Core build-up inlay

Modern prosthetic dentistry often makes it possible to restore even a severely damaged tooth. In certain cases, a core restoration is used — a construction that creates a strong foundation for a crown even when the amount of remaining natural tooth structure is minimal.

A core restoration helps ensure proper distribution of chewing load to the root and increases the reliability of the future prosthetic construction. This restoration option may be appropriate when a strong and stable root is preserved.

A dental core restoration is an individually fabricated prosthetic construction that is placed into the root portion of a tooth after root canal treatment and obturation. It consists of a root part that is fixed inside the prepared canal and a supragingival part — the core — on which a crown is subsequently placed.

Depending on the clinical situation, such prosthetic constructions are made from different materials. The most common are metal cores, which are characterized by high strength and the ability to withstand significant chewing loads. A metal core restoration is most often used in the posterior regions of the dental arch, where high mechanical strength is essential.

In addition to metal cores, ceramic or composite constructions are also used. These options may be appropriate in the anterior region of the dental arch, where the aesthetic appearance of the future restoration is of primary importance.

The choice between this and other prosthetic restoration methods depends on the extent of tooth destruction. If the coronal part is only slightly damaged and a sufficient amount of natural tooth structure remains, the dentist may consider alternative restoration options, such as dental onlays. In cases where the remaining tooth structure is insufficient to securely fix a prosthetic construction, placement of a core restoration anchored in the root is considered the optimal solution.

A core restoration under a crown is not used in the following cases:

• significant destruction or the presence of cracks in the tooth root, making reliable fixation of the construction impossible;

• a short root that cannot serve as a stable support;

• poorly treated or non-patent root canals if they cannot be retreated and hermetically sealed;

• active inflammatory processes in the root area or surrounding tissues that require prior treatment;

• pronounced tooth mobility associated with periodontal tissue damage.

In such situations, the dentist recommends alternative methods of tooth restoration.

Restoration of a tooth using this method begins with an assessment of whether the tooth root can withstand further prosthetic load. The dentist evaluates the condition of the root, the quality of root canal obturation, and other factors, as these aspects determine the reliability of fixation of the construction.

Main stages of core restoration fabrication include:

• clinical examination and radiographic diagnostics to assess the condition of the root and surrounding tissues;

• root canal obturation or retreatment if necessary;

• preparation of the tooth root with formation of a space for the future core;

• taking impressions or performing digital scanning for individual fabrication of the construction;

• fabrication of the core restoration in a dental laboratory;

• try-in and fixation within the root canal.

Following this sequence makes it possible to ensure reliable fixation and create a stable foundation for subsequent crown placement.