Why, when, and how general practitioners restore endodontically treated teeth: a representative survey in Germany

Objective The purpose of this study was to assess current opinions, applied techniques, and materials for the restoration of endodontically treated teeth (ETT) in a nationwide survey in Germany. Material and methods Completed questionnaires from 1,648 dentists were returned (response rate 63 %). Results In general, posts were reported to be used more frequently (51 %) for indirect restorations than for direct restorations (21 %). Dentists restored anterior teeth (65 %) more frequently with direct restorations than posterior teeth (48 %). Compared to an earlier survey, fewer dentists stated that posttreatment stabilizes the remaining tooth structure. The ferrule effect as a key success factor was held by the vast majority of dentists (88 %). A trend towards adhesive techniques both for post placement and core build-up was observed. Composite resins (49 %) were reported to be used twice as much as zinc phosphate cement (24 %) for the luting of posts; composite resins were the core build-up material of choice (75 %). Amalgam was rarely used (0.2 %). Irrespective of the final restoration, fiber posts were the most popular post material (46 % for telescopic crowns vs. 69 % for single crowns). Conclusion Adhesive composite core build-ups with and without fiber posts were the predominant treatment approach to restore ETT in Germany. There was widespread agreement with the ferrule effect as a key restorative success factor for indirect restorations. Clinical significance Today, it is general accepted that ferrule preparation is key. Glass-fiber posts appear to be most popular. Still different systems are used depending on type of final restoration, while the reasons to do so remain unclear.