The purpose of this article is to provide the reader with a rapid, stable, predictable technique for provisionally restoring carious or fractured teeth before endodontic treatment using flowable light-cured composites. The technique described is a modification on the "donut" buildup technique.²

TECHNIQUE
First, remove all carious lesions and suspect restorations (restorations that appear to be unstable or that may fracture during or after endodontic treatment) (Figure, B). If during caries removal the pulp chamber becomes exposed, in the next step, place a cotton pellet in the area to prevent adhesive or composite from collecting there.

Next, place gingival retraction cord around the tooth in any area that is at or below the gingival margin (Figure, C). This step provides excellent hemostasis, in addition to providing visualization of any subgingival tooth margins.

Then, place a single-step, self-etching dental adhesive along any area of the tooth that you will restore and light cure. Using flowable light-cured composite, begin the buildup. Use the maxtrix band of your choice or create the buildup freehand. Incremental curing of the flow-able composite is the best technique, as it allows for better control of the material.

Finally, use a football-shaped diamond bur to reduce the occlusal surface and contour the restoration. On completing this step, proceed with placing the rubber dam and begin the endodontic treatment (Figure, D).

When using restorative materials, follow the manufacturers’ directions to obtain the most predictable results.

CONCLUSION
In endodontic treatment, multiple variables can affect the outcome of a case. The use of this technique will enhance endodontic treatment by preventing marginal leakage before, during and after treatment that is provided before a final restoration is placed; facilitating treatment by increasing tooth surface area for clamp stability; and preventing further breakdown of the tooth by caries or fracture. By planning with a stable pre-endodontic restoration, the clinician is taking the first step toward a successful result.