# 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.

## Key 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.