RELATIONSHIP BETWEEN TOOTH STRUCTURAL ANALYSIS AND RESTORATIVE STRATEGIES IN CASES OF EXTENSIVE CORONAL DESTRUCTION: A LITERATURE REVIEW

Abstract

Introduction: Extensive coronal destruction compromises the mechanical strength of a tooth, making restorative planning dependent on an analysis of the remaining tooth structure. Objective: To analyze the structural criteria that guide the selection of restorative strategies for permanent teeth with significant coronal loss. Methodology: An integrative literature review with a qualitative approach was conducted using the PubMed/MEDLINE, SciELO, Google Scholar, Scopus, and Web of Science databases, covering publications from 2021 to 2026 in both Portuguese and English. Results: Studies indicate that the choice of restoration must consider the remaining tooth structure, the need for retention and cuspal coverage, the ferrule effect, the adhesive condition, and functional demands. Partial-coverage restorations, endocrowns, fiber posts, fiber-reinforced systems, and immediate dentin sealing have shown outcomes that depend on case selection and the specific protocol employed. A significant portion of the evidence—particularly regarding fiber reinforcement—is derived from laboratory studies. Conclusion: Structural preservation and individualized assessment should guide restorative decision-making. Although various strategies offer favorable biomechanical and adhesive outcomes, laboratory findings do not fully replicate the clinical conditions of the oral cavity; this limits direct extrapolation and underscores the need for clinical studies with long-term follow-up.