliminary, and well-designed, long-term controlled studies are required to confirm the durability and broader applicability of this technique.

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