Survival and Success Rate of Restoration Post Endodontic Treatment.

Introduction: Dental restoration following endodontic treatment aims to restore tooth function, aesthetics, and strength compromised by caries or trauma. Loss of tooth structure post-treatment can reduce strength by up to 60%, increasing fracture risk. Restoration choice depends on remaining tooth structure, coronal sealing, retention, and occlusal factors. Direct restorations suit minimal damage, while indirect options like crowns or endocrowns address significant structural loss. Objective: To evaluate the durability and success of post-endodontic restorations through a scoping review focused on remaining tooth structure, restoration techniques, materials, and post use. Methods: A scoping review was conducted using PubMed, ScienceDirect, and Scopus, following PRISMA-ScR guidelines. Included studies were randomized controlled trials, cross-sectional studies, and case-control studies published in English within the last five years. In vitro studies, non-randomized clinical trials, and literature reviews were excluded. Results: From 353 articles, 14 met inclusion criteria. The studies found that indirect restorations exhibited higher success rates (63% to 91.61%) than direct restorations (43.2% to 86.7%). This finding attributed to the inherent advantages of indirect approach. Indirect restorations demonstrated higher 3-year survival rates (82.7 to 99.1%) than direct restorations (75 to 97.6%). Among these, full-coverage crowns were superior, due to their enhanced fracture resistance, ferrule effect, and stress distribution while direct resin composites suffice when adequate tooth structure remains. Direct restorations are recommended for endodontically treated teeth that still have two or more intact coronal walls, as their prognosis and success rates are quite good for both anterior and posterior teeth. Glass-fiber posts reduce root fracture risk compared to metal posts; however, outcomes depend on post design and occlusal load. Conclusion: The long-term success of post-endodontic restorations depends on multiple factors, with remaining tooth structure being paramount. Evidence shows a clear hierarchy: indirect restorations, particularly full-coverage crowns (FCCs), demonstrate superior success and survival rates due to their fracture resistance and effective stress distribution. Direct composites are only viable with substantial remaining tooth structure (≥2 intact walls). Glass-fiber posts are preferred over metal posts to reduce fracture risk. Ultimately, a ferrule-effect-based, tailored approach that matches biomechanical demands to clinical conditions is essential for optimal outcomes.