Immediate Esthetic Build-Up (IEB) for Anterior and Premolar Teeth During Root Canal Therapy.

Immediate root canal therapy on anterior and premolar teeth often leads to esthetic compromise, particularly when multi-visit treatment is needed or coronal structure is significantly damaged. Existing provisional approaches, such as silicone indices, are often impractical in urgent settings due to time constraints. The immediate esthetic build-up (IEB) technique uses a glycerin-coated gutta-percha to serve as a canal projector, defining the access cavity during provisional restoration. Composite or glass ionomer is applied around the cone, with the buccal surface always restored using composite. After the restorative material has set, the cone is removed, leaving a precise access cavity. The IEB serves two purposes: (1) as a pretreatment buildup for structurally compromised teeth to enable secure rubber dam placement and (2) as an esthetic inter-appointment seal during multi-visit therapy to maintain canal patency and coronal integrity. The IEB technique provides a simple, cost-effective method to restore esthetics, facilitate isolation, and preserve tooth structure during urgent endodontic treatment. This practical approach, relying on readily available dental materials, offers predictable outcomes and can be easily integrated into the routine practice of general dentists managing anterior and premolar cases in both pretreatment and multi-visit scenarios.