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The basics for the sound restoration of endodontically treated teeth have not changed despite the advent of new materials and techniques. Adequate retention for posts and crowns, resistance to cyclic shearing forces, minimal insertional stresses, and even distribution of functional stresses are prime requirements that cannot be compromised without jeopardizing the longevity of the final restoration.

Simplified Endodontic Techniques (SET), along with EZ-Fill, a bidirectional spiral and epoxy root canal cement, have been used for more than 2 1/2 years. This particular sequence of instrumentation and obturation provides the dentist with predictable and easily attained success. Periapical areas demonstrate healing, and excess EZ-Fill cement is resorbing. Postoperatively, patients experience approximately 80% less pain in both occurrence and intensity. The adoption of SET, along with EZ-Fill, allows dentists to significantly increase their productivity while dramatically improving the quality of their work.

Artificial cores replace missing tooth structure and contribute to the retention and stability of the subsequent restoration. The post is the anchoring mechanism for the core, which supports the final restoration. Stability of the post and core is the most important factor concerning the long-term success of the post-and-core restoration. The amount of insertional and functional stresses produced and distributed by a post are also associated with retention. An optimal way of maximizing retention, minimizing insertional stresses, and distributing functional stresses may be through the use of a multi-tiered parallel threaded split-shanked post.

The evolution of endodontic treatments has included the introduction of rotary crown-down nickel-titanium instrumentation and the use of thermoplasticized gutta percha to obturate canals. Although these techniques have provided dentists with solutions to problems encountered with earlier generation endodontic procedures, they have also presented deficiencies that are now receiving some critical review. As a result, a systematic technique has been developed that provides a simplified approach for root canal instrumentation and predictable obturation. This article reviews the aspects of earlier endodontic techniques and provides the step-by-step clinical protocol involved with simplified endodontic techniques.

Using a simplified step-back sequence, which consists of traditional .02 tapered stainless-steel hand reamers, the No. 2 peeso reamer, and four manual nickel-titanium instruments, a dentist can easily, safely, and economically create a continuously tapered canal shape. This article discusses the complete coating of canal walls with EZ-Fill epoxy-resin sealer, which is delivered with a bidirectional spiral; and total obturation with a single gutta percha point, which is matched closely to the tapered shape. The results of this system are compared with other techniques.

Canals shaped to wider tapers, specifically .06 mm and .08 mm, have traditionally been associated with thermoplastic fills. However, the canals shaped to .06 mm and .08 mm tapers correlate very closely to the shape of fine-medium and medium gutta-percha points, respectively. Combining the placement of these single-point fills with the patented EZ-Fill bi-directional spiral for well-controlled placement of the EZ-Fill epoxy resin sealer gives the dentist the ability to simplify the obturation procedure with results that are at least equal to those achieved with lateral condensation and thermoplastic techniques.

Restoration of the endodontically treated tooth is a common occurrence in everyday dental practice. Unfortunately, clinical posthole preparation seems to be a random technique. Even for a prefabricated post supplied with matching drills, the task is often difficult or not straightforward. Some questions inevitably arise. How long should the posthole be? How wide should the canal be prepared? How can the proper width be maintained so that the prefabricated post does not strip in the canal and lose its retention? If it is decided to use a cast post, what is the best posthole preparation to maximize retention? Is there an easy way to avoid perforating the root while preparing the canal for the post? Clinically, how can the posthole be prepared quickly, easily, and predictably every time? These key questions must be addressed when preparing the posthole.

A review of 10 years of literature on prefabricated threaded and passive post systems is presented along with recent literature supporting the validity of the split-shanked threaded post design, Flexi-Post. It is important to note that a split-shanked threaded post is altogether different from a solid-shanked threaded post. The research discussed in this article confirms the high retention of the Flexi-Post and dispels the notion that high retention must be accompanied by high stress.