Application of CAD-CAM technologies with customized ceramic posts for root canal-treated teeth: A case report with a 5-year follow-up

Abstract

Digital technologies are increasingly transforming endodontic and restorative workflows, yet long-term evidence on their clinical performance remains limited. This case report addresses that gap by presenting a 5-year follow-up of a patient treated using a fully digital approach combining endodontic and prosthetic procedures. The current report presents a 57-year-old female patient who sought treatment for esthetic and functional concerns related to her upper anterior teeth. Clinical and radiographic examination revealed pulp necrosis and asymptomatic apical periodontitis in tooth right upper lateral incisor #12, and previously treated tooth right upper canine #13 also exhibited signs of persistent apical pathology. A fully digital workflow was implemented, incorporating cone-beam computed tomography (CBCT), intraoral scanning, and digital planning with SICAT Endo software. Tooth #12 underwent primary endodontic treatment, while tooth #13 was retreated orthograde. Customized ceramic post-and-core restorations were designed and fabricated chairside using CAD-CAM technology. Both teeth were restored in single visits using adhesive protocols. At the 5-year follow-up, clinical and CBCT assessments confirmed complete periapical healing and stable, symptom-free function. The patient reported high satisfaction with the esthetic and functional results. This case highlights the effectiveness of combining digital endodontic workflows and CAD-CAM restorations to achieve predictable, efficient, and long-lasting outcomes in complex anterior cases.