CONTENTS

Introduction
History
Key words and definitions
Consideration in restoring endodontically treated teeth.
Effects of endodontic treatment
Anatomic and biologic considerations.
Indications and contraindications.
Ideal reuirements of !ost core.
Classification of !ost core.
Treatment !lanning
Stress analysis for !ost and cores
"actors influencing retension and resistance.
#rinci!les of !re!aration of endodontically treated teeth.
Custom made !ost core
#refabricated systems
#ro$isional restorations
Ad$ances in !ost core system.
%emo$al of e&isting !osts
Success and failure of !ost cores.
Conclusion
%e$iew of literature
%eferences.
INTRODUCTION:
Teeth and artificial dentures, fastened with posts and gold wire, hold setter than all others. They
soeties last fifteen to twenty years and e!en ore without displaceent . . ."
#iree $auchard % &'('.
Restorati!e dentistry and endodontics ha!e reached a point where they en)oy a sy*iotic
relationship.
+ndodontic treatent sa!es the tooth fro e,traction *ut only ade-uate restoration will reinstate it
as a long.ter functioning e*er of the outh. The restoration of a tooth *y root canal treatent is of
liited !alue unless the crown of tooth is satisfactorily restored. The anner in which a root canal filled
tooth is restored is therefore considera*le iportance.
The restoration of the endodontically treated tooth is a su*)ect that has *een e!aluated and
discussed widely in the dental literature. The restoration of endodontically treated tooth is coplicated *y
the fact that uch or all of the coronal tooth structure which norally would *e used in the retention of the
restoration has *een destroyed *y caries, pre!ious restorations, traua, and the endodontic access
preparation itself.
The endodontically treated tooth is a uni-ue su*set of teeth re-uiring restoration *ecause of
se!eral factors such as dehydrated dentin, decreased, decreased structural integrity and ipaired
neurosensory feed *ac/ echanis when copared to a !ital tooth. 0owe!er, the treatent goal ust *e
*ased upon a ultitude of factors specific for each patient, so that the strategic architectural aspects that
ha!e1greatest ipact on the ultiate strength of the pulpless tooth can *e restored1reinforced.
2olution to this pro*le has challenged the in!enti!eness and ingenuity of dentists for centuries.
The endodontically treated tooth ust *e fortified in such a way that it will withstand *oth !ertical
and lateral forces and not *e su*)ect d to fracture. 3alga as routinely used to restore a tooth is not
considered the *est choice, since the cusps are left unprotected and are su*)ected to !ertical fracture. The
use of a crown o!er an endodontically treated tooth, *y itself is not recoended. $urther reduction of
already underined walls ay render the treated tooth su*)ect to hori4ontal fracture at or near the gingi!al
line. 3n inlay, in so far as it too is an intracoronal restoration, leads to sae wea/ness as the aalga.
This lea!es the consideration an onlay, which co!ers the cusps and protects against !ertical fracture. 2till
1
the potential for hori4ontal fracture reains, since the pulp cha*er is usually underined. $or these
reasons !ertical support ust *e added to all of the restorations entioned so that they ay *e strong
enough to protect the treated tooth fro hori4ontal fracture.
Ro reinforce the treated tooth and protect against !ertical fracture, soe type of sta*ili4ation is
re-uired that will fasten the restoration to the reaining tooth structure. This is accoplished *y using a
post 5also referred to a dowel6, prefera*ly with a core or coping and a crown or onlay as superstructure to
gi!e coronal.radicular sta*ili4ation. 3 post and core is a restoration consisting of a post that fills a prepared
root canal and a core inserted into the pulp cha*er that esta*lishes the proper coronal tooth preparation.
The post and core is ade with a rigid aterial which, when ceented into the root canal and pulp cha*er
pro!ides a solid foundation restoration that is well retained in the tooth. 2o the priary function of a post is
to aid in retaining a core to restore lost tooth structure for retention of a restoration and not to pro!ide
strength or resistance to fracture.
2
HISTO%'(

7arious ethods of restoring pulpless teeth ha!e *een reported for ore than 899 years. In &'(',
#ierre $auchard descri*ed the process *y which roots of a,illary anterior teeth were used for the
restoration of single teeth and the replaceent of ultiple teeth. #osts were fa*ricated of gold or sil!er and
held in the root canal space with a heat softened adhesi!e called astic".
In $auchard:s day, replaceent crowns were ade fro *one, i!ory, anial teeth and sound
natural tooth crowns. ;radually, the use of these natural su*stances declined to *e slowly replaced *y
porcelain. 3 pi!ot 5which is today tered a post6 was used to retain the artificial porcelain crown into a root
canal, and the crown post co*ination was tered a pi!ot crown". #orcelain pi!ot crowns were descri*ed
in the early &<99s *y a well./nown dentist of #aris, Du*ois de cheant. #i!oting 5posting6 of artificial
crowns to natural roots *ecae the ost coon ethod of replacing artificial teeth and was reported as
the *est that can *e eployed" *y Chapin 0arris in the Dental 3rt in &<=>.
+arly pi!ot crowns in the United 2tates used seasoned wood 5white hic/ory6 pi!ots. The pi!ot was
adapted to the inside of an all.ceraic crown and also into the root canal space. ?oisture would swell the
wood and retain the pi!ot in place. 2urprisingly, #rothero reported reo!ing two central incisor crowns with
wooden pi!ots that had *een successfully used for &< years. 2u*se-uently, pi!ot crowns were fa*ricated
using wood1etal co*inations, and then ore dura*le all.etal pi!ots were used. ?etal pi!ot retention
was achie!ed *y !arious eans such as threads, pins, surface roughening and split designs that pro!ided
echanical spring retention.
Unfortunately, ade-uate ceents were not a!aila*le to these early practitioners % ceents that
would ha!e enhanced post retention and decreased a*rasion of the root caused *y o!eent of etal
posts within the canal. One of the *est representations of a pi!oted tooth appears in Dental #hysiology and
2urgery, written *y 2ir @ohn Toes in &<(>. Toe:s post length and diaeter confor closely to today:s
principles in fa*ricating posts.
+ndodontic therapies *y these dental pioneers e*raced only inial efforts to clean, shape, and
o*turate the canal. $re-uent use of the wood posts in epty canals led to repeated episodes of swelling
and pain. Aood posts, howe!er, did allow the escape of the so.called or*id huors". 3 groo!e in the
post or root canal pro!ided a pathway for continual suppuration fro the periradicular tissues.
3lthough any of the restorati!e techni-ues used today had their inception in the &<99s
and early &>99s, proper endodontic treatent was neglected until years later. Today, the endodontic and
proshodontic aspects of treatent ha!e ad!anced significantly, new aterial and techni-ues ha!e *een
de!eloped, and a su*stantial *ody of scientific /nowledge is a!aila*le on which to *ase clinical treatent
decisions.
3
Key words and definitions(
#ost or dowel: Refers to a cylindrical or tapered o*)ect that fits into the prepared root canal of a tooth and
is synonyous with the ter post or endodontic post.
+ndodontic post or dowels usually ceented or threaded into a prepared channel, their purpose is
to retain the core and e-ually distri*ute the forces of astication along the long a,is of the tooth.
The dowel is a post as other relati!ely rigid restorati!e aterial placed in the root of a non.!iral
tooth.
&. Core( Refers to a *uild up restoration, usually aalga1coposite placed in a *adly *ro/en
down tooth to restore the *ul/ of the coronal portion of the tooth to facilitate su*se-uent restoration *y
eans of an indirect e,tracoronal restoration. It ay ser!e as either final restoration or as a foundation or
care for a crown.
Is defined as properly shaped and wall restored su*structure which replaces issing coronal
structure and retain the final restoration.
Core replaces coronal tooth structure that is lost and fors a *are that has sufficient *ul/ and
retention for final restoration.
The core consists of restorati!e aterial placed in the coronal area of a tooth. This aterial
replaces carious, fractured or otherwise issing coronal structure and retains the final crown.
8. "errule( Is defined as a etal *and that encircles the e,ternal diension of the residual tooth.
Is defined as 3 =B9
9
etal collar of the crown surrounding the parallel walls of the dentin e,tending
coronal to the shoulder of the preparation which resists stress e,erted during post insertion.
=. #ins : Used alone or in co*ination with posts to pro!ide retention for core aterial.
(. "inal restoration : The for of crown gi!en after post 1 core.
4
CONSI)E%ATIONS IN %ESTO%IN* EN)O)ONTICA++' T%EATE) TOOTH(
The restoration of endodontically treated teeth has been the focus of considerable
contro$ersy and em!iricism. Time,tested methods ha$e been highly successful in some res!ects-
but failure is still a!!arent. %egardless of the system there should be a through understanding of
the anatomy- and biology of dentin and root su!!orting the restoration on the !art of the
!ractitioner to su!!ort the contention that endodontically treated teeth ha$e s!ecial needs that
e&ceed the reuirements of teeth with $ital !ul!. These uniue as!ects include-
36 +ffect of endodontic treatent on teeth and
C6 3natoic and *iologic considerations.
A. Effect of endodontic treatment on teeth(
a6 The role of oisture loss on the nature of dentin
*6 3lterations of strength due to architectural changes in the orphology of the teeth.
c6 Concepts of *ioechanical *eha!ior of tooth structure under stress.
d6 Nature of dentin toughness in pulpless teeth.
e6 Changes in the nature of the collagen alignent in pulpless teeth.
a. %ole of moisture loss(
The oisture content of the coronal dentin is appro,iately &=.8D. 3s the age increases the
oisture content decreases due to increased deposition of peritu*ular dentin which contains ore organic
content and water.
Two a)or coponents of water content in any calcified tissues are,
&6 Outside the calcified atri,,
86 Aithin the calcified atri,.
Aater within the calcified atri, is di!ided in to,
i6 $ree water to hydrate inorganic ions thus *eing in!ol!ed in their o!eent % Cut this
water can *e reo!ed at *etween &99
9
C and &&9
9
C.
5
ii6 $irly *ound water, this doesn:t participate in the o!eent of ions. This firly
*ound water is called the water of hydro,yapatite crystal" and is not su*stantially reduced until
teperature of B99
9
C is reached.
It is deonstrated that the pulpless tooth contains >D less oisture than the !ital tooth and this water
loss is a irre!ersi*le daage and can not *e reco!era*le e!en in saturated atosphere and at *ody
teperature.
b. Architectural changes(
The decreased strength seen in endodontically treated teeth is priarily *ecause of the loss of
coronal tooth structure. +ndodontic procedures reduced tooth stiffness *y a ere ED attri*uted priarily *y
access opening. Ahile a ?OD ca!ity preparation reduces tooth stiffness *y ore than B9D with loss of
arginal ridge contri*uting the greatest loss of tooth strength.
2u*stantial dentin can *e reo!ed during endodontic access preparation or canal cleaning and
shaping, these procedures apparently do not significantly wea/en the tooth.
Aith the reduction of the inner cuspal slopes that unite and support, or e,posure of acute cuspal
angles a greater chance of fracture e,ists.
Con!ersely the e,cessi!e reo!al of radicular dentin during cleaning and shaping or post space
preparation coproises root strength.

c. /iomechanical beha$ior(
The *eha!ior of teeth under load has *een in!estigated and has pro!ided inforation into the
changes occurring in the pulpless tooth. Tidarsh descri*ed an intact tooth as a hollow lainated structure
that defors under load. This lainated structure ay shorten, its sides ay *ulge, and its cusps ay *e
wedged apart *y opposing cusps. 3lthough under physiological loads, coplete elastic reco!ery ta/es
place, peranent deforation ay follow !ery high 1 e,cessi!e on sustained loads. Therefore the tooth
appears to respond li/e a prestressed lainate. It is characteristic of such a structure that it can withstand
greater loads in the prestressed rather than in the unstressed state *ecause in the prestressed state it can
fle, with the !arying degree and angle of load.
0ow does this prestressed state coe a*out in the toothF
One hypothesis suggests that as the crown de!elops, the outward o!eent of the aelo*lasts
and the inward o!eent of the odonto*lasts set up the stressed condition, which is then fro4en or
sta*ili4ed *y inerali4ation of the atri,.
The significance of this phenoenon is that any ca!ity preparation, howe!er sall, destroys the
prestressed state and releases the stresses.
This phenoenon is crucial if the cuspal inner slopes are reo!ed during endodontic access
preparation or ca!ity preparation thus destroying the prestressed state. 2u*se-uently, stress is released,
accopanied *y a slight shift in cuspal structure. 0owe!er, the tooth can defor to a greater e,tent under
applied loads and thus *e ore suscepti*le to fracture. This concept would apply to teeth with endodontic
ca!ity preparation and would *e integrated in the nature of cuspal anatoy, its *ucco.lingual width, and the
angle of inclination.
*rimaldi et al illustrated that there is a direct relationship *etween the aount of central tooth
structure lost in ca!ity preparation and the deforations under load.
To ipro!e the retenti!e and echanical properties as well as to decrease the percentage of root
fractures soe posts with co*ination of two or three *asic types are introduced they are:
&6 #arallel sided posts with tapered apical ends
86 Tapered fle,i post
=6 #arallel 7.loc/ drill and post syste.
(6 #arallel radi, anchor syste.
E6 #arallel threaded posts with pre tapped channels.
d. )entinal toughness(
The toughness is easured *y the total energy re-uired to fracture a aterial. 3nother techni-ue
to deterine the toughness of a aterial in icro indentation iprints ade in a aterial with specific loads
and the depth of indentation indicates a easure of hardness of aterial.
6
Dentin e,hi*its considera*le plastic deforation *eyond the yield point, it is a wea/ *iologic ductile
aterial in which strength and toughness ay !ary.
The shear strengths and toughness !alues of dentin fro endodontically treated teeth is lower and
significantly different fro the !alues for dentin of !ital teeth. It is deonstrated that &(D reduction in the
strength and toughness is seen in endodontically treated teeth.
e. Collagen alteration(
Dentinal collagen consists of large fi*rils characteristic of type I collagen. The interolecular cross
lin/ing of collagen fi*ers achie!e their characteristic physical properties of rigidity, resistance of strength
and rear/a*ly high tensile strength.
It is !erified that there are ore iature and fewer ature cross lin/s in root filled teeth %
3ccounting for decrease in tensile strength and *rittleness of pulpless teeth.
Ahen all a*o!e fi!e aspects of dentinal changes are integrated a reasona*le e,planation for the
changes in the strength of the tooth structure are pulpless teeth can *e forulated. These are fundaental,
irre!ersi*le changes in the anatoy, *iocheistry and *ioechanical properties of dentin which a/es up
the *ul/ of reaining tooth structure after pulpal loss and endodontic treatent.
Dentin of pulpless teeth undergoes alteration in its inherent structure, reducing is tensile strength
and fle,i*ility. Cecause of the oisture loss and architectural changes of tooth structure % root filled teeth
re-uire uni-ue restorati!e procedures related to their radicular anatoy and supporting *one.
/. Anatomic and /iologic considerations(
Other than the alterations ade *y endodontic therapy soe other iportant considerations during
post endodontic restorations they are,
a6 The aount of reaining tooth structure
*6 The anatoic position of the tooth.
c6 The functional load on the tooth.
d6 The esthetic re-uireents for the tooth.
The !arious co*inations of these factors will deterine the selection of posts, cores, crowns and
the techni-ue of the treatent procedure.
a. The amount of remaining tooth structure(
The aount of tooth structure daage is one of the ost iportant aspects in restoration of
endodontically treated tooth. The aount of reaining dentin is far ore significant to the long ter
prognosis of the restored tooth than in the selection of artificial post, core or crown aterials.
Teeth with inial reaining tooth structure present se!eral clinical pro*les, these include.
i6 3n increased root fracture ris/.
ii6 3 greater potential for recurrent caries.
iii6 ;reater chance of restoration dislodgeent or loss.
i!6 3n increased incidence of *iologic width in!asion during preparation.
b. The anatomic !osition of the tooth(
Anterior teeth(
3 non!ital anterior tooth that has lost significant tooth structure re-uires a crown. The crown is
supported *y and retained *y the post and core. Desired physical properties of #osts will deterine the
selection of aterials for the crown, core, post, esthetic post and core aterials are preferred here.
#osterior teeth(
#osterior teeth carry greater occlusal loads than anterior teeth, and restorations ust *e planned
to protect posterior teeth against fracture. The functional forces against olars re-uired crown or onlay
protection.
c. "unctional load of the tooth and !rosthetic needs(
The hori4ontal and tor-uing forces endured *y a*utents for fi,ed or reo!a*le partial dentures
dictate ore e,tensi!e protecti!e and retenti!e features in the restoration. 3*utent teeth for long span
fi,ed *ridges and distal e,tension, reo!a*le partial denture a*sor* greater trans!erse load and re-uire
ore protection than do a*utents of saller *ridges or tooth supported reo!a*le, partial dentures.
7
2iilarly teeth that e,hi*it e,tensi!e wear fro *ru,is, hea!y occlusion or hea!y lateral function re-uire
the full copleent of post, core and crown.
d. Esthetic reuirements of the tooth(
+sthetic changes occur in endodontically treated teeth. Cioechanically altered dentin odifies
light refraction through the tooth and odifies its appearance. Inade-uate endodontic cleaning and shaping
of coronal area also contri*ute to this discoloration.
3nterior teeth, preolars and often the a,illary first olar inha*it the esthetic 4one of the outh. These
teeth are fraed *y the gingi!a and lips to create an esthetically pleasing sile. Teeth in the esthetic 4one
re-uire careful selection of restorati!e aterials and careful handling of tissues.
0. Anatomic considerations(
%adicular considerations(
There reains a treendous dependency on the radiograph as the essential diagnostic aid for
deterining the anatoy of the root to *e restored. Ahile routine periradicular radiographs pro!ide only
two.diensional cross.sectional anatoy of the radicular tissues fro esial to distal, suppleental, !iews
fro pro,ial or occlusal angulation will supply additional inforation regarding the cur!ature or e,tra roots.
0owe!er, since the e,act facio.lingual diensions or the esiodistal shape including the presence
of in!aginations or lainations of the roots *etween the facio.lingual diensions of the root cannot *e
accurately ascertained, it is iperati!e to ha!e a thorough /nowledge of the root anatoy *efore
reconstructing the tooth.
3 *rief re!iew of the a)or concerns in radicular anatoy *efore the restoration of the
endodontically treated tooth is indicated if a post is to *e used.
It is not iperati!e that each endodontically treated tooth should recei!e a post as a part of the
restoration. 2orensen and ?artinoff indicated that treated tooth is unrealistic. Therefore, in those teeth that
need a post to retain a core *uild up careful attention ust *e directed to the root anatoy for selecting the
appropriate post design, including shape, length, and ethod of placeent.
- ?a,illary central and lateral incisors % ha!e sufficient *ul/ of root to accoodate ost post
systes.
- Care ust *e e,ercised in using posts with e,cessi!e length if the root tapers rapidly to the ape, %
*ecause the thinner the root walls at the depth of the post placeent, the greater the chance for
root fracture.
- ?a,illary canines % ha!e wide faciolingual roots and root canal spaces that coonly necessitate
a custo cast post for desired adaptation to the root walls and there is a possi*ility of pro,ial root
in!aginations.
- Restoration of a,illary preolars % presents a !ariety of pro*les when one anticipates a post.
retained core. Root walls are coonly thin, and root tapers rapidly to the ape,, especially when
two distinct roots are present.
- #ro,ial in!aginations and canal splitting are coon during preparation of the canal fro the
coronal to apical root structure.
- Root cur!atures to the distal are coon.preclude using long posts.
- The cur!atures of the palatal root can *e facial, results in root perforation during post space
preparation or ceentation.
- Thinness of these roots % reo!al of dentin for the placeent of a post results in a wea/ened root
wall which in turn leads to fracture either ceentation or during function.
- 2ae o*ser!ations are true for the second preolars, *ut these teeth generally ha!e greater *ul/
of tooth structure.
- ?a,illary olar: 2uita*le root G #alatal root.
+!en this root presents restorati!e pro*les. <ED of the palatal roots cur!e facially and when
in!aginations are present they are located on the palatal and facial surfaces. This co*ination of root
cur!ature and radicular in!aginations predisposes the root walls to wea/ening or perforation during
placeent of long or thic/ posts.
3s a result palatal roots can *e fractured, re-uiring root resection, tooth e,traction or surgical
endodontics to repair the perforation.
#laceent of posts in the ?C and DC roots is contraindicated.
1andibular incisors( Difficult teeth to restore with a post and core % and success rates ha!e *een higher
without a post. root walls are thin and pro,ial in!aginations are coon.
8
#laceent of a post is coonly coproised *y ultiple canals with significant *one loss.
precluding the placeent of a post in an unsupported root. This pro*le was identified *y Reinhardt et al %
in teeth restored with a post and core ha!ing diinished *one support of (.B, stress concentration
occurs *oth at the post ape, and on the ad)acent root periphery in a relati!ely narrow *and of reaining
dentin.potential for fracture in greater.
1andibular canines( siilar as a,illary canines.
1andibular !remolars(
0a!e sufficient *ul/ of root structure.
Care ust *e e,ercised to ensure that the entire root canal has *een anaged *ecoe there is a
procli!ity for ultiple canals.
One area of concern: with first preolar is the angle of the crown to the root. Often the root will *e
lingual inclined and acti!e drilling of a post space perpendicular to the occlusal surfaces will result in a
perforation along the facial wall of the root.
1andibular molars( ?a)or pro*le due to esiodistal thinness of the esial and distal roots. 3long the
root cur!atures, there are coonly in!aginations and perforations that are in!isi*le radiographically.
The roots ay *e su*stantially wea/ened if they are prepared for prefa*ricated circular posts %
*ecause the roots are e,ternally wide facio.lingually and narrow esiodistally. In these cases, fracture ay
occur during post ceentation or patient function. These types of fractures ha!e *een tered
ODONTH3TRO;+NIC" in origin and should *e recogni4ed *y the dentist.
INDIC3TION2 3ND CONTR3INDIC3TION2:
A. IN)ICATIONS (
Anterior teeth(
&6 Ahere the natural crown of root.filled teeth either has *een lost or is e,tensi!ely
daaged.
86 Ahere the root.filled tooth is to *e used as *ridge a*utent.
=6 Ahere a change in a,ial position greater than & is re-uired.
(6 In a crowned anterior endodontically in!ol!ed tooth, to reinforce the crown co!ered tooth
at cer!ical area suscepti*le to fracture.
E6 Intact natural teeth crown grossly discolored and destined to recei!e a crown
B6 Hoss of two pro,ial surfaces with a lingual endodontic access opening which wea/ens
the tooth.
#osterior teeth( Indications-
&6 Indicated when the reaining coronal portion is insufficient to support the restoration and sufficient
long thic/ root structure is present.
86 Indicated when the root.filled tooth is to *e used an a*utent for a *ridge.
=6 In case of alposed teeth, when preparation of tooth would cause e,posure of the pulp. of choice
for aligning coronal portion of the tooth.
(6 Indicated in restored *icuspids that are endodontically in!ol!ed.
E6 3 shortened tooth % due to the nature of destruction, or reo!al of underined, undesira*le tooth
structure.
B6 Ahere there is a !ital tooth with insufficient retention for a con!entional crown
'6 Indicated in fa!ora*le periodontal and periapical conditions with good oral hygiene.
Contraindications (
&6 2e!ere cur!ature of the root.eg: Dilacerations of the root.
86 #ersistent periapical lesion
=6 #oor periodontal health
(6 #oor crown to root ratio
E6 Aea/ 1 fragile roots
B6 Teeth with hea!y occlusal contacts
'6 #atients with unusual and occupational ha*its
<6 +conoic factors
>6 Inade-uate s/ill.
9
I)EA+ %E23I%E1ENTS O" #OST CO%E(
Ideal !ro!erties of the !ost 4!ost.( #osts should ha!e as any of the following clinical features as
possi*le:
&6 ?a,iu protection of the root
86 3de-uate retention within the root
=6 ?a,iu protection of the crown arginal ceent seal
(6 #leasing esthetics, when indicated
E6 Radiopacity
B6 Ce siple, safe, !ersatile, and relia*le in clinical use.
'6 Not create stresses in the reaining tooth tissues during preparation and ceentation.
<6 3llow an e!en distri*ution of all functional stress
>6 Include pro!ision to ensure appropriate support and retention of the core.
&96 Include features of facilitate reo!al, if so re-uired, e!en after prolonged periods of clinical ser!ice.
&&6 Ce ade of *ioinert aterial 5s6 that resist corrosion and other fors of deterioration in the outh
&86 0a!e *een the su*)ect of rele!ant research, including clinical research sufficient to )ustify
recoended applications, to support any clais ade *y anufacturers, and to deonstrate
appropriate in ser!ice perforance.
&=6 Ce widely and readily a!aila*le at reasona*le cost.
&(6 Resist loosening and displaceent due to occlusal and other functional stress.
Core materials( %euirements(
&. 2ta*ility in wet en!ironent
8. +ase of anipulation
=. Rapid, hard set for iediate crown preparation
(. Natural tooth color
E. 0igh copressi!e strength
B. 0igh tensile strength
'. 0igh ?O+
<. 0igh fracture toughness
>. How plastic deforation
&9. Inert 5no corrosion6
&&. Cariostatic properties
&8. Ciocopati*ility
&=. Ine,pensi!eness.
C+ASSI"ICATION O" #OSTS AN) CO%ES(
5. )e!ending u!on the !re!aration (
0.
a. Custo.ade cost post and cores
*. #refa*ricated posts and cores
&. Non.threaded casts posts and cores. +.g. #ara.post, aster.post.
8. Non.threaded wrought posts with cast on cores. +.g. #ost, ;T.post C?.post
and wipta wire.
=. Non.thread wrought posts with direct *uild up cores.
10
Prefabricated posts and cores are further classified into
Metallic
Non-hreaded

hreaded
Non-Metallic
!era"ic #$hite
%irconiu" o&ide'
carbon fiber posts
fiber-reinforced
resin posts
+.g. #ara.post, ?aster.post, ;T.post, C?.post, Unietric post,
Dentatus anchor posts, and 3ncore,tra anchorage posts.
3 non.threaded post relies for its retention as well as e-ual stress
distri*ution, on an intiate fit within the root canal and the use of a luting agent.
Threaded posts pro!ide a distinct retenti!e ad!antage, *ut in the past
their use has *een contro!ersial *ecause of the potential ris/ of root fracture associated with the
acti!e" cutting of the thread during placeent.
?ost odern threaded posts are now designed into canals that ha!e *een prethreaded or tapped
and accordingly these posts are considered to *e passi!e. There is an increase in stress within the root
canal when luting ceent is placed *etween the post and canal wall. 0owe!er there is e!idence that such
fitting stress can *e reduced, if not eliinated, in prethreaded canal % with a split.shan/ post" % *ecause of
escape of e,cess luting ceent occurs !ia the split shan/.
&6 Threaded integral wrought posts with solid core. +.g. Titronic %I.anchor post.
86 Threaded wrought posts with core super structure, +.g. R72 post, +,atec.post, !loc/./oet post,
Radi, % 3n/er % Hong Cytcopost.
=6 Threaded wrought posts with direct *uild up cores. +.g. 7loc/.Ioet post, Tifle, pins, Titronic %
IR post.
6. )e!ending u!on geometrical configuration
a. Tapered
*. #arallel
7. )e!ending u!on surface configuration
a. 2ooth
*. 2errated
c. Threaded
To im!ro$e the retenti$e and mechanical !ro!erties as well to decrease the !ercentage of root
fractures some !osts with combinations of two or more basic ty!es are introduced they are
#arallel sided posts with tapered apical ends
Tapered fle,i post
#arallel 7 loc/ drill and post syste
#arallel radi, anchor syste
#arallel threaded posts with pre tapered channels,
#arallel Sided #osts with Ta!ered A!ical Ends(
These posts, designed to pro!ide the greater retention of parallel posts yet *etter confor to the
tapered apical portion of the canal, coe in 8 !ariations. One, the Degussa, is copletely sooth.sided.
The straight and tapered portions are a*out e-ual in length. The second !ariation is the Unite/ CC0 syste
with lower fre-uency of serrations along the parallel sides and a sooth apical taper of a*out 8 . The
CC0 post also has a larger coronal portion to pro!ide retention for core *uild.up aterials.
#arallel posts with tapered ends ha!e a lower retention potential. They produce little or no
installation stress.These posts produce a definite wedging effect in the area of the apical taper.


Ta!ered "le&i,#ost(
$le,i.#ost is a prefa*ricated, split.shan/, parallel.sided, threaded post that reportedly a*sor*s the
stresses of insertion, while pro!iding a,iu retention.

3s the apical half collapses," it *ecoes a
tapered post.
The $le,i.#ost gains its significant retention *y its threads cutting into the dentin 9.& to 9.8.
The channel to recei!e the post is prepared *y a drill si4ed slightly larger than the diaeter of the shaft of
the post. The *lades 5threads6 e,tend *eyond the shaft *y 9.8 and engage into the dentin. $le,i.#ost
was found to *e twice as retenti!e as #ara.#ost *ut not -uite as retenti!e as the Coston #ost syste.
$le,i.#osts pro!ided the greatest resistance to torsion and tensile loading.
Cecause it is an acti!e.type post, that is, self.threading into the dentin. $le,i.#ost ust e,ert soe
stress when it is installed. It is first screwed" into the prepared canal with a tiny wrench, then reo!ed
countercloc/ wise, to *e reinserted with ceent into the sae dentin threaded groo!es. Cecause the apical
half of the post is split, it collapses inwardly, thus reducing the strains that would otherwise *e produced
were it a solid screw post.

Parallel V-Lock Drill and Post System:
11
The widely separated icro.threads" of the 7.loc/ post e,tend 9.E fro the shaft and
continue its full length. 7.loc/ posts are supplied with precise drills that prepare a parallel.walled canal )ust
slightly larger than the post shaft. They can *e ceented with any ceent or adhesi!e.
Curgess reported that 7.loc/ posts were the ost resistant to copressi!e loading % soewhat
ore than $le,i.post or #ara.#ost. In resistance to torsional loading tests, 7.loc/ posts fell a*out idway
*etween #ara.#osts and $le,i.#osts.

Parallel Radix Anchor System :
Radi, anchor posts gain their priary retention *y self.cutting counter.threads in the dentin. The
Radi, anchor post differs fro the 7.Hoc/ post *y the nu*er of its threads, which are sharp low.fre-uency
helical *lades that e,tend only partly down the shaft. It is !ertically !ented. The Radi, post is designed to fit
snugly in a channel prepared for it in the root. It can *e ceented with any ceent, *ut prefera*ly
Coposite resin.
Cecause of the liited nu*er of threads, the Radi, 3nchor has less retention than other acti!ely
retained posts. ?oreo!er, if the canal is o!oid or too flaring, the *lades ne!er contact dentin. In that case, it
has hardly ore retention in ceent than a sooth post.
3 fully seated Radi, 3nchor induces se!ere stress due to the surface irregularities of the root face
and the nonperpendicular alignent of the post and coronal dentin. #erhaps the ost critical aspects
of parallel.sided threaded design are the initial threading insertion and the later ceentation. $ollowing
channel preparation, the post is carefully threaded into the dentin. It is then *ac/ed out to *e returned,
hopefully engaging the sae counterthreads in the dentin, for final ceentation.
The Radi, anchor post generates greater stress under o*li-ue copressi!e forces than the Iurer
post. The ain load transfer ta/es place *etween the threads and the dentin.
#arallel Threaded #osts with #re,Ta!!ed Channels (
The Iurer 3nchor posts are the only dowels on the ar/et that fit into pretapped counterthreads in
the dentin . 3nother uni-ue feature of the Iurer 3nchor is the Iurer Root $acer which prepares a flat seat in
the root face into which the coronal portion is to fit perfectly.
#arallel.sided, threaded posts, ceented into tapped channels, are superior in retention to all
other post designs. Cecause of its high retenti!e capa*ility, the Iurer post is fa!ored when !ery high loads
ust *e supported : partial denture and o!erdenture attachent a*utents, long span *ridges, etc. This
post is also !ery useful when only short e*edent depths are possi*le *ecause of root length and shape.
Iurer posts produce se!ere apical stress le!els if the ape, of the post fully engages the *e!el
produced *y the twist drill at the channel ape,. This ay *e o*!iated *y triing the post length
short of the apical *e!el in the canal. Ahen ceented, it should *e fully seated with the end of the
threaded shan/ )ust short of the tapered part of the channel. The coronal seat in the root.facer
preparation should *e )ust touching, not screwed down so tightly it produces strains. Ahen Iurer posts
are ceented into their tapped channels, their *uffering effect is less pronounced. The ain load
transfer ta/es place *etween the threads and the dentin. The high.fre-uency threads of the Iurer
design lower the locali4ed stress concentrations under load *ecause of the increased surface contact.


8. New restorati$e classification of endodontically treated teeth (
/y #aul %. Chalifou&
The classification, which presents iportant considerations for restoration, is *ased on the nu*er
of canals, aount of coronal tooth structure, cha*er space, canal -uality, and orientation.
Classes &,8 J= refer to teeth with one, two or three canals. +ach of these classifications is further
su*di!ided into coplete 5c6, partial 5p6 and no 5n6 coronal tooth structure. Coplete coronal tooth structure
coprises a range of BB.&99D, partial, == to BED and no. 9 to =8D. The percentage of reaining coronal
tooth structure, after root canal and restoration preparation is defined as the least of the two percentages:
The first percentage is a easureent of the coronal height % the second percentage of the
sallest hori4ontal cross section in the gingi!al half, *ased on o*ser!ation, e,perience and estiation.
+ach of the a*o!e nine classifications is further su*di!ided1e!aluated *y:
&. Cha*er space
8. Canal -uality
=. Canal orientation
Class Tooth structure
& 5one canal6 Coplete 5C6, partial 5#6, No 5N6
8 5two canals6 Coplete 5C6, partial 5#6, No 5N6
= 5three canals6 Coplete 5C6, partial 5#6, No 5N6
12
C G BB.&99D, # G ==.BED, N G 9.=8D
Sub classification (
Chamber s!ace #resent Interloc9ing: limited interloc9ing non,
interloc9ing
3*sent
Canal -uality 2hape 2egented: straight, cur!ed
Unifor: straight, cur!ed
2i4e Diaeter: unifor, segented
Hength: straight, noral, long
Taper Unifor: parallel, tapered
2egented: parallel, tapered
Canal orientation #arallel
interloc/ing
Canal.canal, canal.coponent

COR+ classification(
The core consists of restorati!e aterial placed in the coronal area of a tooth. This aterial
replaces carious, fractured, or otherwise issing coronal structure and retains the final crown.
The core is anchored to the tooth *y e,tending into the coronal aspect of the canal or through the
endodontic post. The attachent *etween tooth, post and core is echanical, cheical or *oth as the core
and post are usually fa*ricated of different aterials.
The reaining tooth structure can also *e altered to enhance retention of the core. 3lthough, pins,
groo!es and channels can *e placed in the dentin, these odifications all increase the core retention and
resistance to rotation at the e,pense of the tooth structure. In ost cases the irregular nature of the
residual, coronal tooth structure and the noral orphology of the pulp cha*er and canal orifices
eliinate the need for these tooth alterations. Using restorati!e aterials that *ond to tooth structure
enhances retention and resistance without necessitating the reo!al of !alua*le dentin. Therefore, if
additional retenti!e or antirotation for for the core is deeed necessary, dentin reo!al should *e /ept to
a iniu.
1aterials used(
&. Cast gold
8. 3alga
=. Coposite resin
(. ;lass ionoer
E. R?;IC
5. Cast gold( Type III and Type I7 cast gold alloys are used.
Ad$antages(
&. Offers good strength
8. Resistance to lea/age deri!ed fro luting agent
=. Does not a*sor* water
(. COT+ close to that of dentin.
E. Cast gold *uildups re-uire post for retention and su*stantial degree of coronal destruction to *e
used.
)isad$antages(
&. Tie consuing
8. +,pensi!e
0. Amalgam( ?aterial of choice in high stress situations
Ad$antages(
&. 2iple to use
8. Radiopa-ue
=. 0igh copressi!e strength and fracture toughness in *oth static and dynaic loading.
(. 0igh contrasting color to the tooth
E. Diensionally sta*le
B. 3ntiicro*ial
'. 3ccepta*le long.ter perforance as docuented in the literature.
)isad$antages(
13
&. 0igh theral conducti!ity
8. 0igh co.efficient of theral e,pansion than the tooth
=. Does not adhere to the tooth su*stance
(. How early strength %re-uires separate appointent for crown preparation
E. Dar/ color of 3alga % potential to lower the !alue of all % ceraic restorations causing a gray
halo at the gingi!al argin.
6. Com!osite %esin( #ossess satisfactory physical properties for use as core *uildup aterial.
Ad$antages(
&. Relia*le *ond to tooth structure
8. 0ighly radiopa-ue
=. Coand set nature % allows iediate crown preparation
(. 3de-uate fracture toughness and copressi!e strength in static and dynaic loading.
)isad$antages(
&. 0igh coefficient of theral e,pansion % potential for icrolea/age
8. Not diensionally sta*le in wet en!ironent
=. Aater sorption % a*sor*s water G core e,pands, coposite dries G core shrin/s.
7. *lass ionomer cement( It should *e used in posterior teeth with ore than E9D of tooth structure
reaining.
Ad$antages(
&. 3dhesion
8. $luoride release
=. Co.efficient of theral e,pansion siilar to tooth
(. Radiopa-ue
E. Contrasting color to tooth
)isad$antages(
&. How copressi!e strength and fracture toughness
8. How fle,ural strengths.
8. %esin modified glass ionomer cement( Newest a!aila*le core aterial.
Ad$antages(
&. 3dhesion
8. $luoride release
=. +asy to anipulate
(. Interediate physical properties % lie *etween ;IC and coposite resin.
)isad$antages(
&. How fle,ural strength and fracture toughness
8. 7olue in sta*ility % se!ere e,pansion during initial setting reaction.
=. Not a aterial of choice in high stress situations
T%EAT1ENT #+ANNIN*(
5. #atient selection( 3s when e*an/ing on any other restorati!e procedure, the health of the supporting
tissues should *e assessed, and any ad!ice and treatent necessary to ensure the continuing health of
these tissues carried out prior to definiti!e restoration of the teeth thesel!es. The patient:s a*ility and
oti!ation of cooperate in treatent and after care ust *e assessed.
&. The age of the patient is also a rele!ant consideration. In anterior teeth % where the appearance is
iportant, it is usual to place the crown argin, )ust within the gingi!al cre!ice. In young patients,
where eruption either acti!e or passi!e ay not *e coplete, the argin ay *ecoe e,posed
and aesthetically unaccepta*le. In such cases it ay *e necessary periodontally to replace the
crown eleent of the restoration, until such tie as the gingi!al argin reaches a sta*le position.
2ince the crown argin, in such cases will re-uire re.preparation, the post and core eleent
cannot *e designed to strengthen the root *y eans of a diaphrag.
8. #articipation *y the patient in contact sports is another factor to *e considered. It is usually
unrealistic to e,pect the patient to a!oid such acti!ities and so thought should *e gi!en to pro!iding
a outh guard to inii4e the possi*ility of daage to the tooth and crown *y traua.
0. The tooth crown(
$actors to *e considered include:
+,tent of the tissue loss and whether this has resulted in o!er eruption of the
tooth or its opponent.
14
Relationship to the ad)acent teeth.
3ny tilting of the tooth itself or if its: neigh*ors.
Degree of occlusal wear 5points to the agnitude of the forces to which the
crown and post will *e su*)ected during function6.
Cosetic considerations and e,posure.
6. The root(
a. Tooth should ha!e a sound root filling and a good prognosis.
*. $actors, which influence the retention of the post, should *e considered.
+.g.
i6 Tapered posts are not suited to teeth with short roots. 3 threaded parallel.sided post ay gi!e
a greater retention.
ii6 $ine, narrow canals 1 roots % re-uire tapered posts to inii4e the possi*ility of root
perforation.
ST%ESS ANA+'SIS "O% #OST AN) CO%E(
Restoration of the pulpless tooth is critical for successful endodontic therapy. The nature of force
e,isting in teeth and surrounding tissues has *een a su*)ect to in!estigation *y dental researcher for a
century or ore. 3s techni-ue has de!eloped for increasingly radical restorations of daaged teeth,
interest has naturally e,panded to include stresses induced in reconstructed teeth in function.
Inowledge of the /inds of stress noral dental structures ust withstand and therefore restored
structures should withstand is of o*!ious !alue. The a*ility to perfor stress analysis on reconstructed teeth
is of su*stantial iportance in optional prosthesis designs.
Stress analysis methods used(
&. #hotoelastic stress analysis
8. $inite eleent stress analysis
Clinical longe$ity of the !ost and core restoration can be function of (
&. The thic/ness of reaining dentin.
8. ?agnitude and direction of the load.
=. Design of the post.
(. $it of the post into the prepared root canal.
E. Kuality of the ceent layer.
15
Hoading of ceented post and core in a root creates stresses in the root, and if the tensile stresses
are high.fracture of the root ay occur.
$re-uent loading ay cause strains and stresses in the ceent fil and conse-uent release of the
post.
#hysical !rinci!le(
1. Anterior teeth:
In general, Direction of the load

Upper anterior teeth

Upwards and outward, o!ing the crown of the tooth in a la*ial direction out of the arch, ad)acent teeth
gi!ing no support.
In ost cases : central dentinal core of the crown will *e wea/ened *y access ca!ity prep and possi*ly *y
caries as well.

This eans the ain stress will *e accepted *y the reaining dentin at the la*ial gingi!al argins. Unless
there is considera*le *ul/ of dentin in that area % siple restoration of the coronal for ay *e insufficient
to reinforce the tooth as the restoration aterials are wea/ in tension.

;enerally necessary, to reinforce the crown *y placing a post into the root canal. 2o o!ing the potential
point of fracture fro the gingi!al argin of the crown soe distance up to the root towards the root ape,.

Hoad applied to lower anterior teeth

Opposite downwards and inwards directions

Tend to close the arch % and crown will gain support for ad)acent teeth.

Reinforceent *y placeent of the post is therefore not as iportant.

Ta!ered !ost( Increase stress concentration at coronal shoulder. It causes wedging effect % decreased
stress concentration at the ape, % due to a*sence of sharp angles and conser!ation of tooth structure.
#arallel !ost( Disperses the stresses uniforly along its length e,cept at the ape,. Cecause of definite seat
of the post on the dentin, sharp angle at the ape, of the post and reduced tooth structure.
"ACTO%S IN"+3ENCIN* %ETENTION AN) %ESISTANCE(
I. %etention features
5. #ost design (
Regarding retention, the acti!e threaded post is ost retenti!e, followed *y the passi!e parallel
post: the passi!e tapered post is least retenti!e. The style of post selected should *e *ased upon the
aount of retention re-uired for long.ter success of the post.
$or e.g. If the a!aila*le post space is short, E.B, a ore retenti!e acti!e post ay *e indicated.
If the a!aila*le post space is <.> and the canal is not funnel shaped % a tapered post ay *e a *etter
choice. This is *ecause the a!aila*le post space is long enough to pro!ide ade-uate a,ial retention and it
does not re-uire canal enlargeent during post space preparation.
The design of the post head has a significant effect on the retention of the core aterial. 3 post
should *e selected that has a head designed appropriate for the chosen core aterial.
0. #ost length (
It is e!ident that greater post length results in greater post retention. 0owe!er it is iportant that (.
E of gutta.percha reain at the ape, to inii4e lea/age. Ahen placing a passi!e post, it should
generally *e as long as possi*le while not encroaching on the necessary reaining gutta.percha.
6. #ost diameter and remaining dentin (
3lthough post retention slightly increases with an increase in post diaeter, the ultiate tooth.post
co*ination is wea/ened *ecause of the increased post diaeter. The post diaeter should *e as sall as
16
possi*le while pro!iding the necessary rigidity. It is always iportant to lea!e as uch tooth structure as
possi*le in all phases of treatent.
+ach of increase 5*eyond &1=
rd
the root diaeter6 causes a si, fold increase in the potential for
root fracture.
Three different !hiloso!hies regarding !ost diameter(
Conser$ati$e a!!roach( 3d!ocated *y ?attison % to restrict the diaeter of the post to
conser!e the reaining tooth structure.
Increase in post diaeter.ele!ates stress in the radicular surface.
#ro!ortionist a!!roach( 3d!ocated *y 2tern and 0irschfeld % optial diaeter one.third the
diaeter of the root. It preser!es sufficient tooth structure.
#reser$ationist a!!roach( ad!ocated *y 0alle et al % proposed the preser!ation of at least
&.'E of sound dentin around the entire circuference of the post.sufficient to resist fracture of the
tooth.
$or selecting the post diaeter % suggested that the proportionist and preser!ationist approach *e
applied.
7. Surface !re!aration (
#reparation of the *oth the surfaces of the post and the canal surface can significantly increase 1
ipro!e post retention. 3ir a*rasion and notching of the post ha!e *een shown to increases retention. Ha*
data indicate that placing notches or groo!es in the surface of the canal also ipro!es post retention.
8. Canal !re!aration (
There are three priary ethod of gutta.percha reo!al for post space preparation % including
rotary instruents, heat, and sol!ents. 3ll the three ethods are effecti!e % regardless of the ethod used,
care ust *e ta/en to ensure that the #DH is not daaged. In)udicious use of rotary instruents, such as
#eeso Reaers, ay cause a significant teperature increase on the root surface. 2iilarly, a hot
instruent ay daage the #DH.
#ost space preparation ay *e accoplished at the sae appointent in which the canal is
o*turated or can *e delayed for 8(

hrs or ore. The in.!itro data do not indicate that one ethod is superior
to the other.
2uchina and Hudington and ?attison et al found no difference *etween hot instruent reo!al and
reo!al with gates glidden *urs. 0owe!er, 0addi, et al easured significantly less lea/age with a heated
plugger than when either a ;#L instruent or gates glidden drills were used.
;. Cement !lacement (
The ethod used to place ceent into the canal *efore post placeent has a significant effect on
post retention. 2pinning the ceent into the canal with a Hentulo spiral has *een shown to *e the ost
effecti!e ethod. The Hentulo spiral attached to a low speed handpiece soothly spins the ceent into the
lateral walls of the canal and eliinates air poc/ets, hence a*sence of air !oids, which ay ha!e significant
effect on the retention of the post. Other ethods used for placeent of the ceent are use of an
endodontic e,plorer, paper point and direct application of the ceent on the post. These ethods produce
!oids in increasing nu*ers in the following order:
The endodontic e&!lorer < direct a!!lication < !a!er !oint < +entulos!rial(

=. +uting cements (
The iportance of the type of ceent used for Huting posts has *een o!er ephasi4ed in the
dental literature.
Currently there are fi!e types of ceent a!aila*le for post ceentation. In recent years, there has
*een a greater deal of interest in the use of resin ceent to *ond a post into the prepared canal. 2oe la*
studies ha!e shown a significant increase in post retention with resin ceent.
If 4inc o,ide eugenol is used as a sealer % it is not possi*le to *ond a post into a prepared canal
when Minc o,ide eugenol is used as the sealer. Coposite luting ceent pro!ides no ad!antage o!er ore
traditional ceents and it is significantly ore e,pensi!e and techni-ue sensiti!e.
#olycar*o,ylate ceent has a lower copressi!e strength and therefore is not a first choice.
;lass ionoer has ade-uate physical properties % howe!er it is a slow setting aterial that
re-uires any hours of achie!e ade-uate strength. Resin.odified glass ionoer ceent % as originally
forulated, had significant setting e,pansion.
17
The ost traditional 4inc phosphate % has ade-uate physical properties, is ine,pensi!e, and easy
to use % reains an e,cellent choice for post ceentation.
%esin cement ( 0 matrices
a. Calciu alunisoilicate glass polyacrylic acid
*. 0+?3 deri!ati!e
The first atri, undergoes acid.*ase reaction to for an calciu aluinu polysalt hydrogel.
The 8 atrices cross.lin/ to for hy*rid aterials.
Ad$antages (
&. 3dded ad!antages of ;IC
8. Cond to enael and dentin
=. $luoride release
(. Hight cured 1 dual cured
E. Cetter physical properties.
The a*ility of different ceents to retain dental posts is related :
?echanical properties of the ceent
Conding efficiency of the ceent to the two surfaces *eing )oined.
Dura*ility of the ceent
The configuration of the post and the prepared canal, which influences the stress distri*ution
within the ceent, layer.
Minc phosphate, polycar*o,ylate, ;IC and resin ceent % coonly used.
Ceent layer pro!ides a *uffer 4one" that contri*utes to unifor stress distri*ution
*etween the post and the canal
3 thic/en or !aria*ly thic/ened layer of ceent could transfer stresses to the tooth in a
different anner than a unifor layer of ceent.
Inherent wea/ness 1 *rittleness of the ceent affect the fracture resistance of
endodontically treated tooth.
Noral occlusal forces create icroo!eents of a crown and the ceented post.
These icroo!eents are considered to cause disintegration of the *rittle ceent in the ost
coronal surface of the post
Resulting in concentration of stresses at the apical end of the root and leading to root
fracture *ecause of an increased le!er ar.
Newer resin ceents *ond effecti!ely to dentin and to etal. they gi!e additional resistance to
fracture copared to *rittle non.*onding 4inc phosphate ceent % as showed *y ?endi4a et al.
Cementation techniue ( has iportant effect upon the e!entual retention and stress distri*ution of the
post.
+ssential to achie!e a unifor, *u**le free layer of ceent that distri*utes the stress
e!enly throughout the entire root canal.
Use of a lentulosprial % considered to *e superior to place the ceent into the canal. It
gi!es *etter spinning and spreading of the ceent *ecause of centrifugal dispersion of the ceent.
It also reduces !oids and increases the contact of the ceent with the walls.
During ceentation % post space should *e free of any residue, as it has *een reported
that e!en a sall nodule on the post surface or teporary ceent residue in the canal can
generate enough force to cause root fracture during and after post ceentation.
Other !ossible causes of root fracture are (
De!elopent of hydrostatic pressure in the ceent
+,cessi!e seating pressure
+,cessi!e tor-ue e,erted *y the clinician on the post during ceentation.
/efore cementation of the !ost (
&. #ost space should *e cleaned *y a chelating agent, &'D +DT3 for =9 seconds.
8. $ollowed *y rinsing with E.8D NaOCI 5=9 sec6
=. Canals should *e rinsed with water and dried with paper points.
This procedure will help the post space wall to *e free of root canal sealant, de*ris and dentinal
sear layer.
>inc
!hos!hate
#oly
carbo&ylate
*IC %esin
ionomer
Com!omer Adhesi$e
resin cement
$il 8E N8E N8E O8E O8E
18
thic/ness
Aor/ing
tie
&.E.E &.'E.8.E 8.=.E 8.( =.&9 9.E.E
2etting tie E.&( B.> B.> 8 =.' &.&E
Cop.
2trength
5?#3P
B8.&9& B'.>& &88.&B8 (9.&(& &>(.899 &'>.8EE
+lastic
odulus
&=.8 . &&.8 . &' (.E.>.<
#ulp
irritation
?oderate How 0igh 0igh 0igh 0igh
2olu*ility 0igh 0igh How 7ery low 7ery low 7ery low
?icrolea/ag
e
0igh 7ery high How.
high
7ery low 0igh.to !ery
high
7ery low to low
Reo!ed of +asy ?ediu ?ediu ?ediu ?ediu Difficult
Retention ?oderate How.oderate ?oderat
e.high
?oderate.
high
?oderate 0igh

+i and white ? 1echanical !ro!erties of luting cement (
>n !hos!hate
41!a.
#oly
carbo&ylate
41!a.
*IC 41!a. A%C 41!a. %1*IC 41!a.
Diaetral T.2 &9 &8 &(.8& ((.E9 &'.8'
$le,ural
strength
(.' &(.=.89 '.&> '9.&99 E9.E=
@. Aenting (
Cecause of the intraradicular hydrostatic pressure created during ceentation of the post, a
eans for ceent to escape ust always *e pro!ided. Cecause !irtually all prefa*ricated posts ha!e a
!enting echanis incorporated in their design, this factor is iportant with the custo cast post. 3 !ent
ay *e incorporated in the pattern *efore casting or into the with a *ur prior to ceentation.
II. THE %ESISTANCE T%IA)(
2econd a)or consideration in the design of the post restoration is the resistance of the tooth %
post.crown co*ination. If the resistance re-uireents are not et, the pro*a*ility of failure is high,
regardless of the retenti!eness of the post.
Three paraeters of resistance ust *e considered. The resistance triad consists of the
8. $errule effect
=. 7ertical reaining coronal tooth structure
(. 3nti rotation.
These features wor/ in co*ination: therefore, if one of the features is inial or non.e,istent,
one are *oth of the reaining features ust *e increased.
0. The first feature of the resistance triad is the ferrule (
The $errule is a etal ring or cap intended for strengthening. The word pro*a*ly originates fro
co*ining the Hatin for iron 5ferru6 and *racelets 5!iriola6 5Crown, &>>=6.
"errul B ferrum C $iriola 4+atin term.
3 dental ferrule is an encircling *and of cast etal around the coronal surface of the tooth. It has
*een proposed that the use of a ferrule as part of the core or artificial crown ay *e of *enefit in reinforcing
root.filed tooth.
3 protecti!e, or ferrule effect" should occur owing to the ferrule resisting stresses such as
functional le!er forces, the wedging effect of tapered posts and the lateral forces e,erted during the post
insertion.
%osen proposed the concept of an e,tracoronal *race" su*gingi!al collar or apron of gold which
e,tends as far as possi*le *eyond the gingi!al seat of the core and copletely surrounds the perieter of
the cer!ical part of the tooth. It is an e,tension of the restoration crown, which *y its hugging action
pre!ents shattering of the root.
19
The collar significantly reduced the incidence of root fracture.
To *e effecti!e % it ust encircle the tooth 5=B9
9
6 and ideally e,tend at least &.E onto tooth
structure *elow the post and core argin.
6. Aertical remaining tooth structure (
Traditionally, it was thought that the face of the root should *e flattened prior to the construction of
the post and core. 0owe!er, it has *een shown that lea!ing as uch natural reaining tooth structure as
possi*le will significantly increase the resistance of the final restoration. Unfortunately, *ecause of caries,
traua, or iatrogenic reo!al, !ertical reaining tooth structure is not always a!aila*le.
7. Antirotation (
+!ery post and core ust ha!e an antirotation feature incorporated in the preparation.
3n elongated or o*long canal orifice can ser!e as an antirotation for post and core.
0owe!er, as the canal *ecoes ore round, the need for incorporation of antirotation
features *ecoes ore iportant. This is especially true for anterior teeth.
3u,illary pins and /eyways are prepared in the face of the root prior to construction of the post
and are ost coon antirotation de!ices.
Instrumentation.
3 wide !ariety of instruents can *e used for enlarging the root canal for a post: 2afe.ended
reaers, hand file, standard *urs with long shan/s.
The preparation is *egun *y placing a hot endodontic plugger appro,iately half the length of the
canal. This is followed *y the actual post preparation. #eeso reaers or ;ates ;lidden drills are widely
used for preparing the post space.
The ;ates ;lidden drill shares se!eral coon traits with the #eeso reaer: a non.cutting tip and
a siilar configuration in the cutting end. On the other hand, the ;ates ;lidden drill has uch shorter
cutting flutes 5&.E.(.96 than those of the #eeso reaer 5'.E.<.E6. 3ll si4es of *oth instruents
easure &< fro the cutting end 5*ase of the safety tip6 to the end of the tapered shaft, which is flush
with the head of the handpiece.
Cecause the #eeso reaers ha!e a sharp, *ut noncutting tip, they will follow the path of least
resistance, which is the cleared canal or the gutta percha in the canal. #eeso reaers will also confor
ore consistently to the original canal in the apical region than will other types of instruents.
Cegin with the largest si4e that will fit easily into the canal. #repare the canal to the coplete
predeterined length. Then switch to the ne,t largest instruent in the graduated series and repeat the
process. Do this until the desired diaeter has *een attained. ;ates ;lidden drills are easily used *ecause
the cutting portion is saller and ore aneu!era*le. They are often easier to use in starting !ery sall
canals. The ;ates ;lidden drills, distinguished *y their shorter cutting flutes and ore fle,i*le shafts, use
the sae nu*ering syste. The si4es range fro 9.B to &.E. 0owe!er, so that a no. ( #eeso reaer
5&.=6 and a No.( ;ates ;lidden drill 5&.&6 are not of the sae diaeter. The preparation should *e
copleted with the series of #eeso reaers, howe!er. The #eeso reaers nu*ered &.B, range in
diaeter fro 9.' to &.' in graduated increents of 9.8 . The longer cutting segent in it will
prepare a straighter canal wall with less li/elihood of an undercut. The instruent is leaned o!er lightly as it
is withdrawn fro the outh of the canal. This will result in an essential parallel.sided preparation with a
tapered orifice.
#eeso %eamer SiDes:
%eamer
Number
)iameter Teeth
& 9.' ?andi*ular incisor
8 9.> ?a,illary first preolar
?a,illary second olar 5D$6
?andi*ular first olar 5?H6
?andi*ular second olar 5?$, ?H6
= &.& ?a,illary second preolar
?a,illary first olar 5?$, D$6
?a,illary second olar 5?$6
?andi*ular first olar 5?$, D6
?andi*ular second olar 5D6
(. &.= ?a,illary lateral incisor
20
?andi*ular preolar
?a,illary olar 5H6
E &.E Canine
B &.' ?a,illary central incisor.
Custo cast post has a long history of clinical success
De!eloped in the &>=9:s to replace the one.piece post crowns.
This procedure re-uires casting a post and core as a separate coponent fro the crown
This two.step procedure ipro!es the arginal adaptation and allows for a !ariation in the path
of insertion of the crown.
The traditional custo cast post core pro!ides a *etter geoetric adaptation to e,cessi!ely
flared or elliptical canals.
It alost always re-uires iniu tooth structure reo!al
Custo cast post and cores adapt well to e,treely tapered canals or those with a non.circular
cross.section or irregular shape, and roots with inial reaining coronal tooth structure.
This ethod re-uires two.appointent !isits and a la*oratory fee.
3s it is cast in an alloy with a odulus of elasticity as high as &9 ties the natural dentin G this
possi*le incopati*ility can create stress concentration in the les rigid root, resulting in post separation
or failure.
The transission of occlusal forces through the etal cores can focus stresses at specific
regions of the root, causing root fracture.
Upon esthetic considerations, case etallic post can result in discoloration and shadowing of the
gingi!a and the cer!ical aspect of the tooth.
The custo % cast post has a long history of clinical success. 0owe!er, when it is copared to
parallel pre.fa*ricated posts, *oth in !itro and in !i!o, its superiority is -uestiona*le.
There are, howe!er circustances in which the custo.cast post is the restoration of choice,
including, the following:
&. Ahen ultiple cores are *eing placed in the sae arch. It is ore cost effecti!e to prepare
ultiple post spaces, a/e an ipression and fa*ricate the posts in the la*oratory.
8. Ahen post and cores are *eing placed in sall teeth, such as andi*ular incisors. In these
circustances, it is often difficult to retain the core aterial on the head of the post.
=. Ahen the angle of the core ust *e changed in relation to the post. #refa*ricated posts should not
*e *entQ therefore, the custo % cost *est fulfills this re-uireent.
(. Ahen an all.ceraic non.core restoration is placed it is necessary to ha!e a core that
appro,iately the color of natural tooth structure. If a large core is *eing placed in a high.stress
situation, resin coposite ay not *e the aterial of choice due to the fact that it tends to defor
under a load. In this circustance, the post and core can *e cast in etal, and porcelain can *e
fi,ed to the core to siulate the color of natural tooth structure. The core porcelain can than *e
etched with hydrofluoric acid and the all.ceraic crown can *e *onded to the core.
The traditional custo cast post core pro!ides a *etter geoetric adaptation to e,cessi!ely flared
or elliptical canals and alost always re-uires iniu tooth structure reo!al. Custo.cast post and
cores adapt well to e,treely tapered canals or those with a non.circular cross.section or irregular shape
and roots with inial reaining coronal tooth structure.
#atterns for custo cast posts can *e fored either directly in the outh or indirectly in the
la*oratory. Regardless, this ethod re-uires two appointent !isits and a la*, fee. 3lso, *ecause it is cast
in an alloy with a odulus of elasticity that can *e as high as &9 ties greater than that of natural dentin,
this possi*le incopati*ility failure. 3dditionally, the transission of occlusal forces through the etal core
can focus stresses at specific regions of the root, causing root fracture.
$urtherore, upon esthetic consideration the cast etallic post can result in discoloration and
shadowing of the gingi!a and the cer!ical aspect of the tooth.
"3N)A1ENTA+ %3+ES "O% E#OSTF
The !ost must be atleast as long as the crown it is to carry.
The !ost must ha$e !arallel sides or ha$e a ma&imum con$ergence of 6.8
G
.
The !ost must achie$e a !recision fit in the root canal.

21
)esign !rinci!les to be consideredH
The following design principles should *e considered when using any post.retained crown syste
in the reconstruction of the tooth restorati!e cople,.
&. ?a,iu post retention and core sta*ility.
8. Inherent antirotation of the post and core cople, *y accentuating the eccentric coronal shape of
the root canal.
=. ?inial reo!al of the tooth structure
(. ?orphologic intra.radicular adaptation.
E. Optial esthetics
B. Inherent resistance to catastrophic failure of the root.
'. Hac/ of corrosi!eness
<. #ost with siilar odulus of elasticity as root dentin to distri*ute applied forces e!enly along the
length of the post.
>. Restorati!e aterials with fle,ural and tensile strength characteristics siilar to root structure.
&9. 3 syste with uninterrupted *onding at all interfaces, resulting in increased resistance to fatigue
and fracture, enhanced retention, and reduction in icrolea/age and *acterial infiltration.
%ational design !rinci!les for !ost and cores(
No atter which ceent or core aterial is used, there are certain design principles that need to
*e followed.
#rime obIecti$es include(
&. 3 sealed interface *etween the restoration and the tooth structure, *oth down the post cha*er
and under the core. It is prefera*le that the luting aterial should *ond to the tooth and pre!ent
recurrent caries.
8. 3de-uate retention prefera*ly not gained solely fro the post *ut also fro the core. Tooth
structure can and should *e retained, pro!iding it has sufficient *ul/ and strength.
=. Inherent antirotation of the post and core cople,
(. ?inial stressing of the residual tooth structure in preparation, post insertion, or postoperati!e
function.
E. Negligi*le interference with preparation and restoration of the final crown cople,.
B. Inherent resistance to catastrophic failure such as fracture of the tooth, caries down the post
cha*er, gross fracture of the core, or fracture of the post at the tooth le!el.

#refa*ricated posts : 3ccording to shape 3ccording to surface configuration
#arallel 3cti!e
Tapered #assi!e
#arallel tapered

Cut threaded post e,hi*it unfa!ora*le patterns of stress distri*ution on placeent and during faction.
Concentrate seen at the dentinal thread interface. To reduce stress induced *y acti!e posts.
&. #retapping post channels
8. Hiiting the nu*er of post threads
=. Counter rotating the post *y an R after its full engageent.
Custom #ost,Core (
Custo post.core can *e fa*ricated in two techni-ues :
Direct
Indirect
The procedures differ only in the eans *y which the post and core pattern is generated. Coth
utili4e instruentation and aterials fro the sae syste.
In the direct techni-ue the custo post.core pattern is fa*ricated directly in the outh on the
prepared tooth.
The indirect techni-ue utili4es an ipression and stone die of the tooth for pattern fa*rication. The pattern
fro either the direct or indirect techni-ue is then in!ested and cast with gold or any other crown and *ridge
alloy.
Direct technique
The direct custo post core is ade *y fa*ricating a resin or wa, pattern in the prepared tooth in
the patient:s outh. 2oe for of plastic post or thin etal post is used as the central reinforceent
around which the resin or wa, pattern is fored. Relining the post, while it does ta/e tie pro!ides for an
accurate fit of the post in the canal, with faciolingual irregularities in the canal incorporated into the anti.
22
rotational aspect of the post. Ahen the canal is not o!oid enough to pro!ide the needed anti.rotational
sta*ility, the canal preparation is odified with /eyways to resist tor-ue in the restoration.
The pattern can *e ade of wa, reinforced with a plastic rod, a *ur, a etal pin or a paper clip.
3crylic resin can also *e used for this purpose or wa, and acrylic can *e co*ined. The use of resin allows
the pattern to *e fored into a well adapted solid post that can *e anipulated easily in the outh without
*ecoing distorted or loose in the canal.
3fter reo!ing as uch gutta.percha as possi*le with a hot endodontic plugger, *egin the actual canal
preparation with the largest reaer which will fit into the canal.
?a/e a radiograph to chec/ the accuracy of the preparation depth. Use the radiograph to a/e any
necessary ad)ustents in the reaer length.
3 /eyway is placed in the orifice of the canal to pro!ide anti.rotational sta*ility to the post. One or ore
!ertical groo!es are cut in the walls of the canals, e,tending =.( down the canal. The sae effect
can *e achie!ed on a ulti rooted tooth *y placing a short post into a second canal.
The /eyway should *e cut to the depth of the diaeter of a No. &'9 *ur 5nearly &.9 6 in the area of
greatest *ul/. 3 second opposing /eyway is placed in larger teeth.
3dd a proinent contra*e!el to pro!ide a collar around the occlusal circuference of the preparation. It
will aid in holding the tooth together and pre!enting fracture. This ser!es as a safeguard on a precision
fitting post, which can e,ert lateral forces during ceentation.
The post.core pattern will *e fa*ricated with a plastic screw and resin . Once the preparation is ready
for the fa*rication of direct pattern, wrap a cotton pellet tightly around a No.& #eeso reaer and dip it
into the duralay lu*ricant. The cotton should *e copletely coated with the lu*ricant.
Insert the peeso reaer to the entire length of the post preparation. Then pup the reaer in and out
to a/e sure that the entire canal is well coated. 2oe of the lu*ricant should *e on the coronal part of
the preparation as well.
Use &( gauge plastic sprues for the pattern. They are hard enough to reinforce the pattern and they will
*urnout cleanly. #lastic tooth pic/s are softened *y the onoer and often are separated fro the
pattern during reo!al.
Tri the sprue with a garnet disc so that it will fit into the canal easily. It ust reach the apical end of
the post preparation. Cut a sall notch in the facial portion of the occlusal end of the plastic sprue to
aid in orienting the pattern in su*se-uent steps. Coat the plastic sprue with onoer.
?i, the duralay onoer and polyer to a thin, runny consistency in a dappen dish and fill the outh
of the lu*ricated canal as copletely as possi*le with a plastic filling instruent.
Coat the plastic sprue with the acrylic while it is still fluid.
2eat the resin co!ered sprue in the canal until it has touched the apical end of the post preparation.
?a/e sure that all the e,ternal contra*e!el is co!ered at this tie.
?ore resin is added to the coronal portion of the pattern to pro!ide the *ul/ for the core. It can *e
added while the post is still polyeri4ing or it can *e added as a fresh i, to the polyeri4ed post.
Ahen the resin on the post itself *ecoes doughy, pup the pattern up and down to pre!ent its *eing
loc/ed into any undercuts in the canal.
Reo!e the post fro the canal and see if it e,tends the full length of the prepared canal . $ill any
!oids with soft utility wa, and replace the pattern.
2hape the coronal portion of the pattern to for it into a crown preparation for the final restoration.
Reo!e the pattern fro the outh end roughly shape the a,ial surface with a garnet disc. Replace it
in the tooth fro tie to tie to ensure that the contours *eing shaped are consistent with the
reaining coronal tooth structure. Ce sure that the finish line of the final crown preparation is on tooth
structure and not on the core.
3fter coplete finishing of core pattern, it is cast in gold or nic/el %chroe alloy.
The core portion of the casting should *e soothened to a satin or atte finish.
Use a car*ide no:=( *ur to cut a 7.shaped ceent escape !ent on the side of the post. This groo!e
should help greatly to pre!ent daaging lateral stresses during ceentation. Ahile using the hard
nic/el.chroe alloys, this tas/ can *e ade easier and faster *y placing the groo!e in the acrylic
pattern and retouching it in the finished casting.
#repare a thin i, of 4inc phosphate ceent and insert soe into the outh of the dried, isolated
canal. Co!er the *lade of the instruent with ceent a second tie and hold it incisal to the outh of
the canal. Insert slowly rotating lentulo spiral paste filler through the ass of the li-uid ceent to carry
23
the ceent into the canal. 3pply ore ceent to the outh of the canal until no ore will o!e into the
canal.
Hi*erally coat the post with the fluid ceent and insert the post into the canal.
2eat the post slowly with finger pressure, allowing the ceent to escape ahead of the post. If the
incisal edge of the core is uncoforta*le against the finger, cushion it with a cotton roll. Ne!er allet
the post to place. The close fitting hydraulic cha*er fored *y a custo post o!ing through a
!iscous li-uid in a parallel walled canal can produce considera*le stress in the lateral walls of the tooth,
and fracture could result.
Ahen the ceent has set , go o!er the a,ial surfaces of the core and tooth structure with a fine grit
diaond as it is iportant to reo!e any inor undercuts in the a,ial surfaces near the argin of the
post.core. If allowed to reain, any defects in the a,ial surface could present o*stacles to the
successful copletion of the final restoration.
The tooth can now *e restored with a crown. The portion of the coronal tooth for that has *een *uilt
up with the core can *e treated as though it were tooth structure when the final restoration is fa*ricated.

24
Indirect technique

3 custo post.core can also *e fa*ricated *y a/ing wa, or resin pattern on a cast of the
prepared tooth.
3n ipression can *e ade *y in)ecting ipression aterial into the canal and then using a
lentulo spiral paste filler to ensure the eliination of entrapped air and !oids in the ipression of the canal.
The ipression is reinforced with soe type of rigid post. The ites that ha!e *een used for this purpose
are paper clips, short lengths of wire, plastic sprues, and a root canal instruent. These reinforcing de!ices
not only strengthen the ipression when it is ade, *ut also when it is poured and separated.
3 custo acrylic post can also *e ade in the tooth to ser!e as the ipression of the canal in
transferring it to a cast for fa*rication of the core and restoration. Ahen the indirect techni-ue is used with
one of the prefa*ricated precision plastic patterns, a post pattern is placed into the canal, and it is pic/ed up
in the ipression. The post then creates its own space in the cast when the ipression is poured.
Ahile any ipression aterial with which the operator is failiar can *e used, light *ody
elastoeric aterials which are ore fle,i*le is preferred.
Once the cast is poured, a reo!a*le die should *e fa*ricated. The cast is ounted in a Di.Ho/
tray. This perits the use of a reo!a*le die without any possi*le interference *etween a post pin on
the *otto of the die and the post core preparation deep within the die.
The wa, pattern can now *e fa*ricated on the die and wor/ing cast.
25
Hu*ricate the die copiously with a die lu*ricant. ?a/e sure the post preparation is well filled.
Dead soft,&8 gauge round wa, fors can *e used to for the post. It is placed into the *otto of
the canal in the lu*ricated die. Cut it off flush with the top of the coronal tooth structure with a sharp
la*oratory /nife.
;rasp a piece of wire such as a straightened paper clip in cotton pliers and heat it in the flae of a
Cunsen *urner. #lunge the hot wire into the canal until it touches the *otto, elting all the wa, in the
canal. 0old it steady until the wire cools and the wa, solidifies.
;ently pup the wire and soft wa, post in and out a few ties to a/e sure that it is easily
reo!a*le fro the die.
Use regular inlay wa, to *uild up the core portion of the wa, pattern.
$inish the argins of the core with a war *ea!er tail *urnisher to produce as well fitting a casting
as possi*le.
The copleted wa, pattern will ha!e the paper clip protruding fro the incisal edge or lingual
surface. The wire will ser!e as the ain support of the sprue. 2oft wa, is added to the wire to thic/en it
to the diaeter of a &9 or &8 gauge sprue.
In!esting and casting can *e done in the regular way. #lace the copleted post .core in the die,
a/ing sure that it is copletely seated.
Relu*ricate the die and lu*ricate the core. Then wa, a coping for the porcelain fused to etal
crown.
2eat the cast coping *ac/ on the post core in the die. The arginal adaptation should *e good and
the fit of the coping o!er the post core and die should *e passi!e, i.e., there should *e no *inding.
#orcelain fused to etal restoration is fa*ricated.
The post.core and crown are ceented se-uentially, paying particular attention to the arginal fit
of the porcelain fused to etal crown.
If there is any -uestion a*out the a*ility of the technician to produce a well fitting crown with this
non % stop techni-ue, then the post.core should *e ceented and an ipression is ade for
fa*rication of the porcelain fused to etal.
C3STO1 )OJE+,CO%E 4TJO #IECE. (
2ingle piece post.core is an e,cellent restoration for anterior teeth and preolars, it is not often
used for olars. If a olar has any *ul/ of coronal tooth structure reaining, it usually will *e restored with
an aalga or a coposite resin pin core. If there is no reaining coronal tooth structure, it is necessary to
use at least one dowel to pro!ide sta*ility against hori4ontally directed forces. If a olar is to *e restored
with a single crown, a single.piece cast dowel.core or an aalga or coposite resin core with one or
ore prefa*ricated etal dowels can *e used. 3 cast dowel core placed down one priary canal of a
posterior tooth can *e successful if the root is fairly long, straight, and *ul/y.
0owe!er, if a se!erely daaged tooth is to *e su*)ected to the stresses of acting as an a*utent
for a fi,ed *ridge or reo!a*le partial denture, ore resistance and retention are re-uired. Cecause of the
root di!ergence found in ost olars, using a dowel.core with two or three parallel dowels e,tended into
ultiple roots can *e -uite ha4ardous. Therefore a ulti.piece dowel core with separate dowels should *e
eployed.
The dowel.core for a andi*ular olar is usually di!ided into esial and distal segents. The
a,illary olar dowel %core is coposed of facial and lingual coponents with the dowels in the two facial
canals paralleling each other. Ahen the esiofacial and distofacial canals are too di!ergent to perit
parallel dowels, a separate third dowel is re-uired.
$or a two piece dowel.core to achie!e a,iu strength and retention fro the dowels in
di!ergent canals, the pieces ust *e rigidly *ound together after insertion. 3 nu*er of ingenious ethods
ha!e *een proposed for accoplishing this. The core can *e ade in two hal!es, held together *y
interloc/ing lugs, which can *e fored fro a coercially a!aila*le non.rigid connector pattern or *y
cutting a /eyway or do!etail in one half of the core pattern.
3 coonly used solution for the pro*le is the fa*rication of the core with an integral dowel and
a channel in the core through which an accessory dowel is ceented. The hole for the interloc/ing
accessory dowel is aligned with a preparation in another di!erging canal. The accessory dowel acts as a
dowel.core within a dowel.core and its di!ergent direction helps to nail the core in place. The secondary
dowel can *e a prefa*ricated post or wire, or it can *e a cast custo dowel. 3 !ariation on this thee uses
a core with no attached dowel. It is pierced with channels for two or three di!erging separate dowels which,
when inserted and ceented, will hold the core firly in position.
26
$inally the core *e fa*ricated in two hal!es with pin holes in the first half and interloc/ing pins in
the second half. The core is pinned together when *oth hal!es ha!e *een ceented in the tooth.
3ny of these interloc/ing ethods can *e fa*ricated *y the direct techni-ue or *y the indirect
techni-ue of which the latter techni-ue sees to *e far ore e,peditious and siple.
In indirect techni-ue, it is iportant to o*tain an accurate ipression of the canal preparation. 3
short segent of wire 5paper clip6 is placed in each canal to reinforce the ipression dowel . Once
the cast is ready, the wa, pattern for the facial half of the dowel core will *e fa*ricated first. On a
andi*ular tooth, it would *e esial half.
;auged, plastic sprues are tried into the two facial canals. Tri the with coarse garnet discs so
they will fit easily to the *otto of their respecti!e dowel preparation.
3fter sufficient lu*rication, place soft round wa, fors into each of the two facial canals. Cut the
off flush with the root face of the tooth.
#lunge a hot #IT no.& instruent to the *otto of each of the canals, elting the soft wa,
copletely. Ahile the wa, in the facial canals is still soft, insert the tried solid plastic sprues
into the wa, and sho!e each of the to the *otto of its respecti!e canal.
To pro!ide the loc/ing echanis for tying the two hal!es of the core together after ceentation,
pin holes are drilled in the facial half of the core.
The facial half of a core is then produced. The e,ternal a,ial contours of the facial half will *e
consistent with the a,ial walls of a full crown preparation. The lingual surface will *e flat sooth
surface, which parallels the path of insertion of the palatal canal. Use an enael hatchet for core
and &.E wide ledge or shoulder in the occlusal third of the lingual surface.
Carefully align a 9.' drill with the path of insertion of the palatal canal.
Drill the pin holes in the ledge, a/ing the parallel with each other and the path of insertion of
the palatal canal. $or a,iu effecti!eness, they should e,tent the full length of the core.
3 short section of thin pencil lead is placed in each pinhole *efore in!esting. This will /eep the
holes patent during *urnout and casting. 3*out 8 of graphite should show at each end of the
pin hole to ensure that the rods will *e held securely *y the in!estent.
The pattern is in!ested, *urned out, and cast .3 gold alloy should *e used *ecause graphite rods
are eployed to aintain the pin holes. The containation of a chroiu containing alloy with
car*on will increase *rittleness and decrease corrosion resistance. Use the 9.' drill to reo!e
the graphite fro the pin holes. Once the casting for the facial half of the dowel core has *een
fa*ricated, the lingual half can *e ade against it on the cast.
2eat the copleted facial of the dowel.core into the facial canals. Chec/ to a/e sure that the
lingual surface and the two pin holes are parallel with the dowel preparation in the palatal canal.
Insert nylon *ristles into each of the pin holes and lu*ricate the lingual surface of the facial core.
Relu*ricate the palatal canal profusely.
Try a &( gauge plastic sprue into the palatal canal. Tri the sides of the spring with a coarse
garnet disc to allow the sprue to slip easily to the *otto of the canal.
Aa, or acrylic resin can *e used to *uild the pattern. 3 fresh i, of resin is placed in the outh of
the canal, and the tried plastic sprue is seated to place.
Ahen the acrylic is near polyeri4ation, pup the sprue in and out se!eral ties to ensure that it
will not loc/ into any undercuts.
Use a second i, of acrylic to *uild.up the re-uired *ul/ for the lingual half of the core. The resin
should surround the nylon *ristles pro)ecting fro the facial core, and it should o!erlay the occlusal
aspect of the facial core.
Use garnet discs and car*ide *urs to shape the a,ial contours and occlusal planes of the lingual
core. The core should now rese*le a tooth preparation for a full crown.
Use inlay wa, to touch up any !oids in the acrylic pattern. ?argins should *e well adapted and
a,ial surfaces should *e free fro undercuts.
3fter the lingual half is in!ested and cast, finishing is done with a*rasi!e discs and ru**er wheels.
The two hal!es of the dowel core are asse*led in the wor/ing cast to ensure that they will fit
together in the tooth.
The two piece dowel .core is now ready to *e ceented in the tooth to re*uild it for placeent of
the final restoration. The facial half will *e ceented first following iediately *y the lingual
half .On a andi*ular tooth the esial would *e first, followed *y the distal.
27
Cut a !.shaped ceent !ent down the length of each dowel to assist coplete seating and the
pre!ention of daaging stresses. The ceented dowel.core is now ready for copletion. The finish
line is touched up with a chafer diaond to pro!ide space for the *ul/ of etal ad)acent to the acute
argin in the final crown. The argin of the final restoration will *e placed on solid tooth structure to
pro!ide a arginal seal and to pro!ide a *and of reinforcing etal apical to the core
#refabricated !ost core systems: .
)owel,Core under a crown(
There are occasions when a tooth which has *een restored with a crown will fracture causing the
displaceent of the crown. This is caused *y wea/ened structural integrity of the crown as a result of
pre!ious restorations, caries, sall diaeter of coronal tooth structure, *rittleness, traua or a co*ination
of soe or all of these factors. 2uch a tooth ay ha!e *een endodontically treated without placeent of the
dowel % core or it ay still ha!e *een !ital.
7ery often the fracture of the tooth will ean rea/ing the crown, or in the se!ere cases in which
the fracture e,tends too far apically, it ay e!en ean loss of the tooth. There are conditions which ay
perit less drastic treatent. Crowns that eet two criteria can *e reused. $irst, the fracture ust *e
restricted to coronal tooth structure without e,tending far enough apically to intersect the finish line. 2econd,
the crown ust e,hi*it ade-uate argins and ha!e accepta*le contours and esthetics.
The tooth is restored endodontically, if that has not already *een done. 3 dowel preparation is then
ade in the canal and a dowel. core is fa*ricated using the inside of the crown as a atri, for the coronal
portion of the dowel.core pattern.
)owel,Inlay crown re!air 4Secondary intention !ost and core. (
The teeth that ha!e *een restored with crown will soeties re-uire endodontic treatent later. It
is a good idea to inii4e these situations *y ne!er placing a cast restoration on a tooth with a pulp cap
o!er an e,posure. Ne!ertheless, not e!ery pulpal coplication can *e foreseen, and endodontic treatent
will occasionally *e re-uired after the tooth has *een restored.
In ost cases, the root canal treatent will *e done through the cast restoration. Ahile it is
possi*le to reo!e a crown, the crown or the tooth preparation under it ay *e daaged in the process. If
an otherwise sound restoration ust *e penetrated to pro!ide an endodontic access, there arises a
-uestion of how will the tooth *e restored after the endodontic procedure has *een copleted.
It is not enough to place an aalga or coposite resin restoration in the access opening for a
single.rooted tooth. The tooth structure co!ered *y a crown suffers fro the sae wea/ness that *esets an
endodontically treated tooth *efore placeent of a crown. In fact, the pro*le is pro*a*ly a little worse in
this case. 3n endodontic access through a crown is often larger *ecause the crown o*scures the
orphology of the tooth and a/es it ore difficult to locate the pulp cha*er.
The solutions for these pro*les include
&. Cast dowels with an attached inlay to close the access opening .
8. #refa*ricated dowel with a coposite resin closure restoration.
=. 3 prefa*ricated dowel with an aalga seal.
This process of repair has *een referred as a secondary intention" dowel or post and core.
Core "abrication with #recision #lastic )owel
The prefa*ricated precision dowel fors part of a syste in which the dowel is designed to fit a
canal space shaped *y a specific instruent of atching si4e and configuration. This differs fro the
custo dowel.core *ecause the canal is prepared to fit the dowel rather than a pattern *eing ade as an
ipression of the internal aspect of the tooth. The resulting fit ay not *e as e,act *ut it is usually clinically
accepta*le.
#recision plastic dowels are a!aila*le in parallel and tapered configuration. #arallel dowels e,hi*it
superior retention: studies ha!e found the to *e &.> ties, =.= ties and (.E ties as retenti!e as
prefa*ricated tapered dowels of e-ual length. If the surface is serrated, retention will *e ipro!ed e!en
ore.
Core fabrication with Precision parallel plastic dowel:
#refa*ricated dowel patterns are a!aila*le with a serrated surface and parallel .sided geoetry
5#ara.#ost6. It is designed to *e used with one or ore parallel pins set in dentin peripheral to the canal.
The pins act priarily as anti.rotational features, although they ay add soe retention and resistance to
dowel.cores which are lac/ing those -ualities *ecause of tooth si4e or orphology. The #ara.#ost is
anufactured with a groo!e running its entire length to act as a ceent !ent.
Conditions which perit the use of a serrated parallel plastic dowel pattern include a fairly *ul/y
root and a canal which is essentially straight. The dowel pic/ed ust *e large enough in diaeter to include
28
the coronal portion of the canal, *ut sall enough to lea!e an ade-uate thic/ness of dentin at the apical
end. If the coronal portion of the canal has *een enlarged e,cessi!ely, a sall dowel ay fit too loosely,
and a larger dowel ay cause insufficient tooth structure to *e left in the apical section.
It is also necessary to e!aluate the tooth structure a!aila*le for pin placeent. If there is
insufficient *ul/ to accoodate pins, /ey ways can *e prepared in the walls of the canal. The ost
iportant factor in the retention of a precision parallel dowel, as with any dowel, is length. 2ince no part of
the dowel preparation de!eloped *y the standard #ara.#ost drill is rounded o!er or tapered, the dowel
space tends to coe closer to the e,terior of the root at its apical e,tension. 3n assessent of the length of
the dowel space should ta/e this into account. The dowel should *e at least as long as possi*le without
encroaching on the apical (.9. of the endodontic filling.
Color coded plastic posts are a!aila*le in diaeters of &.8E . 5red6, &.E9 . 5*lac/6, and &.'E
. 5green6. Diaeters of 9.> and &.9 can also *e o*tained. There is a paralleling )ig for each of
the diaeters to *e used in con)unction with a 9.' #araa, twist drill. #lastic pins are used for an
ipression if the indirect techni-ue is eployed, and Iridioplatinu pins are used for the wa, pattern and
casting .
3 tooth *eing considered as a candidate for restoration with a #ara.#ost dowel.core should not *e
e,cessi!ely tapered, and an ade-uate aount of tooth structure for pin placeent should *e present
around the periphery of the canal.
The canal preparation is done, using the appropriate si4e of drill for the #ara.#ost /it.
The paralleling )ig and a 9.' #araa, drill are used to place pin holes parallel with the dowel
space.
3fter the plastic dowel pattern and iridioplatinu pins ha!e *een inserted, the core portion of the
pattern is fa*ricated fro autopolyeri4ing acrylic resin . #reparation of the core is accoplished
,producing in it the contour of a crown preparation for a porcelain fused to etal crown .
The cast dowel.core is chec/ed for coplete seating and ade-uate fit. 3ny odifications needed
on the core should *e accoplished prior to ceentation .
The fa*rication of the final crown is now accoplished. The dowel.core restoration is treated )ust
as if it were a preparation in natural tooth structure.
Core fabrication with Precision tapered plastic dowel
?ost of the precision plastic dowel syste which are ar/eted today are tapered with the taper
ranging fro &.&
9
to B.8
9
. Ideally, the use of a tapered precision plastic dowel with a atched reaer of the
sae si4e o*!iates the need for relining the dowel in the canal when the dowel core is fa*ricated. The use
of a taper is ad!ocated *y soe authors *ecause it ore nearly appro,iates the tapered configuration of
roots, there*y lessening the chance of a lateral perforation during dowel preparation. Tapered dowels
e,hi*it the least stress during ceentation, *ut they do tend to ha!e a wedging effect.
To atch the tapered plastic pattern to the dowel preparation with accuracy, it ay *e necessary
to cut a little length for the sall end of the pattern, or reinstruent the canal to enlarge it slightly,
depending on whether the dowel is too loose or too tight. This ust *e done with great care, coparing the
depth of the dowel preparation and the length of the dowel pattern. Otherwise, it is possi*le to wedge a
tapered dowel into the canal a/ing contact with the walls short of full seating of the dowel. The operator
ay isinterpret the slight tug.*ac/ that he feels as a anifestation of an accurate fit.
The use of a tapered precision plastic dowel with a atched. reaer of sae si4e o*!iates the
need for relining the dowel in the canal when the dowel core is fa*ricated. The ost coonly used
tapered plastic dowels are : &. Cali*rated Instruentation /it
&. Coloraa /it
8. #.D posts
=. The +ndowel syste
The C.I 5Cali*rated instruentation6 Iit consists of three rotary instruents. The dowel preparation
is *egun with a *i*e!el twist drill. Ahen the initial channel has *een prepared, it is enlarged with a pointed
reaer. The final diaeter and taper is achie!ed with a tapered fissure *ur whose si4e and taper atch
those of the dowel pattern. The sooth %sided patterns ha!e a taper of 8.B
9
, and they are a!aila*le in two
si4es: &.9.&.= and &.8.&.B . The two nu*ers in each set indicate the diaeters at the tip and &9
fro the tip. There is a separate set of instruents for each dowel si4e .
There are fi!e si4es of patterns in the Coloraa Iit: 9.<.&.= ., 9.>.&.( ., &.9.&.B ., &.9.
&.< ., and &.&.8.9 . The sooth sided dowel patterns are actually a co*ination of tapered and
parallel % sided, with the tapered portion increasing in length fro E.9 on the sallest dowel to >.9
29
on the largest. The tapered portion has a con!ergence angle of B.8
9
. The dowel preparation is
accoplished with a color.coded engine reaer of a atching si4e, which is tapered near the tip and
parallel.sided ad)acent to the shan/.
#.D #ostsS are sooth sided plastic dowel patterns with a unifor con!ergence angle of &.B
9
. The
dowel space is prepared with a reaer of li/e taper and diaeter. +ach reaer has an ad)usta*le sliding
etal stop which is held in place with a set screw. The patterns are a!aila*le in si4es: 9.>.&.= , &.&.&.E
, &.=.&.' , &.'.8.& , and &.>.8.= .
The +ndowelS syste differs fro the others in that its sooth tapered dowel patterns are
atched to hand instruents, i.e., the standardi4ed endodontic files and reaers. Therefore, they e,hi*it
the &.&
9
taper of standardi4ed endodontic instruents. The dowels are a!aila*le in eight si4es: '9 59.'.9.>
.6, <9 59.<.&.9 .6, >959.>.&.&.6,&99 5&.9.&.8.6,&&9 5&.&.&.= .6, &89 5&.8.&.( .6, &=9 5&.=.
&.E .6, and &(9 5&.(.&.B .6. In each pair of nu*ers, the first designates the diaeter at the tip, while
the second represents the diaeter &9 . fro the tip.
The preparation for the dowel.core is *egun *y appro,iating the preparation for the final
restoration, a porcelain fused to etal crown. This will facilitate fa*rication of a properly contoured
core pattern later.
3 series of hand files will *e used to enlarge and lengthen the canal to the desired si4e. Cecause
standardi4ed endodontic hand files are used, this step could *e nearly copleted at the tie of
endodontic treatent and erely touched up at this point.
3 /eyway should *e placed at the outh of the canal to pro!ide anti.rotational resistance. 7ertical
groo!es =.( . long are use on single rooted teeth, and a short dowel in a second canal is used
on ulti rooted teeth.
The dowel %core pattern will *e fa*ricated with the corresponding si4e of tapered plastic +ndowel
pattern. It can *e used for a/ing an ipression for the indirect techni-ue, or a direct core can *e
attached to the dowel in the tooth. Coth wa, and resin ha!e *een descri*ed for this purpose .
2hape the coronal *ul/ of resin to for it into a crown preparation for the restoration which will
ultiately *e placed on the tooth.
The tooth is ready to *e restored with a crown, treating that portion of coronal tooth for, which
has *een *uilt up with the core as though it were tooth structure.
#refabricated )owel K Cast Core (
3nother approach to the fa*rication of dowel %core is one in which a precision ade prefa*ricated
dowel is atched in si4e to a *ur or hand reaer. 3fter the dowel preparation is copleted, the
prefa*ricated dowel is fit in the canal. The core is then ade of resin or wa, *y either the direct or indirect
techni-ue. The etal dowel and its attached core pattern are in!ested and the core is *urned out. Then the
core is cast in etal.
3d!antages :
&. #art of the dowel core is already copleted *efore the procedure is e!en *egun i.e., the dowel.
8. 2uperior strength of a wrought or drawn dowel when copared to a cast one especially when the
dowel is less than &.E in diaeter. The prefa*ricated dowels ha!e *een ade of a !ariety of
aterials: gold, gold.platinu.palladiu. iridoplatinu, platini4ed wire, nic/el.co*alt.chroiu and
stainless steel. The core can *e fa*ricated *y the direct or indirect techni-ue. Coth parallel and
tapered dowels are a!aila*le.
3 coonly used syste has *een the +ndo.#ostS, which has also *een grouped under #recision
Tapered #lastic Dowel and descri*ed earlier. The preparation for this type of dowel core is sae as that of
#recision Tapered #lastic Dowel.
#refabricated )owel K Com!osite %esin Core(
30
#erhaps the siplest and ost efficient ethod for the fa*rication of a dowel core restoration is
the coposite resin core in co*ination with a prefa*ricated stainless steel dowel. The entire procedure,
fro copletion of endodontic o*turation through the finished crown preparation, can *e accoplished in a
single appointent. This syste can *e successfully used in a wide range of clinical situations. 3t
one e,tree, this type of dowel has *een shown to significantly strengthen teeth with no coronal
destruction other than the endodontic access preparation.3t the other end of the spectru, the
prefa*ricated dowel1coposite resin core can *e used to restore *oth anterior and posterior teeth than ha!e
little or no intact coronal tooth structure.
Coposite resin is easily and -uic/ly placed as a core aterial, and it has the added ad!antage of
*eing copletely polyeri4ed within inutes, allowing wor/ on the core preparation to progress
iediately. #reparations on aalga cores, on the other hand, often ust *e delayed until a su*se-uent
appointent. The resin re-uires less *ul/ of core aterial, a/ing it the aterial of choice for anterior teeth
where there is often inial space around the dowel.
The prefa*ricated dowel 1 coposite resin core is ade-uate for restoration of single anterior teeth.
0owe!er ost anterior *ridge a*utents should ha!e cast dowel.cores. ?any olars re-uiring crowns can
also *e restored with this syste. Two or three dowels can usually *e placed for resistance to o*li-uely
directed forces, and there is typically roo for a generous *ul/ of core aterial. On olars with e,cessi!e
destructi!e of coronal tooth structure or with !ery deep finish lines, aalga ay *e the aterial of choice
rather than coposite resin.
The dowel portion of the dowel1 coposite resin core acts to resist any lateral forces placed on the
crown. Care is ta/en to e,tend the finish lines for the final restoration well *elow the coposite core. This
gi!es the tooth a ferrule effect to resist any !ertical forces. 3u,illary pins should *e used routinely to resist
any rotational forces placed on the restoration. It is also pro!ed that pins e*edded in core aterial across
a tooth ay ha!e a *uttressing effect and resist splitting forces on the root.
The prefa*ricated dowel1coposite resin core can also *e used to restore a pre!iously crowned
tooth that has *een endodontically treated. The head of the dowel is tried to fit within the confines of the
access preparation and the dowel is tried to fit within the confines of the access preparation and the
dowel is ceented. The space around the head is then restored with aalga or coposite.
There are se!eral prefa*ricated stainless.steel dowels of *oth parallel. sided and tapered designs
that are suita*le for use with coposite resin cores. The techni-ue for all of these systes is !irtually the
sae with only inor odifications in the ethod of canal instruentation. They should all *e used with
au,iliary pins.
The prefa*ricated dowel systes used are
&. CC0 syste
8. C.I 5cali*rated instruent6/it
=. Coloraa dowel
(. +llan nu*ond $ast posts
E. #.D crown post
B. #ara %post
CC0 syste is coprised of two or three lengths in each of fi!e diaeters, for a total of &( si4es.
They are eant to *e used with #eeso reaers and they coe in diaeters of 9.< ., &.9 .,
&.8.,&.(.and &.B . The dowels are serrated and parallel % sided, with tapered tips and a round
*utton on the occlusal end .
+llan NuCond $ast #osts are serrated stainless steel dowels with a &.B
9
taper. The canal is
prepared with tapered reaers of atching si4es. There are si, si4esQ 9.>.&.8 ., &.&.&.(., &.=.&.B
., &.E.&.< ., &.'. 8.& ., and &.> % 8.= ..
The C.I /it, Coloraa dowel, #.D crown post has also *een grouped under #recision Tapered
#lastic Dowel and #ara #ost under #recision #arallel #lastic Dowel which has *een descri*ed earlier.
The coronal preparation for prefa*ricated dowel1coposite resin core is accoplished in uch the
sae way as it is for a custo cast dowel.core.
Ahen the preparation of the canal space is initiated, soe of the gutta percha in the coronal
portion of the canal can *e reo!ed with a hot instruent. The length is esta*lished with a peeso
reaer or a ;ates ;lidden drill.
The shaping of the canal is now accoplished with the #ara %#ost drill.
#in holes are drilled around the canal space so that au,iliary pins can *e placed.
The pin holes are drilled to a depth of 8. with a self.liiting 9.E . twist drill. It is not
necessary for these pin holes to parallel the canal
31
The pins can now *e placed. Ceented pins are preferred *y soe authors *ecause self
threading pins do produce stress, and they can cause dentinal cra4ing. If there is ade-uate *ul/ of
tooth structure, and if the tooth has *een non!ital for only a short period of tie so that resilience is
not ipaired, sall threaded pins should not represent too great a ha4ard.
3 hand wrench is used in an easily accessi*le area . Ahen the pins are threaded into place, stop
as soon as any resistance is encountered to pre!ent dentinal fracture. Cac/ off" slightly to reduce
stress, *ut not enough to produce a loose fit. The pins are shortened, if needed to insure that they
will *e within the confines of the copleted preparation and that they will not interfere with
placeent of the dowel. 3t least 8.9 . of pin should *e left e,posed.
The stainless steel dowel is now tried into the prepared space. 3ny reduction in length should *e
accoplished fro the apical end, as the dowel head can pro!ide added retention to the core
aterial. The dowel should ha!e a snug fit in the canal. If it does not, the canal has *een
o!erinstruented.
3 thin i, of ceent is ade of either 4inc phosphate, polycar % *o,ylate or glass ionoer
ceents.
Ceent is placed into the canal. 3n endodontic plugger, periodontal pro*e, or Hentulo spiral can
*e used for this purpose.
3 generous layer of ceent is placed on the dowel. The dowel is slowly pushed to the end of the
canal space, allowing tie for e,cess ceent to escape. 0old the dowel in place with finger
pressure until the initial ceent set occurs.
3fter the ceent has achie!ed its initial set, e,cess is reo!ed fro around the pins and the
coronal portion of the dowel.
3 atri, *and or crown for is placed around the tooth to perit the placeent of coposite resin
.
3 preparation for a porcelain fused to etal crown is accoplished with diaond stones in a high
speed hand piece, treating the coposite resin as though it were tooth structure.
The porcelain fused to etal crown can now *e fa*ricated o!er the coposite resin core, which is
retained and *olstered *y a stainless steel dowel.
Core "abrication with #arallel Threaded )owel 4#reta!!ed.
This is another type of dowel which perits the copletion of the tooth *uild.up in a single
appointent. It eploys threads on its parallel sides for retention, and it is inserted into a canal whose walls
are pre threaded with a special tap. It differs fro Other types of dowel *ecause it is not passi!ely inserted
into the canal and held in place entirely *y the ceent Ahether this threaded dowel is retained *y
echanical interaction, or siply *y increasing the surface area two or three fold, it deonstrates superior
retention to other types of dowels.
Concern has *een e,pressed o!er increasing the potential of root fracture *y threading dowels
into the canal. The stresses generated *y threaded dowels certainly are greater than those generated *y
dowels retained *y ceent alone. 0owe!er, echanical testing has shown that when the tap is used
profusely, fracture cannot *e induced. 3s with any threaded retention de!ice, there is soe ha4ard for the
tooth. The ris/ is inial if the tooth in which it is to *e placed is properly selected and the if the dowel is
used correctly. The Iurer 3nchor syste should not *e used on teeth with thin, fragile walls nor should it *e
used, *y the hea!y % handed operator. Iurer Crown 3nchor is a syste *y parallel threaded pretapped
dowel. The crown anchor consist of a stainless steel threaded shan/ 5dowel6 with a slotted achine *rass
head 5core6. The canal is enlarged with an elongated engine reaer, and its orifice is counter sun/ with a
root facer. 3 tap is then used to thread the canal for insertion of the anchor .
The Iurer $in.Hoc/ utili4es a threaded "root face fin" or loc/ nut to snug against the countersun/
root face. 3 narrow collar near the slotted end ser!es as additional retention for the coposite resin core
which will *e added after ceentation of the anchor .
The Iurer Crown 2a!er is a siple threaded dowel that has neither a head nor a loc/ nut and,
therefore, does not re-uire the use of a root facing instruent. It consists of a parallel threaded dowel which
is ceented in the canal and ser!es as the retention for a coposite resin *uild.up.
#reparation of the dowel space will *e accoplished with an engine reaer, which rese*les the
#eeso reaer, e,cept for the greater length of the cutting flutes 5&E.,copared with <.9 for
a no.B #eeso reaer6.
32
3 root facer is used to pro!ide a flat countersin/ on the root surface around the outh of the canal.
The counter sin/ allows the head, or core, of the anchor to *e set copletely within tooth structure,
pro!iding resistance to o*li-uely directed forces. It pro!ides protection to the head and a/es it
less suscepti*le to fracture. #repare the countersin/ to a iniu depth of &.9.
Use the tap to thread the canals. Cecause this is the tie of greatest stress *uild %up, it ust *e
done carefully. Use only new, sharp taps. 3 tap should *e discarded when the anchors in its /it
ha!e *een used up.
The anchor is tried in to esta*lish its length and deterine the ad)ustent necessary in the length
of the dowel .
The head or core of the anchor ust *e shaped to rese*le the contours of a crown preparation
for the final restoration. $our ad)ustents are usually en-uired
&. The incisor edge will pro*a*ly need to *e shortened.
8. The incisal portion of facial surface ust *e reduced to o!e the incisor.facial line angle
to the lingual.
=. 3 conca!e area in the incisal 81= of the lingual surface ust *e created and
(. The a,ial walls should *e slightly tapered.
3 slot is cut on the *rass head at right angle to the incisal edge. This is ade to screw the
anchor into the tooth during ceentation.
3 ceent escape !ent is e,treely iportant in the seating of a threaded dowel. Cut a large
!.shaped groo!e fro the apical end of the dowel to the *ase of the core.
#repare a thin i, of 4inc phosphate ceent on the glass sla* and apply a thin unifor coat
o!er the dowel. Do not place any ceent into the canal. Ceent does not play a significant
role in the retention of the threaded dowel, *ut is iportant as a sealer.
Insert the dowel in the canal and thread it to position with the screw dri!er. 2top fro tie to
tie to allow e,cess ceent to escape fro the !ent. If the dowel tends to o!erseat, that is
turn past the position at which the facial and lingual features are in proper alignent, do not
hesitate to re!erse the anchor &1< or &1( turn to produce correct alignent.
Ahen the ceent has set, the tooth which has *een *uilt up with the Iurer Crown 3nchor is
ready for fa*rication of the final restoration.
Core "abrication with #arallel Self Threading )owel(
This type of dowel offers a retention de!ice which is interediate *etween the stainless steel
dowel 1 coposite resin core and the pretapped parallel threaded crown anchor. The retention afforded *y
this type of dowel, whose threads are widely separated and shallow, is >(D greater than that for a serrated
stainless steel post of the sae si4e.
The self.threading anchor is &'.(ED less retenti!e than siilar si4e of pretapped threaded
anchors. Cecause the radi, anchor utili4es threads for uch of its retention, it is capa*le of producing stress
in the root. Continuing to thread the anchor after resistance is encountered could result in root fracture or
stripping of the threads. If the dowel ape, is allowed to engage the supporting tooth structure high apical
stresses will *e generated. 0igh stress concentration will de!elop in the coronal portion of the root if the
coronal flanges of the head coe in contact with the root face. In order to a!oid these pro*les, it is
recoended that the dowel *e re!ersed or *ac/ed off a half turn when slight resistance to threading is felt
during ceentation.
Radi, Crown 3nchors is a *rand of parallel self.threading dowel. They are a!aila*le in three
diaeters, &.&E , &.=E and &.B . The anchor consists of a low profile retenti!e spiral and a head
with fi!e rows of fins or laellae which retain the coposite resin core that is *uilt around it. ?aillefer
reaers of appropriate atching si4es are used for canal enlargeent.
The shallow threaded spiral on the coronal B9D of the dowel is interrupted *y four ceent !ents
which run the length of the dowel .
The anchor dri!er or wrench, used for threading the dowel into the canal, has four prongs which
firly engage four slots in the sides of the head. 3nchor wor/s *est in teeth whose clinical crowns ha!e
soe length and !olue .
Cegin the tooth preparation for the parallel self.threading dowel *y reo!ing ost of the coronal
tooth structure with a diaond in a high speed hand.piece.
33
Cegin the preparation of the dowel space with #eeso reaers, which are saller than atching
si4e ?aillefer reaer eant for the chosen si4e of anchor. The reaers are siilar in configuration
to the #eeso reaers, e,cept for the greater length of the cutting flutes on the ?aillefer reaer.
The anchor dri!er pro!ided with the /it is used initially for tapping the canal and then for reinsertion
of the anchor into the tooth during ceentation.
3s the ceent sets around the dowel, reo!e the e,cess fro the laellae of the head and fro
under the *otto ost fin near the root face. The tooth is then ready for fa*rication of the
coposite resin core around the anchor head .
The preparation for the final restoration will *e ade in the coposite resin core with a diaond
stone in a high speed handpiece.
The final restoration is placed o!er the coposite resin core which is retained with a Radi, 3nchor.
Core "abrication with Ta!ered Self,Threading )owel (
This style of dowel has *een in use for o!er E9 years. It is the siplest of all the threaded dowels.
The taper of the dowels is !aria*le. ?any of the ha!e two tapers: one at the tip and another for the ain
*ody of the thread. The taper for the tip can *e as little as &9
9
and as uch as =9
9
*eing less on long, thin
dowels and greater on short, thic/ ones. The taper on the ain *ody of the thread can range fro 9.=
9
. 3n
aalga or coposite resin core is usually fa*ricated around the dowel after it is ceented.
Indications (
Cecause of its dowel si4e and the *ul/y head, tapered self. threading dowels are generally
restricted to use in olars. It is fre-uently used on teeth with a iniu of coronal tooth structure and
ultiple di!ergent canals.
The non.parallel relationship adds to the retenti!e -ualities of the self.threaded dowel. Its use
should *e reser!ed priarily for single tooth restorations.
3d!antages :
The tapered self.threading dowel is siple and easy to use. The fact that it engages dentin with its
threads un-uestiona*ly pro!ides e,cellent retention. Dowel.core can *e placed in a single appointent,
often it can *e done in the appointent during which the endodontic o*turation is accoplished.
Disad!antages:
This type of dowels also produce high stress concentration with its wedge. li/e action producing
stress concentrations ore se!ere than those seen in other types of threaded dowels. The danger of root
fracture is ost acute when e,cessi!e tor-ue is applied or when the dowel is o!er twisted. Harger diaeter
dowel ha!e *een o*ser!ed to cause root fracture especially in the teeth with o!oid canal.
It has *een recoended that tapered, self threading dowels *e passi!ely ceented in slightly
o!ersi4ed canals. In a slight odification, a dowel with a snug sliding fit *e ceented, engaging the threads
no ore than a single turn during seating.
This type of dowels ha!e *een ar/eted under different *rand naes, of which the Dentatus
2crew post is the ost coonly used. It is currently ar/ed in a stainless steel and a gold. plated *rass
dowel, a!aila*le in B diaeters, &.9, &.8, &.=, &.E, &.B, and &.< . There are four lengths of dowels, '.<,
>.=, &&.< and &(.8 . The head of each screw post is s-uare, with two crossing slots on the end. There
are two seating wrenches pro!ided with the syste.
One wrench is designed to fit internally into the head of the dowel to allow placeent of the dowel
in tight areas. It also perits insertion of a dowel whose head shape and si4e ha!e *een altered . 3 second
wrench fits o!er the head of the dowel. It is useful on se!erely *ro/en.down teeth in which the dowel head
is unaltered. The Dentatus 2crew #ost should *e considered for olar teeth in which the restoration of the
coronal portion of the tooth is *eyond the scope of the typical pin.retained core.
The dowel spaces are now prepared in the straightest and *ul/iest roots. In ost cases, it is
possi*le to place two dowels. The distal canal of a andi*ular olar and the palatal canal of a
a,illary olar are usually the *est suited to accoodate the priary dowel.
The Dentatus 2crew #osts are prepared for ceentation *y trying the in and a/ing any
necessary ad)ustents .
3n aalga or coposite resin core can now *e placed. No au,iliary pins will *e needed, unless
only one dowel is used. In such cases, pins should *e placed as anti.rotational retenti!e
coponents .
#reparation of the core is accoplished with *urs and diaonds as though it were tooth structure.
On an aalga core of this si4e, preparation is pro*a*ly *est delayed until a su*se-uent
34
appointent. Use of a spherical high copper aalga will achie!e a hard enough set to do the
preparation at the sae appointent. +!en its surface is ore easily instruented at a later
appointent, howe!er.
The crown can *e fa*ricated o!er the core in usual anner.
Amalgam #in Core And Com!osite %esin #in Core
Not e!ery endodontically treated tooth will re-uire the use of a dowel in its canal to retain the core
and assist the crown in withstanding occlusal forces. ?ost olars can *e successfully restored without a
dowel. Their greater circuference generally eliinates the necessity of a dowel to *olster the tooth.
2elf threading pins are the ost retenti!e of all pins. The retention of the aalga core is su*)ect
to se!eral !aria*les. The depth of insertion of the pins into the dentin will play a role in their retention. The
optiu depth for self threading pins ha!e *een put at 8 , while for ceented pins it is =.( . The pin
should also e,tend 8 fro the tooth into the aalga.
It is generally consistent with the epirical recoendation of & pin for each issing line angle of
tooth structure, & pin per issing cusp and & pin per issing wall. On the other hand, as the nu*er of pins
is increased to produce greater retention, the aalga and the dentin are siultaneously wea/ened.
Crowns ceented to aalga core are significantly ore retenti!e initially than those ceented to
coposite resin core, although the latter gains strength with the passage of tie.
Coposite resin cores ha!e *een descri*ed for use with different types of dowel. They can also *e
used with pins in place of aalga cores for the restoration of olars with soe reaining coronal tooth
structure. In addition to *eing easy to anipulate and strong, coposite resin has the great ad!antage of
allowing core insertion and crown preparation in one appointent.
On the negati!e side, coposite resin cores e,hi*it greater icro lea/age than do aalga cores.
Ahen this is coupled with the o*ser!ation that crowns ceented to cores, aalga or resin, lea/ ore
than crowns ceented to tooth structure., there is a strong potential for lea/age into the canal. This finding
is gi!en credence *y the clinical recoendation that the crown argin *e on tooth structure, well
reo!ed for the argin of the core. Coposite resin cores show less tensile *ond strength for cast
crowns than do aalga cores at the tie of ceentation.
Coposite resin cores should *e eployed only in the *uild.up of teeth to recei!e single crowns.

#%OAISIONA+ %ESTO%ATIONS "O% EN)O)ONTICA++' T%EATE) TEETH
3 teporary restoration coonly plays an iportant role in the successful restoration of a tooth.
It is true that the norally essential role of pulpal protection is not of concern in dealing with an
endodontically treated tooth. Ne!ertheless, the teporary restoration ay *e e!en ore iportant to the
patent recei!ing a dowel.core and a crown.
$unctions:.
+sthetic role
#rotects the tooth fro further daage
#re!ents igration of ad)acent contacting teeth
#ro!ides occlusal function
3 nu*er of different crown forers and dowels are used in !arious co*inations. #olycar*onate
crowns ha!e *een relined with acrylic, as ha!e celluloid crown fors. O!er ipressions and plastic shells
ha!e used to for the outer contours of the crown. Other types of retenti!e de!ices ha!e included plastic
dowels relined with acrylic resin, a silicone dowel reinforced with a paper clip, etal dowels with no acrylic
lining, and a wooden atch stic/. 2oe prefa*ricated dowel systes ha!e steel dowels ade specially for
teporary crowns. 0owe!er, they wor/ *est if the atching reaer was used in preparing the canal for the
final dowel.core.
The polycar*onate crown is well suited for the routine single crown. If the teporary restoration
in!ol!es a *ridge, or unusual alignent or orphology in a single crown, a custo plastic shell will pro*a*ly
pro!ide the *est result in the shortest tie.
#olycarbonate Crown
35
The polycar*onate crown is used with a paper clip dowel to pro!ide teporary co!erage for the
endodontically treated tooth. The coronal portion of the restoration is coposed of a polycar*onate crown,
relined with acrylic resin.
Initially, a crown is chosen that has diensions copati*le with the space it will occupy. In ost
cases, the crown will not adapt around the e,isting root without odification. +,cess length is reo!ed for
the gingi!al argin of the crown, while the incisal area is left intact. This process is continued until the
crown is adapted reasona*ly well to the gingi!al finish line, with the incisal edge in the proper position
relati!e to the ad)acent teeth.
3 section of paper clip ade of hea!y gauge wire is placed into the canal to its full depth. 3 felt tip
pen ar/ is placed 8.( . a*o!e the reaining coronal tooth structure. The length of wire e,tending into
the crown will *e dictated *y the length of the crown. The longer the e,posed piece of paper clip, the *etter
its retention in the acrylic resin in the crown.
Using a separating disc, cut the length of paper clip.. 2oe sall notches can *e placed in the
wire at this tie to assist in retention of the resin. #lace a *end near the end of the wire. Ahen e*edded
in the teporary crown, this *end will pre!ent the dowel fro pulling out and rotating. Try the tried
dowel in the canal and confir that the polycar*onate crown will ha!e roo to seat without *inding on the
wire.
The root face is lightly lu*ricated with petrolatu to pre!ent any acrylic resin fro stic/ing to the
tooth during polyeri4ation.
3 thin i, of teporary acrylic resin is placed on the root face around the orifice of the canal.
3!oid placing any resin deep into the canal space itself, since this can a/e the crown difficult to reo!e.
Insert the paper clip dowel into the canal. $ill the polycar*onate crown with the sae i, of acrylic resin.
+liinate any !oids in the aterial *efore placing it on the tooth. 2eat the crown and confir that it is in the
proper position relati!e to the ad)acent teeth. +,cess acrylic can *e reo!ed with an e,plorer to a/e
triing easier. 3s the aterial reaches a doughy consistency, the crown should *e puped in and out of
the tooth se!eral ties to a!oid *eing loc/ed in place during polyeri4ation.
The pin.teporary crown can *e placed in hot water to speed polyeri4ation. #rior to triing
and contouring, it is helpful to ar/ the argin on the inside of the crown with a sharp pencil. The
teporary crown is tried with sandpaper discs. The polycar*onate crown will fre-uently *e
o!ercontoured in the gingi!al one.third. 2pecial attention should *e gi!en to properly shaping the restoration
and a/ing any needed ad)ustents in occlusion. #erforating the polycar*onate crown is not a pro*le
*ecause there is an underlying *ul/ of acrylic. The teporary crown is first polished with fine puice and
then with a high.lustre denture polish.
Teporary ceent should *e placed only in the coronal portion of the restoration. 3!oid getting
ceent in the canal space. 3 4inc o,ide.eugenol ceent i,ed with an e-ual part of petrolatu is
accepta*le. 2eat the pin.teporary crown and hold it in place with fir finger pressure until the ceent is
set. Carefully clean the e,cess ceent fro around the argins.
Clear #lastic Shell
3nother ethod for constructing a pin.teporary crown in!ol!es the use of a clear plastic shell.
Ahile the shell can *e shaped *y a !acuu foring achine, it is ore easily and econoically adapted *y
using silicone putty. Cegin *y placing the putty into an unperforated stoc/ etal ipression tray.
Cut a sheet of coping aterial in half and place it in a wire frae, shiny side down. The plastic
aterial is slowly heated o!er a flae until it sags. If it is translucent, it should *ecoe clear as it softens. If
the aterial is the clear !ariety, it should *e heated until it *egins to so/e slightly.
The heated coping aterial is -uic/ly carried to the diagnostic cast. If the tooth to *e restored is
*adly *ro/en down, it should ha!e *een wa,ed to an accepta*le contour and duplicated in plaster or stone.
3 duplicate cast is necessary *ecause the hot plastic would elt the wa, if it were placed on the original
cast.
The tray loaded with putty is placed o!er the plastic and firly seated on the cast. Copressed air
can *e *lown on the shell to speed cooling. 3fter a*out =9 seconds, the tray and the silicone putty are
reo!ed. 3 well adapted plastic shell co!ers the cast. The coping aterial is reo!ed fro the cast and
tried with scissors.
The finished shell should e,tend at least one tooth in either direction fro the tooth *eing restored.
It should also *e tried to e,tend no ore than 8.= , *eyond the gingi!al sulcus. 3 paper clip is
prepared in the sae anner descri*ed pre!iously. The end is *ent to aid retention in the teporary crown.
The shell is filled with teporary acrylic resin. Cefore seating the shell, e,aine the acrylic fro the outside
to a/e sure there are no o*!ious !oids or *u**les. They can *e eliinated uch ore easily at this tie
36
than they can *e filled in later. If the old appears ade-uately filled, the shell can *e seated. ?a/e sure that
it is in the proper position *y firly pressing on the incisal edges of the ad)acent teeth. 3!oid pushing on the
tooth *eing restored *ecause the coping aterial ay o!er seat and distort the teporary crown.
Ahen the aterial reaches a doughy consistency, reo!e the shell and separate it fro the
teporary crown. If it is left in place too long, it can *e loc/ed in place in the canal or *etween ad)acent
teeth.
Tri off as uch flash as possi*le with scissors while the acrylic is still doughy. Reseat the crown
on the tooth and reo!e it. Drop the teporary crown in a *owl of hot water to speed polyeri4ation. The
teporary crown is contoured with a sandpaper disc. Chec/ the occlusion and ad)ust as necessary. #olish
the crown first with puice and then with high luster denture polish. Ceentation procedure is sae as that
descri*ed for polycar*onate.
Success of failure of !ost core (
None of the clinical data pro!ide definiti!e support of the concept that posts and cases strengthen
endodontically treated teeth or ipro!e their long ter prognosis. Their purpose is for retention of a core
that will pro!ide appropriate support for the definiti!e crown or prosthesis.
a. Jhat is the clinical failure rate or !ost and coresL
2e!eral studied pro!ide clinical data regarding the nu*er of posts and cores that failure o!er
certain tie periods. Ahen this no is di!ided *y the total no of posts and cores placed, the a*solute failure
rate is deterined. 3 >D o!erall a!erage for a*solute failure was calculated *y o!er aging the a*solute
failure percentage fro eight studies. In these studies the a*solute percent of failure ranged fro ' to &(D.
b. Jhat are the most common ty!es of !ost and core failuresL
2e!en studies indicate that post loosening is the ost coon cause of post and core failure.
Root fracture is the second ost coon failure cause, followed *y post fracture.
c. Is there a relationshi! between !ost form and the !otential for root fractureL
Ha*oratory tests generally indicate that all types of threaded posts produce the greatest potential
for root fracture. Ahen coparing tapered and parallel ceented posts using photelastic stress analysis,
the results generally fa!or the parallel ceented posts.
Ahen e!aluating the co*ined data fro ultiple clinical studies, threaded posts generally
produced the highest root fracture incidence 5'D6 copared with tapered ceented posts 5=D6 and parallel
ceented 5&D6.
d. )oes !ost diameter affect retention and the !otential for tooth fracture L
2tudies relating post diaeter to post retention ha!e failure to esta*lish a definiti!e relation ship.
Two studies deterined that these was no increase in post retention as the diaeter increased, where as
three studies found no significant retention changes with diaeter !ariations.
3 ore definiti!e relation ship has *een esta*lished *etween post diaeter and stress in the tooth.
3s the post diaeter increases, stress also increases in the tooth. Deutsch et al deterined that there was
a sinfold increase in the potential for root fracture with e!ery illieter the tooths diaeter was decreased.
e. Jhat is the relationshi! between !ost diameter and !otential for root !erforationsL
These are three distinct philosophies of post space preparation. One group ad!ocated the
narrowest diaeter for fa*rication of a certain post length 5the conser!ationists6. 3nother group proposed a
space with a diaeter that does not e,ceed one.third the root diaeter 5the praportionists6 the third group
ad!ised lea!ing at least & of sound dentin surrounding the entire post 5the preser!ationists6.
The instruents used to prepared roots should *e related in si4e to toot diensions co a!oid
e,cessi!e post diaeters that lead to root perforation. 2afe instruent diaeter to use are 9.B to 9.' for
sall teeth such as andi*ular incisors and & to &.8 for large diaeter roots such as the a,illary
central incisor. ?olar posts longer than ' ha!e on increased chance of perforations and therefore
should *e a!oided e!en when using instruents of an appropriate diaeter.
%ECENT A)AANCES IN #OST S'STE1S (
5. "I/E%,%EIN"O%CE) %ESIN #OST S'STE1S
Car*on fi*er post syste
Huscent anchor post syste
Twin luscent anchor post systes
Dou*le.taper post systes 5D.T.#ost syste6
37
Huine, post technology
Conda*le reinforceent fi*er syste
#arapost fi*er white syste
3natoic post:n core.

0. CE%A1IC #OST AN) CO%E S'STE1

"I/E%,%EIN"O%CE) CO1#OSITE #OST S'STE1 (
The addition of fibers to a !olymer matri& results in a significant im!ro$ement in the mechanical
!ro!erties of (
2trength
$racture toughness
2tiffness
$atigue resistance
"I/E%S 1A' /E CO1#OSE) O"
AO7+N #OHT+T0TH+N+,
;H322 OR
C3RCON
Ad$antages (
One appointent techni-ue
No la*oratory fees
No corrosion
Negligi*le root fracture
No designated orifice si4e
Increased retention resulting fro surface irregularities
Conser!ed tooth structure
No negati!e effect on esthetics
)isad$antages (
Techni-ue sensiti!ity
Need for a careful adhesi!e protocol
Need to aintain an in!entory of the reinforceent aterials.
CA%/ON "I/E% #OST S'STE1
INT%O)3CE) IN 5MMG /' )3%ET- %E'NA3) N )3%ET
38
These new posts are fa*ricated fro continuous unidirectional car*on fi*ers, < in
diaeter, e*edded in an epo,y atri,.
The fi*ers constitute B(D of the post *y weight. Used in +urope and Canada 5where it is
/nown as CO?#O2I#O2T6 since &>>9, the C.#O2T is now a!aila*le in the United 2tates.
The C.#O2T has *een shown to ha!e a high fatigue resistance and high tensile strength
aong its ad!antages o!er other systes. The odulus of elasticity of the C.#O2T is siilar to dentin,
which allows it to fle, slightly and not fracture roots as readily as a stainless steel post.
The C.#O2T is coposed of car*on fi*ers in an epo,y atri,. It is cylindrically shaped with a two.
stepped shan/ and a!aila*le in = diaeters :
&.(, &.<, and 8.&.
"lemming et al- Isidor N /rondum- and #urton and #ayne ha!e reported that this new type of post
syste has ade-uate rigidity and a high resistance to loading.
Aith proper *onding, the car*on post can restore the tooth to the sae strength as stainless
posts. $leing postulated that this ay *e due to the ore fa!ora*le stress distri*ution, which is a result
of the passi!e *onding echanis.
1ECHANICA+ #%O#E%TIES (
The Coposipost has the following echanical properties :
CO?#R+22ION ((9 ?#3
20+3RIN; &'9 ?#3
T+N2ION &,B99 ?#3
- ?ODUHU2 O$ +H32TICITT : 7aria*le *etween &&9 ;#a and < ;#a,
- 3ccording to the angle of the fi*ers. In the case of a >9 degree incidence
- 3ngle with the a,is of the post, the odulus of elasticity will *e < ;#a,
- Ahich is identical to the radicular dentine
)%AJ/ACKS O" C,#OST S'STE1
It is not esthetic G causes *lac/ 1 gray shadow due to car*on in
the coposition.
The post is radiolucent
+3SCENT ANCHO% #OST S'STE1 (
39
The one.stop effecti!e procedure for curing coposites within the confines of canals pro!iding
anchorage and flawless aesthetics.
Transits polyeri4ing light within the confines of canals.
#ro!ides the one.stop core anchor foundation with all restorati!e aterials.
Reflects natural hues for flawless aesthetic restoration.
7isi*le radiolucency in canal and through the core aterials.
3!aila*le in = diaeters to fit !ery sli and large canals.
&6 Using the post space created, a Huscent anchor is tried into the
canal. If there has *een no oisture containation, the o,ygen.inhi*ited layer is still a!aila*le for
the ne,t restorati!e layer.
86 Hu,acore, an autoi,ed, self.cured resin is in)ected directly into the
canal. The Huscent post is inserted into the uncured coposite resin, and the core *uild.up is
coenced iediately. The lu,acore will set within ( inutes, at which point it can *e shaped.
=6 3fter preparation for a full crown, the Huscent anchor post.and.core
is ready for the ipression and pro!isionali4ation steps.
Aith the introduction of the Huscent 3nchor 5Dentatus U23, Htd.6 past technical coproises are
eliinated. The anchors transilluinate light, are easy to use, and offer significant *enefits in radiolucency,
retention, and super* esthetics.
TJIN +3SCENT ANCHO%S (
Twice the In$ention- Twice the %etention O
This inno!ati!e design is !isi*le assurance against accidental de*onding of adhesi!e and resin.
core aterials. The sli id.section creates a physical cho/e". The !ent groo!e eliinates air resin
entrapent and pre!ents rotational dislocation. It all adds upto a winning co*ination of light transission,
attracti!e esthetics and twice the retention.
+ight transmitting ( +ffecti!ely polyeri4es coposite within the deep confines of
canals.
40
Esthetics ( +liinates shadows at the gingi!al, root and crown interface as well as
through thin.lainate coposite restorations. Reflects the surrounding colors and hues, copati*le
with natural esthetics.
1onobloc strength ( Hight or dual cure coposites *onds to the fi*erglass reinforced
anchors creating a cohesi!e, !ery strong foundation for restorations.
Narrow radial midsection ( ?echanical resistance seen in the anchor:s idsection
pro!ides dou*le retention against accidental de*onding of resins and restorati!e aterials.
)ouble,end alternati$es ( The anchor cone shaped.end can *e placed in deeper and
narrower canals without e,cess reo!al of dentin or canal wall. The parallel end can *e alternati!ely
placed into long, wider canals of teeth. The parallel canals can *e refined with drills, used in parallel
canal post techni-ues.
+ongitudinal $ent,groo$e( +liinates trapped air *u**les causing porosity, for
copletely filling the canal. 3dditionally, the !ent.groo!e creates an antirotational resistance in the
surrounding polyeri4ed resin aterial.
+ow modulus of elasticity 40G.5 *!a. ( The 3nchor:s elasticity in the range of healthy
teeth, pro!ides safety and cohesi!e resistance to ipact.
"le&ural Strength 48=M 1!a.( The Twin 3nchors within the rang of healthy teeth are
outperforing etal posts.l
Con$enient ( Copati*le for use with ost off the shelf, *rand.nae light cured
adhesi!es and resins. 52hould *e used in accordance with nfr:s. specifications6.
"est ( The one.stop procedure of siultaneously luting the anchor the *uilding a
ono*loc core with dual.cure aterials is econoical and highly effecti!e.
Aersatile ( Hucent 3nchor and the Twin Hucent intro /its contain assorted sall, ediu
and large anchors with atching reaers, and light transitting fors.to.fit retainers for cores. The
con!enient refill /its contain &E anchors in & si4e.
TJIN,+3SCENT STA%TE% KIT
3!aila*le in = diaeters to fit large and !ery sli canals.
&E twin luscent anchors 5E of each si4e, sall, ediu, large6
= corresponding si4e reaers
& pathfinder
& pro*os II router
&E fors to fit
)O3/+E TA#E% #OST S'STE1 4).T #OST.
The capacity of different types of post.and.core to protect the prosthetic restoration fro
*ioechanical failures !aries greatly. #ost.to.canal adaptation represents an iportant eleent in the
*ioechanical perforance of the prosthetic restoration.
41
The new DT. #ost syste was designed with the purpose of pro!iding close canal adaptation wit
inial tooth structure reo!al.
The DT. #ost syste see to offer a logical solution in restoring endodontically.treated teeth.
D.T. #ost pro!ides *igger taper at the coronal le!el.
3 *etter adaptation at the coronal le!el increases the aount of the fi*er.epo,y high
perforance aterial, therefore, conse-uently decreases the thic/ness of the resin ceent, a lower
perforance aterial, and reduces its polyeri4ation total shrin/age.
D.T post co*ines the conser!ati!e aspect of +ndo.coposipost U? apically, and the
greater si4e of the Coposipost coronally.
The post is fa*ricated with a prestressed glass fi*er syste due to which it can resist ore than
&,99,99,999 cycles in a fatigue resistance test, in which the closest copetition could only ta/e &,'=,999
cycles.
T%ANSI++31INATIN* +31INEP #OST S'STE1 (
3 user friendly, single office !isit solution for restoring coproised thin.willed roots with
strong adhesi!e aterials.
3ll too often, fragile, thin.walled teeth present a)or restorati!e pro*les : cast posts or
e,tractions were often the only alternati!e.
Cut today, there is a user friendly, single office !isit solution to this pro*le.
The clear light transitting posts polyeri4e light.cured coposites within the entire root
canal. 3fter curing, the HU?IN+L post is reo!ed, lea!ing a ready canal for a corresponding classic
post.
Reinfroced root strength : Hight.cured coposites internally reinforce the root structure
pro!iding a,iu sheer load support and retention.
Ipro!ed control : Hight.curing coposites are easy to control, ore adapti!e, and safer
than auto.cured coposites that ay preaturely harden.
Centered canal position : The luine, post techni-ue centers the canal and fors a
selected si4ed, full length parallel sided canal for corresponding dentatus classic etal posts.
2uperior aesthetics : The light.cured coposite inside the canal as/s etal posts with a
reflecti!e tooth colored foundation for odern restorations.
Techni-ue !ersatility : Huine, sooth and groo!ed posts ay *e also used as an
ipression and casta*le post pattern in the direct and indicrect fa*rication of posts.
2uperior deli!ery syste : 2election of Huine, and etal posts in all si4es along with
corresponding reaers and coponents are pac/aged in the refilla*le, easy to use dispenser.
#A%A#OST "I/E% JHITE S'STE1 (
The esthetic para post you:!e *een waiting forU..
?aterial coposition #hysical properties
;lass $i*er (8D Tensile strength &899 ?pa
Resin 8>D $racture resistance 5ean6 '&.>> Ig
$iller 8>D $le,ural 2trength >>9 ?#a
$le,ural ?odulus 8>.8 ;#a
Copressi!e 2trength =(9 ?#a
Ahite, translucent color inii4es the possi*ility of shadowing in anterior restorations.
?etal.free for esthetics and for patients with etal allergies.
$le,ural odulus easures closer to dentin than other post aterials.
$illed resin1uni.directional fi*er atri, strengthens the structure of the post without.
Coproising fle,i*ility.
42
#assi!e, parallel.sided design irrors the -ualities of etal #ara#ostVs.
3nti.rotational post hed of e,cellent adaptation of core aterial.
2pecially fa*ricated to *ond with ost resin ceents and core aterials.
Readily reo!ed if endodontic re.treatent *ecoes necessary.
The posts are color coded for use with e,isting #ara#ostV drills.
/ON)A/+E %EIN"O%CE1ENT "I/E% #OST (
This ethod uses a *onda*le reinforceent fi*er 5e.g Ri**ond, 2eattle, AashingtonQ
Connect, Ierr6, a fourth.generation *onding agent 5e.g. Opti*ond, Ierr6 a dual.cure hy*rid coposite
5e.g., 7eriolin/ II, I!oclar 7i!adent6 as the luting agent, and a dual.cure hy*rid coposite as the core
*uildup.
The reinforceent aterial used for the post consists of polyethylene wo!en fi*ers that
are treated with cold.gas plasa.
This plasa treatent con!erts the ultrahigh olecular weight fi*ers fro hydropho*ic
aterial to hydrophilic. The effect of such treatent is to allow for coplete wetting and infusion of the
fi*ers *y resin, creating a lower contact angle with the wetting resin and pro!iding a greater *onded
surface area to enhance the adhesion to any synthetic restorati!e aterial.
2pectroscopic analysis shows an increase in 9.C G 9 functional groups that allows
cheical *onding *etween the polyethylene fi*ers and the resin.
2e!eral types of wea!es are used *y !arious anufacturers, which can influence
strength, sta*ility and dura*ility.
The leno wea!e of ri**ond reportedly resists shifting and sliding under tension ore than
a plain wea!e, inii4ing crac/ propagation *y reducing the coalescence of icro crac/s within the
resin atri, into crac/s that could lead to failure of the restorati!e cople,.
This fi*er networ/ also pro!ides an efficient transfer of stress within the internal fi*er
fraewor/ *y a*sor*ing the stresses that are applied to the restorati!e cople, and redirecting those
forces along the long a,is of the reaining root structure.
A)AANTA*ES (
?a,iu post retention and core sta*ility
Conser!ation of tooth structure
Internal adaptation
Optial esthetics
Resistant to catastrophic root failure
Hac/ of corrosi!eness
?odulus of elasticity siilar to root dentin
$le,ural and tensile strengths siilar to root structure
Uninterrupted *onding at all interface.
)ISA)AANTA*ES
Techni-ue sensiti!ity
Need for a careful adhesi!e protocol
Need to aintain an in!entory of the reinforceent aterials
Need to deonstrate long ter effecti!eness.
The ideal syste of products for the endodontic.restorati!e continuu includes :
3n esthetic resin fi*er post
3 coposite core
3utoi,ed resin luting ceent
Current techni-ues that co*ine the autoi,ed resin luting ceent and coposite core into the
sae coponent.
43
CE%A1IC #OSTQS CO%E
Com!osition (
Tetragonal Mirconia polycrystals 5MrO8.TM#6 2ta*ili4ed *y = ol D T8O=
. >(.>D MrO8
. E.&D T8O=
CE%A1IC CO%E 1ATE%IA+
In &>>' I!oclar introduced a ceraic core aterials that can *e heat pressed directly onto Mirconia
posts 5I#2 +press Coso Ingot6.
;lass Ceraic ingot de!eloped for the heat pressing techni-ue is coposed of :
E<.ED 2iO8 *y weight
&E.ED MrO8 *y weight
(.9D #8OE *y weight
<.9D Hi8O *y weight, with &( additi!es such as Na8O, I8O, 3l8O=, and $.
Ad$antages
Ciocopati*ility
0igh fle,ural strength G &(99 ?pa
#aralleW 2ided post designed
0igh strength and resilience
Optial esthetic appearance
Do not e,hi*it gal!anic corrosion
)isad$antages
+ow
$racture 2trength
$racture Toughness
%E1OAA+ O" EPISTIN* #OSTS
Occasionally the dentist is confronted with an endodontically treated tooth with a poor prognosis
*ecause of the fractured dowel. Retreateent with a post and core cannot *e attepted unless the
fractured post is reo!ed. This can *e dangerous, howe!er, *ecause the roots are *rittle.
If sufficient length of post is e,posed coronally, a post can *e retrie!ed with thin. *ea/ed forceps.
7i*rating the post first with an ultrasonic scaler will wea/en *rittle ceent and facilitate reo!al. 3 thin
scaler tip or special post reo!al tip is recoended. Ultrasonic reo!al is slower than other ethods and
ay result in an increased nu*er of canal intradentin crac/s. 3lternati!ely, a post puller can *e used. This
de!ice consists of a !ise to grip the post and legs that *ear on the root face. 3 screw acti!ates the !ise and
thus e,tracts the post.
3 post that has fractured within the root canal cannot *e reo!ed with a post puller. The *est
eans for handling an e*edded fractured post was descri*ed *y ?asserann. 0e de!eloped and
designed an instruent for e,tracting posts or rigid instruents that are *ro/en deeply within the roots with
iniu daage. The ethod in!ol!es gripping the o*)ect through a tu*e or trephine which acts as a tu*e.
!ice. This ethod is relati!ely harless to the tooth and periodontiu.
1asserann #rocedure (
$ro the ?asserann /it, the appropriate si4e trepan *ur is deterined *y a gauge supplied in the
/it. 2ince the trepan *urs are hollow end.cutting tu*es, they fit o!er the end of the post and slide down its
outside. The instruent is turned *y hand cutting a sall trench around the post. The fragent ser!es as
44
the guide in the reo!al of the dentin or ceent fro around the post. 3fter proceeding fro one third to
one half the way down the post, the trepan *ur is replaced with the ne,t saller si4e, which will grip the end
of the post to lift it out of the canal. If necessary, the trepans can *e used to e,tend to the *otto of the post
for easy reo!al.
3fter the post is reo!ed, the root canal is enlarged with a #eeso reaer so that a con!entional
cast post and core can *e ade. Hater an appropriate crown can *e ade for the tooth.
Ad$antages (
&6 It is siple,
86 Hittle heat is generated,
=6 There is no danger of pushing fragents further into the root, and
(6 +,cessi!e forces are eliinated with little chance of perforation or splitting the root.
This techni-ue ay a/e it possi*le to sa!e strategic teeth that other wise ight *e lost.
#ierre ?achtou, #hilippe 2arfati and 3nna ;ene!ie!e presented the ;onon post reo!ing syste
for reo!ing posts fro the root canals prior to endodontic retreatent.
*onon !ost remo$al techniue (
The principle of this instruent is copara*le to a cor/ screw. The post and the tooth are
separated *y pitting the tooth against the post and creating enough force to o!ercoe the *ond.
&6 The first step is to free the head of the post fro the coronal tooth structure. 3ll restorations
including crowns ust *e reo!ed.
Circuferential prereduction of the core ay *e achie!ed using a tapered diaond *ur at high
speed.
86 3n ultrasound de!ice is useful to !i*rate the post and disintegrate the ceent.
=6 In order to facilitate the centering of the trephine, a special *ur included in the ;onon /it is used to
taper the protruding head of the post.
(6 The high strength trephine is used to *ore and gauge the protruding post to the e,act si4e of a
corresponding andrel which is specially anufactured to thread the post.
E6 Cefore the andrel is screwed onto the post, three rings are positioned onto its shan/. This acts to
cushion the andrel and to spread the forces onto the root surface as the post is *eing e,tracted.
B6 The e,tracting pliers are fi,ed on the andrel and the )aws of the pliers are e,panded *y
tightening the /nurled /no*. This procedure will separate the post fro the tooth -uic/ly and safely
facilitating endodontic retreatent.
2oeties the space *etween the ad)acent teeth is saller than the width of the )aws. This pro*le
ay *e resol!ed *y slipping a hollow tu*e included in the pac/age into the long" threaded andrel.

CONC+3SION(
+ndodontic therapy is an essential coponent of the practice of restorati!e dentistry at the close of
the 89
th
century. Dental practice and its success are ine,trica*ly tied to the -uality of the restoration. Cefore
a/ing a treatent decision, the restorati!e dentist ust e!aluate the -uality of endodontic treatent, the
periodontal support a!aila*le, and the status of the reaining tooth structure. The su*se-uent restoration
for the endodontically treated tooth is function of the reaining tooth structure, the shape and configuration
of the canals, and the functional and esthetic deands on the tooth.
3rri!ing at the *est solution is a cople, process, affected *y any different !aria*les, including
a!aila*le post systes and restorati!e foundation aterials. 3lthough there are additional e,periental
la*oratory data on which to *ase a restorati!e decision, long.ter controlled clinical data are not yet
a!aila*le. Restoring the endodontically treated tooth reains one of the ost challenging pro*les facing
the restorati!e dentist. 3n uncoplicated and systeatic decision a/ing process, *ased on uni!ersally
accepted philosophy and techni-ues, is necessary to a,ii4e chances for a successful restorati!e
outcoe.
If certain *asic principles are followed in the restorati!e of endodontically treated teeth, it is
possi*le to achie!e high le!els of clinical success with ost of the current restorati!e systes. These
principles include:
3!oid *acterial containation of the root.canal syste.
#ro!ide cuspal co!erage for posterior teeth.
45
#reser!e radicular and coronal tooth structure.
Use posts with ade-uate strength in thin diaeters
#ro!ide ade-uate post length for retention
?a,ii4e resistance fro including an ade-uate ferrule
Use posts that are retrie!a*le.
46
%e$iew of literature
Doinic/ C. Harato 5&>BB6 described the fabrication of the !ost and crown for !ul!less teeth
which can be cast as one unit by constructing a !attern with cold,cure acrylic resin and wa&. A
single unit cast !ost and crown sa$ed $aluable chair time and sim!lified an o!eration without
sacrificing accuracy or esthetic reuirements.
1orton +. #erel and "redric9 I. 1uroff 45M=0. outlined the principles that are essential for any
successful post and core restoration regardless of the ethod used *ased on *oth endodontic and fi,ed
prosthodontic considerations.
The post ust *e long enough to pre!ent e,cessi!e internal stresses on the root.
The diaeter of the post ust *e ade-uate to a!oid *ending the cast gold.
3 positi!e occlusal seat for the core portion will pre!ent wedging action *y the conical post.
#roper internal adaptation of the post will distri*ute the internal stresses as e!enly as possi*le
and will allow for only a thin, e!en layer of ceent seal.
The core portion should *e as close to the ideal as possi*le to recei!e the selected retainer. The
core should replace only that issing tooth structure.
The post should lie in the direction of the long a,is of the root.
Eugene C. Hanson and Angelo A. Ca!uto 45M=7. conducted a study to pro!ide guidelines for the
retention of dowels eploying !arious dental ceents such as polycar*o,ylate, 4inc phosphate and ethyl
cyanoacrylate with e*edent periods of &.Ehrs, ' to &8 days and =9 to (( days 5short, interediate and
long ters respecti!ely6.
Ahaledent #ara.#osts which are cylindrical, serrated, !ented, stainless steel dowels with
diaeters 9.9E inch, 9.9B inch and 9.9' inch were used. The 9.9B inch diaeter #ara.#ost e,hi*ited the
highest retention for all ceents. Cyanoacrylate ceents was the ost retenti!e for all diaeter dowels at
&.Ehrs. Aith e*edent ters of se!en days or longer, there was no significant difference *etween
ceents according to retention !alues. Retention !alues increased with increasing tie after installation for
all ceents and dowels. The teeth treated with caphorated onochlorophenol and ha!ing 9.9B inch
dowels showed no significant differences in retention with any of the three ceents.
Os$aldo >mener 45M@G. conducted a preliinary study to e!aluate the effect of dowel preparation
on the apical seal of root canals o*turated with sectional sil!er cones, or gutta.percha with lateral
condensation and sealer ceent.
The apical seal for the well.fitted sil!er point was ost !ulnera*le when a section of the cone ust
*e reo!ed during the dowel preparation. 0owe!er, the apical lea/age appeared nota*ly reduced when the
sil!er point was not distur*ed. In root canals sealed with lateral condensation of ultiple gutta.percha
points, lea/age was reduced considera*ly when ore than ( of gutta.percha filling reained in the
apical portion of the canal. No significant difference was found when the coronal portion of the root canal
filling was reo!ed iediately after placeent.
Edmund H. Kwan and *erald J.Harrington45M@5. e!aluated the effect of two post preparation
techni-ues % the war pluggers and files and ;ates ;lidden drills on the apical seal iediately after filling
47
the root canal with filled teeth that ha!e not had post preparations copleted using India in/. They found
that
5a6 The use of ;ates.;lidden drills to reo!e gutta.percha for preparation of post space,
iediately after filling the root, resulted in statistically less lea/age copared with ;utta.
percha filled controls.
5*6 The use of war pluggers and files to reo!e gutta.percha for preparation of post space
iediately after filling the root canal when copared with gutta.percha filled controls, no
statistical difference in lea/age was found.
5c6 The degree of apical lea/age was not related to the length of gutta.percha reaining after
preparation of the post space.
E. #atric9 Hoag and Thomas *. )wyer 45M@0.

conducted an in!itro study to e!aluate three
clinical techni-ues for re*uilding posterior teeth
a6 3n interloc/ing stoc/ and cast.gold post and core.
*6 3 standardi4ed stainless steel post and coposite resin core.
c6 3n aalga post and core techni-ue.
The effect of a full gold crown on the three types of *uildups was also e!aluated.
The results indicated that the ethod of post and core techni-ue ay not *e as significant as the
placeent of full co!erage cast.gold crown restorations with sound design and placeent of argins
*eyond the *uildup restoration.
Allan S. )eutsch et al 45M@8. identified the /ey !aria*le of root fracture li/e the design of
prefa*ricated posts and deterined their interrelationships. Three post types were tested
a6 The Radi, no. 8 post
*6 The ?edidenta ediu long post and
c6 The Dentatus ?.E post.
They found that the conical threaded posts 5Dentatus6 fractured roots ore often and at lower
tor-ue than parallel posts5Radi, No.8 #ost and ?edidenta6. The ean tor-ue !alue for fractures for
Dentatus was 8>.E inch.ounces, ?edidenta.=E.' inch.ounces and Radi,.=B.( inch.ounces.
%.A. Oli$a and R.A. +owe 45M@;. e!aluated the effect of water sorption on coposite cores as it
relates to the arginal seating of cast restorations and its tie of occurrence. They found out that
Coposite cores were not diensionally sta*le when e,posed to oisture. Coposite core preparations
e,posed to oisture *egan to change diensionally within & hr.The arginal seating of crowns constructed
o!er these coposite cores was affected *y the insta*ility of the core aterial.
%. +ewis and /.*. N. Smith 45M@@. identified the features of failed post retained crowns in order
to point to further ipro!eents in clinical techni-ue. $i!e a)or causes of post crown failure were caries,
root fracture, echanical failure of the post including *ending and fracture, and ceentation failure or
loosening of the post. Deceentation accounted for the great a)ority of failures. Ahene!er possi*le, a
ore retenti!e design than the sooth tapered cast post should *e used. The recoendation that the
post length should *e at least e-ual to the length of the crown reains a sound clinical guideline. $ailure of
the post crown within = years of ceentation was ore coon than later failure.
#ierre 1achtou- #hili!!e Sarfati and Anna *ene$ie$e Cohen 45M@M. presented the ;onon
post reo!ing syste for reo!ing posts fro root canals prior to endodontic retreatent which is safe
and efficient and can *e used for anterior, *icuspid and e!en olar teeth. The /it is also a!aila*le with
trephines which ha!e counter cloc/wise threading. These trephines will facilitate the reo!al of screw and
threaded posts.
Thomas K$ist-E$a %ydin and Claes %eit 45M@M.

conducted a study to in!estigate the relationship
*etween length and -uality of root filling seal in teeth with posts and radiographic status of the periapical
tissues. They found out that roots with posts in which the reaining root filling was shorter than =
showed a statistically significant higher fre-uency of periapical radioluciences and an iproper seal was
ore unfa!oura*le in roots with posts. They finally concluded that the placeent of a post will not per se
48
decrease the pro*a*ility of periapical healing. They also suggested that the reaining root filling ust not
*e shorter than =.
Rohn A. Sorensen and 1ichael R. Engelman 45MMG. e!aluated the fracture resistance of
endodontically treated anterior teeth with !arious ferrule designs and aount of coronal tooth structure.
They found out that
a6 One illieter of coronal dentin a*o!e the shoulder significantly increased the failure
threshold.
*6 The preparations of the coronal walls should *e parallel for a,iu resistance for.
c6 The contra*e!el design at either the tooth.core )unction or the crown argin did not
ipro!e the failure threshold and
d6 The a,ial width of the tooth at the crown argin did not significantly increase the
fracture resistance or alter the failure threshold.
Roe 1. *oss- J. Rames Jright Rr.- and Jilliam ". /owles 45MM0.

tested different dental luting
aterials for as/ing the radiographic iage of ceented titaniu alloy posts. They found out that ;lass
Ionoer luting aterials o*scured the outline of titaniu alloy prefa*ricated posts ore than coposite
resin, *ut less than 4inc phosphate or polycar*o,ylate ceents.
Kc%olf- 1J #ar9er and */ #elleu 45MM0. e!aluated the stress generated *y fi!e prefa*ricated
endodontic dowels. #ara post, Ceta #ost, Iurer Crown 3nchor, $le,i.#ost, Radi, 3nchor using a two
diensional photoelastic odel. The ceented retained posts. #ara #osts and Ceta #osts were the least
stressful of all the posts tested. Of the threaded posts % $le,i #ost and Radi, 3nchor produced the least
stress and the Iurer Crown 3nchor produced the ost stress. The $le,i.#ost and Iurer Crown 3nchor
were the ost retenti!e, the Radi, 3nchor were one.half as retenti!e and the ceent.retained Ceta #ost
and #ara.#ost were the least retenti!e. 2o the Radi, 3nchor and $le,i.#ost designs pro!ided the *est
co*ination of high retention and low stress.
#atrice 1ilot and %. Sheldon Stein 45MM0.

deterined the role of post selection and *e!el on the
tooth preparation and su*se-uent crown restoration with respect to root fracture with siulated clinical
forces. Three different post and core systes were used : a6 Cast post and core *6 #ara #ost #lus #ost
and c6 $le,i.#ost #ost. The core *uild.up aterial was Ietac 2il!er aterial. They found out that when
ost of the tooth structure is preser!ed, the post selection has little or no effect on resistance to root
fracture. 3 *e!eled preparation with the concoitant final restoration offers an increased resistance to root
fracture. 3 non.*e!eled preparation with a concoitant final restoration is ore prone to an incidence of
!ertical fracture.
#atric9 1. +loyd and Royce ". #ali9 45MM6. re!iewed the literature regarding the diaeter of
dowels and identified three distinct philosophies of dowel space preparation. One group ad!ocated the
narrowest diaeter for the fa*rication of a dowel to the desired length. 3nother recoended a dowel
space with an apical diaeter e-ual to one third of the narrowest diension of the root at the terinus of
the dowel. 3 third group ad!ised that at least & of sound dentin should surround the entire surface of the
dowel.
3 co*ination of the one third and & inial philosophies yielded a practical guideline for
dowel space preparation, particularly in aged teeth.
).*. #urton and R.A. #ayne 45MM;. in!estigated the fle,ural stiffness of the car*on fi*er root
canal posts and copared it with the stiffness of stainless steel post.They also copared the retention of a
resin coposite core aterial to the car*on fi*er and the stainless steel posts.
The car*on fi*er aterial was stiffer under trans!erse loading than was stainless steel *ecause of
its ade-uate rigidity. The resin coposite core aterial was retained ore strongly to the stainless steel
posts than to the car*on fi*er posts in tensile testing. The configuration of the posts significantly affected
the retention of the resin coposite cores and the ode of fracture on tensile loading.
49
*i$anni E. Sidoli- #aul .A. King and )erric9 .R. Setchell 45MM=.

copared the in!itro
perforance and the failure characteristics of the Coposipost syste which coprises of an epo,y.*ased
car*on fi*er post, a coposite core aterial and a low !iscosity Cis.;?3 *onding resin against e,isting
pore and core co*inations ie. stainless steel post and coposite core, gold alloy post and gold alloy core
and an endodontically treated tooth only. The ean stress at failure was <.<> for Coposipost syste, 8.(9
for 2tainless 2teel post and Coposite core, &E.8E for Cast gold alloy post 1 gold alloy core, 8(.<( for
endodontically treated tooth only. The Coposipost syste e,hi*ited significantly inferior stress !alues at
failure when copared with a cast gold alloy post and core co*ination when tested with a single angled
copressi!e load. Cut the ode of failure of the Coposipost syste with angled copressi!e load testing
was ore fa!oura*le to the reaining tooth structure when copared with the cast gold alloy post and core
syste. +ndodontically treated teeth only were significantly ore resistant to angled copressi!e loading
when copared with teeth restored with the !arious post and core systes.
Ron #. )ean- /illie *ail Reansonne and Ni9hil Sar9ar 45MM@.

conducted a study to e!aluate the
influence of endodontic and restorati!e procedures on fracture resistance of teeth and copare the
incidence of root fracture aong teeth restored with three different types of posts 5Car*on fi*er
post,Tapered 22 post,#arallel 22 post6 each supporting a coposite core *uild .up.
The groups with post and coposite *uild. ups failed at significantly lower force than the teeth in
which the crowns had not *een reo!ed. There was no significant difference in the aount of force
re-uired to produce failure aong the three groups with different posts and a coposite *uild.up. The
group restored with the car*on post had no root factures, whereas there were fi!e fractures in each of the
parallel and tapered post groups.
/uranadham S- Auilino S. A and Stanford C.1 45MMM.
8
created a guideline in deterining the
dowel length in relation to the al!eolar *one le!el. They said that the cast dowels should *e e,tended ore
than ( *elow the *one le!el to inii4e the stresses in the dowel and dentin regardless of the C:R ratio
of the restored tooth.
Sonthi Sirimani- )ouglas .N. %iis and Ste$en .1. 1organo 45MMM.

copared the resistance to
!ertical root fracture of e,tracted teeth treated with post and core systes that were odified with
polyethylene wo!en fi*res 5Ri**ond6 with those treated with con!entional post and core systes. They
found that cast posts and cores resulted in significantly higher failure thresholds than all others, e,cept for
prefa*ricated, copara*ly si4ed, parallel.sided posts with coposite cores. The polyethylene wo!en fi*er
and coposite resin without a prefa*ricated post resulted in significantly fewer !ertical root fractures *ut
ean failure was the lowest. 2aller diaeter prefa*ricated posts co*ined with the polyethylene wo!en
fi*er and coposite cores ipro!ed resistance to failure.
S!iros .O. Koutayas and 1atthias Kern 45MMM. descri*ed the fa*rication of all.ceraic posts and
cores, using high.toughness ceraic aterials such as aluina or 4irconia ceraics, through ( different
techni-ues :
a6 The slip.casting techni-ue.in which the core *uildup and the post are ade in & piece fro the
aluiniu o,ide ceraic aterial.In.ceraQ
*6 The copy.illing techni-ue which in!ol!es a anually guided copy.illing process in which a
predesigned resin pattern is surface treated and copied in ceraicQ
c6 The 8.piece techni-ue which in!ol!es a prefa*ricated 4irconia ceraic post and a copy.illed
aluina or 4irconia ceraic core and
d6 The heat press techni-ue, which in!ol!es a prefa*ricated 4irconia ceraic post and a heat
pressed glass.ceraic core.
The 8.piece techni-ue appeared to *e the ost proising ethod for post and core fa*rication
which in addition to ipro!ed esthetics pro!ided a post and core with ipro!ed echanical properties.
/rett I. Cohen et al 40GGG.

copared the retention of 8 types of cores, Ti.core Titaniu reinforced
Coposite and ;C ?iracle ?i, sil!er reinforced ;lass Ionoer, with = post designs naely, the $le,i.#ost,
and 3ccess #ost stainless steel dowels and a Cerapost Ceraic dowel. They found out that the post head
designs of the stainless steel 3ccess #ost and $le,i.#ost dowel pro!ided greater retention than the sooth
ceraic head design of the Cerapost dowel. Ti.core coposite core aterial e,hi*ited significantly higher
strength and was ore retenti!e than ?iracle ?i, glass Ionoer aterial.
50
%a!hael #ilo and A$iad Tamse 40GGG.

conducted a study to e!aluate the residual dentin
thic/ness of andi*ular preolar after preparation of post space with ;ates ;lidden and #ara #ost drills
with an inno!ati!e uffle de!ice. The ad!antage of a uffle syste is the a*ility to successi!ely study
se!eral steps that allowed each root to ser!e as its own control.
Natural anatoy of andi*ular preolars in the post space fro Ceentoenael )unction to E
apically coprised of constant residual dentin thic/ness in the $acioHingual a,is and a decrease of & in
the ?esioDistal a,is. Rotary instruent, such as ;ates ;lidden and #ara#ost drills, reo!ed su*stantially
ore dentin in the ?esioDistal a,is. ?inial residual dentin thic/ness of & was appro,iated *y No. E
#ara#ost drill, E *elow the Ceentoenael )unction. ?inial or no reduction of residual dentin
thic/ness during post space was recoended for andi*ular preolars with oral 1ri**on shaped cross
sectional canal anatoy.
Alison R.E. 2ualtrough-Nicholas.#.Chandler and )a$id *.#urton 40GG6.

copared the
retention of fi!e different esthetic post systes XHight post 5tapered6, Hightpost 5parallel.sided6, #arapost
$i*rewhite, 2nowpost and Dentatus HuscentY of siilar diensions in e,tracted teeth using titaniu posts
as controls. 3ll posts were *onded using #ana!ia $.3 (. hollow, etal slee!e was luted o!er the free
end of each post prior to ounting.
#arallel.sided Hightposts were significantly ore retenti!e than all other posts. #arapost $i*rewhite
posts were ore retenti!e than tapered Hightposts and 2nowposts. 2errated, parallel.sided stainless steel
posts were no ore retenti!e than either parallel.sided or tapered tooth.colored posts. #ost diension ay
influence the retention of tooth.colored posts, with parallel.sided posts *eing ore retenti!e than tapered
posts.
Chetan Arora et al 40GG6.

highlighted soe of the iportant *ioechanical considerations that
should *e ta/en into account while restoring an endodontically treated tooth with post and core.
2oe of the ost iportant features of successful design for post and core are :
&6 3de-uate apical seal
86 ?iniu canal enlargeent
=6 3de-uate post length
(6 #ositi!e hori4ontal stop
E6 7ertical wall to pre!ent rotation
B6 3de-uate argin placeent
%etention of a !ost within the root canal is de!endent on 7 maIor factors
a6 Hength
*6 Diaeter
c6 2hape
d6 2urface configuration
Hength: The post should *e as long as possi*le without )eopardi4ing the apical seal and integrity of
reaining tooth structure. It is ad!ised to aintain =.E of apical seal with gutta.percha.
Diaeter: #ost should *e as narrow as possi*le so that it is copati*le with tooth strength to reduce
incidence of perforation. Cut it should *e wide enough to a!oid *ending or *rea/ing.
2urface configuration: 2errated or Roughened post is ore retenti!e than a sooth one. Threaded posts
are the ost retenti!e of all, *ut they also generate greatest stress 2ooth posts de!elop least stress *ut
they also pro!ide least retention.
2hape: #arallel post is considered ost retenti!e with least stress. R+2I2T3NC+ : $errule is
suggested to ipro!e the integrity of endodontically treated tooth. 3nti.rotational groo!e can *e placed
within the canal in the ost *ul/iest portion to pre!ent post rotation within the root canal when too uch of
tooth structure has *een destroyed. 3 positi!e hori4ontal step appro, 8 deep can *e ade within the
root to inii4e the splitting potential of a post *y resisting apically directed forces and also *y pre!enting
wedging.
)a$id *. #urton- Nicholas #. Chandler and Alison R.E. 2ualtrough 40GG6.

in!estigated the
effects of therocycling on the retention of 8 glass.fi*er and resin %Coposite posts. The two *rands of
glass.fi*er and resin.Coposite posts in!estigated were
51
5. +uscent Anchors 4)entatus. which are smooth,sided !ost- 5.;mm in diameter coronally-
ta!ering to 5.Gmm a!ically.
86 Hightposts 5RTD6 which are sooth.sided posts, with a &.< diaeter in the coronal one third,
tapering to &.9 apically.
There was no significant difference in the forces re-uired to cause post.retention failure *etween
the control and therocycled speciens. Hightposts were significantly ore retenti!e than Huscent 3nchor
without therocycling, *ut this distinction was not apparent in the therocycled groups. ;lass.fi*er and
resin posts ceented with resin ceent offer accepta*le le!els of retention and are not suscepti*le to
reduced retention fro therocycling. Therocycling should *e gi!en less ephasis in tests for the
retention of root canal posts ceented with resin ceents.
Elio 1eDDomo- "ernando 1assa and Silmar )alla +ibera 40GG6.

in!estigated the fracture
resistance in teeth restored with cast post and cores with and without ferrule and using two different luting
ceents % 4inc phosphate and resin ceents.
3 8.99 cer!ical root ferrule showed higher fracture resistance regardless of the luting agent
used. There was no statistical difference *etween the group of speciens ceented with resin ceent and
without ferrule and the ferruled groups. The non.ferruled group with 4inc.phosphate ceent showed the
poorest results. The resin ceent was *etter than 4inc.phosphate ceent in the no ferruled group.
"ahad Al,Harbi and )an Nathanson 40GG6. e!aluated the retenti!e strength of coposite and
ceraic endodontic dowel systes to the tooth and to the core foundation. The dowel systes tested
were : Resin dowels 5$i*re/or X$RYQ Huscent XHUY Q Twin luscent 3nchor XTHUY6 Q Ceraic dowels 5Cerapost
XCRY Q Cosopost XCOY6 Q and a Titaniu dowel 5#ara#ost L0 XTiY6. In the Dowel to core retention, all
esthetic dowels had significantly lower retenti!e !alues to core foundation than the Titaniu #ara#ost .
3ong the esthetic dowels, the $i*re/or dowel syste produced the highest core retenti!e !alue 5==' N6.
In the dowel to tooth retention, the fi*er.reinforced resin dowels 5Twin luscent and $i*re/or6 had ean
retention !alues to teeth siilar to the Titaniu #ara.#osts ceented with resin and significantly higher
than the Titaniu #ara.#osts ceented with 4inc phosphate luting agent. Ceraic dowel systes had
significantly lower retenti!e !alues than the other dowel systes tested.
1ian K. Ibal et al 40GG6. e,plored the possi*le associations *etween prosthodontic, occlusal,
endodontic, and periodontal factors and the endodontic status of endodontically treated teeth. Three factors
were significantly associated with the presence of radiolucency : confired occlusal contact, *y !irtue of
the tooth *eing in!ol!ed in group function or the only contact in wor/ing. side and protrusi!e o!eents,
endodontic filling and crown argins of poor -uality.
% )e Castro Albuuerue et al 40GG6. e!aluated the effect of different anatoic shapes and
aterials of posts in the stress distri*ution on an endodontically treated incisor. Three post shapes
5tapered, cylindrical and two.stage cylindrical6 ade of three different aterials 5stainless steel, titaniu
and car*on fi*re on Cisphenol 3.;lycidyl ?ethacrylate 5Cis.;?3 atri,6 were copared in this study. The
stress concentrations did not significantly affect the region ad)acent to the al!eolar *one crest at the
palatine portion of the tooth, regardless of the post shape or aterial. 0owe!er, stress concentration on the
post 1 dentin interface on the palatine side of the tooth root presented signified !ariations for different post
shapes and aterials. #ost shapes had relati!ely sall ipact on the stress concentrations while post
aterials introduced higher !ariations on the. 2tainless steel posts presented the highest le!el of stress
concentration, followed *y Titaniu and Car*on 1 Cis.;?3 posts.
S.O. Hedlund- N.*. Rohansson and *. SIogren 40GG6.

e!aluated the retention of prefa*ricated
root canal posts pro!ided with a core of resin coposite. The prefa*ricated root canal posts studied were
Cosopost, Coposipost car*on fi*res, Coposipost 1 +stheti.#lus, Coposipost Hight.#ost and #ara
#ost $i*erwhite.
Only the Cosopost syste e,hi*ited retention !alues lower than the con!entionally cast gold
alloy posts luted with 4inc.phosphate ceent due to an adhesi!e failure at the interface *etween the
ceent and the ceraic.
Newman 1#, 'aman #, )ennison R, %after 1, /illyE5899=6copared the effect of = fi*er.reinforced
coposite post systes on the fracture resistance and ode of failure of endodontically treated teeth, and
concluded that the load to failure of the stainless steel posts were significantly stronger than all the
52
coposite posts studied. 0owe!er, the ode of failure or deflection of the fi*er.reinforced coposite posts
is protecti!e to the reaining tooth structure.
"errari 1, 1ason #N, *oracci C, #ashley )H, Tay "%5899(6
They hypothesi4ed that deinerali4ed collagen atrices 5DC?s6 created in dentin *y acidic 4inc
phosphate ceent within the dowel spaces degrade with tie. $orty.two post.restored teeth were e,tracted
after three periods of clinical ser!ice and were e,ained, 2+? re!ealed a progressi!e degradation of the
DC?s, *ecoing less dense after = to E years, losing structural integrity after B to > years, and partially
disappearing after &9 to &8 years. T+? re!ealed e!idence of collagenolytic acti!ity within the DC?s, with
loss of cross.*anding and unra!eling into icrofi*rils, and gelatinolytic acti!ity that resulted in disintegration
of the icrofi*rils.and concluded that Cacterial coloni4ation and the release of *acterial en4yes and of
host.deri!ed atri, etalloproteinases ay contri*ute to the degradation of collagen fi*rils in root dentin
after clinical function.
Sahafi A, #eutDfeldt A, Asmussen E, *otfredsen K5899(6
e!aluated the effect of ceent, post aterial, surface treatent, and shape 5&6 on the retention of posts
luted in the root canals of e,tracted huan teeth and 586 on the failure orphology, and concluded that
Choice of luting ceent was critical for all three types of posts. #arallel posts showed superior retention to
tapered posts.
Chen PT, +i PN, *uan >2, +iu P*, *u 'P5899(6 in!estigated stress distri*ution of different aterials
restored post.cores in dentine to pro!ide a theoretical guidance for clinical use, and concluded that The
aterials with elastic odulus siilar to that of dentin, such as polythene fi*er reinforced coposite, ay
*e suita*le for post restoration.
3sumeD A, Coban9ara "K, ODtur9 N, Es9itascioglu *,
/elli S5899(6 copared icrolea/age of = esthetic, adhesi!ely luted dowel systes with a con!entional
dowel syste, and concluded that, Resin.supported polyethylene fi*er dowels and glass fi*er dowels
tested e,hi*ited less icrolea/age copared to 4irconia dowel systes. The latter syste should *e further
e!aluated *ecause of its unaccepta*le le!el of lea/age.
+arson T)5899(6. Re!iewed the rele!ant literature fro &>>&.899=, a period of tie when adhesi!e resin
luting aterials *ecae a!aila*le and luting crowns with 4inc phosphate ceents decreased.. 3alga
cores are regarded as the strongest aterial, *est a*le to withstand ad!erse stress and restore teeth
ha!ing the greatest loss of tooth structure. Coposite resins, whether cheically cured or light cured,
reinforced or not, appear *est capa*le of core restoration for oderately *ro/en down teeth. ;lass ionoer
aterials are considered too wea/ to withstand stress as a core aterial, *ut are recoended as a *ase
aterial to fill in undercuts and ipro!e the accuracy of ipression and fit of a crown.
#aul SR, Jerder #5899E6 Retrospecti!ely e!aluated 4irconiu o,ide posts with either direct resin
coposite cores or indirect glass.ceraic cores after se!eral years of clinical ser!ice. 3nd they concluded
clinical success of 4irconiu o,ide posts with direct coposite cores suggests that this ethod of post.and.
core reconstruction is clinically proising. Mirconiu o,ide posts with indirect glass.ceraic cores displayed
a significantly higher failure rate and a high dropout.
*iachetti +, Scaminaci %usso ), /ertini ", *iuliani A5899E6
+!aluated The perforance of *oth light.curing and dual.cured adhesi!e1luting systes 5as control6, when
used in co*ination with translucent fi*re posts, which was e!aluated *y eans of pull.out test and
scanning electron icroscopy 52+? 6 o*ser!ation. and they concluded that Dual curing of the 3ll Cond
8ZRelyL 3RC syste sees to *e the ost appropriate ethod since it allows to cure e!en those areas
53
which would not *e otherwise reached *y light. On the other hand, in apical areas, the incoplete curing of
the +,citeZTetric $low syste could ipro!e the post adaptation and allow the achie!eent of *oth an
ipro!ed apical seal and a ore e!en distri*ution of the stress along the canal walls.
Island *, Jhite *E5899E6 copared two different types of fi*ers and analy4ed the fracture resistance
*etween the two of the. Two groups were fored. ;roup I used non pre.ipregnated resin fi*ers and
group II used pre.ipregnated resin fi*ers. Concluded that pre.ipregnated fi*ers offer a *etter fracture
resistance when used as post in endodontically treated priary anterior teeth.
1onticelli ", *oracci C, *randini S, *arcia,*odoy ", "errari 15899E6 e!aluated the structural
characteristics of post.and.core units ade of a fi*er post and of different types of resin.*ased coposites
used as core aterials using 2canning electron icroscope. 3nd concluded Cores *uilt up with flowa*le
coposites showed the highest integrity and the *est adaptation onto the post.
da Sil$a %S, de Almeida Antunes %#, "erraD CC, Orsi IA5899E6 +!aluated The effect of the use of 8D
chlorhe,idine gel in post.space preparation on car*on fi*er post retention and the *ond strength of a resin
ceent used to lute car*on fi*er posts, when drills and ( different su*stances were used for the post.space
preparation. 3nd concluded that Lylene and chlorhe,idine gel are good su*stances for the post.space
preparation *ut the second has the ad!antage of antiicro*ial acti!ity and low to,icity.
Tan #+, Auilino SA, *ratton )*, Stanford C1, Tan SC, Rohnson JT, )awson )5899E6 in!estigated
the resistance to static loading of endodontically treated teeth with unifor and nonunifor ferrule
configurations, 3nd they deonstrated that central incisors restored with cast dowel1core and crowns with
a 8. unifor ferrule were ore fracture resistant copared to central incisors with nonunifor 59.E to 8
6 ferrule heights. Coth the 8. ferrule and nonunifor ferrule groups were ore fracture resistant than
the group that lac/ed a ferrule.
A9soy *, Cotert HS, Kor9ut +5899E6 e!aluated the retention *etween a prefa*ricated dowel and =
different core aterials with or without a dual.polyeri4ed adhesi!e resin luting agent. 3nd concluded that
adhesi!e resin luting agent tested appeared to ha!e a significant strengthening effect on the dowel.head
retention of the core aterials.
Jillershausen /, Te9yatan H, Krummenauer ", /riseno 1arrouin /5899E6 conducted a non.
randoi4ed cohort study to e!aluate the 2ur!i!al rate of endodontically treated teeth in relation to
conser!ati!e !s post insertion techni-ues, and concluded The results showed a high success rate for
endodontically treated teeth when the final restoration was placed within a short period of tie 5two wee/s6.
3 higher tooth loss was o*ser!ed when etal post systes were eployed suggesting that precaution is
recoended when these types of posts are inserted.
Tait C1, %ic9etts )N, Higgins AR5899E6 highlighted the fact that any anterior teeth re-uiring restoration
are se!erely wea/ened ha!ing wide, flared canal spaces, and thin dentinal walls that are prone to fracture.
Traditionally these teeth ha!e *een restored using etal posts and are often unsuccessful *ecause of lac/
of retention or root fracture. and they Descri*ed ineral trio,ide aggregate 5?T36 can *e used to for an
iediate apical seal rather than waiting onths for ape,ification. Aea/ened roots can *e reinforced using
dentine *onding agents and coposite resin and if insufficient coronal tooth structure is present a -uart4.
fi*re post can *e placed to retain a coposite core.
'oldas O, A9o$a T, 3ysal H5899E6 e!aluated the stress transfer of different post and core systes to the
cer!ical part of the artificially created flared root canals, *y using strain gauges. The post.core systes
in!estigated were: 5a6 cast post.core syste without resin reinforceent, 5*6 cast post.core syste with
resin reinforceent, 5c6 pre.fa*ricated post and resin core with resin reinforceent. It was concluded that
the resin reinforceent of root canals *efore post.core applications reduces the stresses at the cer!ical part
of the root surfaces.
54
Car$alho CA, Aalera 1C, Oli$eira +), Camargo CH5899E6
e!aluated in !itro the efficacy of root reinforceents *y light.cured coposite resin or 4irconiu fi*er post
in siulated iature non.!ital teeth.and concluded that the use of root reinforceents with 4irconiu
fi*er post or coposite resin can increase significantly the structural resistance of the wea/ened teeth,
decreasing the ris/ of the fracture.
1annocci ", 2ualtrough AR, Jorthington HA, Jatson T", #itt "ord T%5899E6 copared the clinical
success rate of endodontically treated preolars restored with fi*er posts and direct coposite to the
restorations of preolars using aalga. 3nd concluded that restorations with fi*er posts and coposite
were found to *e ore effecti!e than aalga in pre!enting root fractures *ut less effecti!e in pre!enting
secondary caries.
Creugers NH, 1entin9 A*, "o99inga JA, Kreulen C15899E6. Tested whether: 5&6 the sur!i!al rate of
cast post.and.core restorations is *etter than the sur!i!al of direct post.and.core restorations and post.free
all.coposite coresQ and 586the sur!i!al of these *uildup restorations is influenced *y the reaining dentin
height after preparation, and concluded The type of post and core was not rele!ant with respect to sur!i!al.
The aount of reaining dentin height after preparation influenced the longe!ity of a post.and.core
restoration.
/runton #A, Christensen *R, Cheung SJ, /ur9e "R, Jilson NH5899E6 in!estigated, *y -uestionnaire,
the use and selection of aterials and techni-ues for indirect restorations and fi,ed prosthodontics *y
dental practitioners in the North Aest of +ngland and 2cotland. 3nd concluded the a)ority of the
practitioners sur!eyed in this study used: aalga for core *uild.upsQ indirect postsQ addition.cured silicone
for ipressionsQ and glass.ionoer ceents for luting procedures.
Ju PH, Chen P1, 'ang ', Niu +, 'ao J5899E6 accessed the effects of post[s diaeter on the retention of
post.core restorations 3nd concluded that Ahen the proportion of length and diaeter was saller than
(.='8, the retention of post.core crown syste increased with the decrease of the post[s diaeter. Ahile
the proportion was lager than a certain !alue, this rule did not e,ist.
Hu S, Osada T, ShimiDu T, Jarita K, Kawawa T5899E6 e!aluated the resistance to fracture of
endodontically treated teeth with flared canals restored with different post and core The results of this study
suggested that RC# prepared with &. ferrule was the ost desira*le restoration for structurally
coproised roots.
/ibliogra!hy (
&. 3l*u-uer-ue RDC, #alleto HTD3, $ontana R0CT2, Ciini C3 @r. 2tress analysis of an upper
central incisor restored with different posts. @ Oral Reha*il 899=Q =9: >=B.>(=.
8. 3/soy ;, Cotert 02, Ior/ul H. +ffect of an adhesi!e resin luting agent as the dowel head retention
of three different core aterials. @ #osthet Dent. 899E ?ayQ>=5E6:(=>.(E.
=. 3l.har*i $, Nathanson D. In 7itro assessent of four esthetic dowels to resin core foundation and
teeth. @ #rosthet Dent 899=Q >9: E('.EEE.
(. 3rora C, 2ingh RI, Chitre 7, 3ras ?. Cioechanical considerations in the restoration of
+ndodontically treated teeth with post and core. @. Ind . #rosth. 2oc 899=Q =: (&.(E.
E. 3yna +, Celen/ 2. Use of an alternati!e pontic foundation techni-ue for a fi*re reinforced
coposite fi,ed partial denture: a clinical report. @ #rosthet Dent. 899E ?ayQ>=5E6:(&8.E.
B. Crown #H, 0ic/s NH. Reha*ilitation of +ndodontically Treated Teeth using the Radiopa-ue $i*er
#ost. Copend Contin +du Dent 899=Q 8(: 8'E.8<(.
'. Curanadha 2, 3-uilino 23, 2tanford C?. Relation *etween Dowel +,tension and Cone He!el in
3nterior Teeth. @ Dent Res &>>>Q '<: 888 5a*stract >=96.
<. Caputo 33, 0o/aa 2N. 2tress and retention properties of a new threaded endodontic post.
Kuintessence Int &><'Q &<: (=&.(=E.
>. Cheung A. 3 re!iew of anageent of endodontically treated teeth. #ost, core and final
restorations. @ 3 Dent 3ssoc 899E ?ayQ&=B5E6:B&&.>.
55
&9. Car!alho C3, 7alera ?C, Oli!eira HD, Caargo C0. 2tructural resistance in iature teeth using
root reinforceent is !itro. Dent Trauatol. 899E @unQ8&5=6:&EE.>.
&&. Cohen CI, #agnillo ?I, Newan I, ?usi/ant CH, Deutsch 32. Retention of a core aterial
supported *y three post head designs. @ #rosthet Dent 8999Q <=: B8(.B8<.
&8. Cohen 2, Curns RC. #athways of the #ulp. <
th
+dn. 2t. Houis : C! ?os*yQ &>>(. p. 'B>.'>&.
&=. Dean @#, @eansonne C;, 2ar/ar N. In 7itro e!aluation of a Car*on $i*er #ost. @ +ndod &>><Q 8(:
<9'.<&9.
&(. Deliperi s, Cradwell DN, Coiana ;. Reconstruction and de!ital teeth using direct fi*er reinforced
coposite resins: a care report. @ 3dhes Dent. 899E suer,'586:&BE.'&.
&E. Deutsch 32, Ca!allari @, ?usi/ant CH, 2il!erstein H, Hepley @, #etroni ;. Root fracture and the
design of prefa*ricated posts. @ #rosthet Dent &><EQ E=: B='.B(9.
&B. +rtugrual 0M, Isail T0. 3n!itro coparison of cast etal dowel retention using !arious luting
agent and tensile loading. @ #rosthet Dent. 899E ?ayQ>=5E6:((B.E8.
&'. $o//inga A3, He Cell 3?, Ireulen C?, Hassila H7, 7allittu #I, Creugers N0. +, !i!o fracture
resistance of fracture resistance of direct resin coposite coplete crowns with and without posts
on a,illary preolars. Int +ndod @. 899E 3prQ=<5(6:=89.'.
&<. $reedan ;3. +sthetic #ost.3nd.Core Treatent. Dent Clin North 3 899&Q (E: &9=.&&B.
&>. ;al!an RI, Ro*ertello $@, Hynde T3. In !itro coparison of fluoride release of si, direct core
aterials. @ #rosthet Dent 8999Q <=: B8>.B==.
89. ;oldrich N. Construction of posts for teeth with e,isting restorations. @ #rosthet Dent &>'9Q 8=:
&'=.&'B.
8&. ;ardon ?#. The reo!al of gutta.percha and root canal sealess fro root canals. NM Dent @.
899EQ&9&586:((.E8.
88. ;oracci ;, Raffaelli O, ?onticelli D$, Calleri C, Cestelli +, $errari ?. The adhesion *etween
prefa*ricated $RC. #osts and coposite resin cores: ?icrotensile *ond strength with and without
post % silani4ation. Dent ?ater. 899E ?ayQ8&5E6:(='.((.
8=. ;oss @?, Aright A@ @r, Cowles A$. Radiographic appearance of titaniu alloy prefa*ricated
posts ceented with different luting aterials. @ #rosthet Dent &>>8Q B': B=8.B='.
8(. ;u4y ;+, Nicholls @I. In 7itro Coparison of intact endodontically treated teeth with and without
endo.post reinforceent. @ #rosthet Dent &>'>Q (8: =>.(=.
8E. 0all DH, Aillias 7?. Crown repair with a cast post and core. @ #rosthet Dent &><EQ E=: B(&.B(8.
8B. 0anson +C, Caputo 33. Ceenting edius and retenti!e characteristics of dowels. @ #rosthet
Dent &>'(Q =8: EE&.EE'.
8'. 0edlund 2O, @ohansson N;, 2)ogren ;. Retention of #refa*ricated and Indi!idually cast root
canal posts in 7itro. Cr Dent @ 899=Q &>E: &EE.&E<.
8<. 0oag +#, Dwyer T;. 3 Copariti!e e!aluation of three post and core techni-ue. @ #rosthet Dent
&><8Q (': &''.&<&.
8>. Ingle @I, Ca/land HI. +ndodontics. (
th
ed. Caltiore : Aillias and Ail/insQ &>>(: p. <<9 % >89.
=9. I-*al ?I, @ohansson 33, 3/eel R$, Cergenholt4 3, Oar R. 3 Retrospecti!e 3nalysis of factors
associated with the #eriapical 2tatus of Restored, +ndodontically Treated Teeth. Int @ #rosthodont
899=Q &B: =&.=<.
=&. @aco*y A+ @r. #ractical techni-ue for the fa*rication of a direct pattern for a post.core restoration.
@ #rosthet Dent &>'BQ =E: =E'.=B9.
=8. Iarapanou 7, 7era @, Ca*rera #, Ahite RR and ;oldan ?. +ffect of Iediate and Delayed
#ost #reparation on 3pical Dye Hea/age using Two different sealers. @ +ndod &>>BQ 88: E<=.E<E.
==. Iing #3, 2etchell D@, Rees @2. Clinical e!aluation of a car*on fi*re reinforced car*on endodontic
post. @ Oral Reha*il 899=Q =9: '<E.'<>.
=(. Ioutayas 2O, Iern ?. 3ll.ceraic posts and cores : The state of the art. Kuintessence Int &>>>Q
=9: =<=.=>8.
=E. Irupp @D, Caputo 33, Tra*ert IC, 2tandlee @#. Dowel retention with glass.ionoer ceent. @
#rosthet Dent &>'>Q (&: &B=.&BB.
=B. I!ist T, Rydin +, Reit C. The Relati!e $re-uency of periapical lesions in teeth with Root Canal
Retained #osts. @ +ndod &><>Q &E: E'<.E<9.
='. Iwan +0, 0arrington ;A. The effect of iediate post preparation on apical seal. @ +ndod &><&Q
': =8E.=8>.
=<. Harato DC. 2ingle Unit cast post crown for pulpless anterior tooth roots. @ #rosthet Dent &>BBQ &B:
&(E.&(>.
=>. Hewis R, 2ith C;N. 3 clinical sur!ey of failed post retained crowns. Cr Dent @ &><<Q &BE: >E.>'.
56
(9. Hloyd #?, #ali/ @$. The philosophies of dowel diaeter #reparation : 3 Hiterature re!iew. @
#rosthet Dent &>>=Q B>: =8.=B.
(&. ?achtou #, 2arfati #, Cohen 3;. #ost Reo!al prior to Retreatent. @ +ndod &><>Q &E: EE8.EE(.
(8. ?alferrari 2, ?onaco C, 2cotti R. Clinical +!aluation of Teeth Restored with Kuart4 $i*er.
Reinforced +po,y Resin #osts. Int @ #rosthodont 899=Q &B: =>.((.
(=. ?e/ayara))ananonth T, Iiat.anuay 2, 2alinas T@. 3 co*ined direct dowel and indirect core
techni-ue. Kuintessence Int 8999Q =&: &>.8=.
((. ?e44oo +, ?assa $, Hi*era 2D. $racture resistance of teeth restored with two different post.
and.core designs ceented with two different ceents : 3n in !itro study. Kuintessence Int 899=Q
=(: =9&.=9B.
(E. ?ilot #, 2tein R2. Root fracture in endodontically treated teeth related to post selection and crown
design. @ #rosthet Dent &>>8Q B<: (8<.(=E.
(B. ?onticelli $, ;randini 2, ;oracci C, $errari ?. Clinical Ceha!ior of Translucent.$i*er #osts: 3 8.
year prospecti!e study. Int @ #rosthodont 899=Q &B: E>=.E>B.
('. Oli!a R3, Howe @3. Diensional sta*ility of coposite used as a core aterial. @ #rosthet Dent
&><BQ EB: EE(.EB&.
(<. #erel ?H, ?uroff $I. Clinical criteria for posts and cores. @ #rosthet Dent &>'8Q 8<: (9E.(&&.
(>. #ilo R, Tase 3. Residual dentin thic/ness in andi*ular preolar prepared with ;ates ;lidden
and #arapost Drills. @ #rosthet Dent 8999Q <=: B&'.B8=.
E9. #reis/el 0A. O!erdentures ?ade +asy % 3 guide to Iplant and Root supported prostheses.
Kuintessence, Chicago &>>B. p. (E.BB.
E&. #urton D;, Chandler N#, Kualtrough 3@+. +ffect of therocycling on the retention of glass.fi*er
root canal posts. Kuintessence Int 899=Q =(: =BB.=B>.
E8. #urton D;, #ayne @3. Coparison of Car*on fi*er and stainless steel root canal posts.
Kuintessence Int &>>BQ 8': >=.>'.
E=. Kualtrough 3@+, Chandler N#, #urton D;. 3 coparison of the retention of tooth % colored posts.
Kuintessence Int 899=Q =(: &>>.89&.
E(. Rolf IC, #ar/er ?A, #elleu ;C. 2tress 3nalysis of fi!e prefa*ricated +ndodontic Dowel Designs :
3 #hotoelastic study. Oper Dent &>>8Q &': <B.>8.
EE. Rosenstiel 2$, Hand ?$, $ugioto @. Conteporary $i,ed #rosthodontics, =
rd
+dition. 2t Houis :
?os*y, 899&. p. 8'8.=&8.
EB. 2aupe A3, ;lus/in 30, Rad/e R3 @r : 3 coparati!e study of fracture resistance *etween
orphologic dowel and cores and a resin.reinforced dowel syste in the intraradicular restoration
of structurally coproised roots. Kuintessence Int &>>BQ 8': (<=.(>&.
E'. 2ahafi 3, #eut4 $eldt 3, Ra!holt ;, 3sussen +, ;otfredsen I. Resistance to cyclic loading of
teeth restored with posts.
E<. 2eow HH, Ton C;, Ailson N0. Reaining tooth structure associated with !arious preparation
designs for the endodontically treated a,illary second preolar. +us @ #rosthodont Restor Dent.
899E @unQ &=586:E'.B(.
E>. 2hilling*urg 0T, Iessler @C. Restoration of the +ndodontically treated tooth. Chicago:
Kuintessence, &><8.
B9. 2idoli ;+, Iing #3, 2etchell D@. 3n in !itro e!aluation of a car*on.fi*er.*ased post and core
syste. @ #rosthet Dent &>>'Q '<: E.>.
B&. 2iriani 2, Riis DN, ?organo 2?. 3n in !itro.study of the fracture resistance and the incidence of
!ertical root fracture of pulpless teeth restored with si, post.and.core systes. @ #rosthet Dent
&>>>Q <&: 8B8.8B>.
B8. 2orensen @3, +ngelan ?@. +ffect of post adaptation on fracture resistance of endodontically
treated teeth. @ #rosthet Dent &>>9Q B(: (&>.(8(.
B=. 2orensen @3, +ngelan ?@. $errule design and fracture resistance of endodontically treated
teeth. @ #rosthet Dent &>>9Q B=: E8>.E=B.
B(. 2orensen @3, ?artinoff @T. +ndodontically treated teeth as a*utents. @ #rosthet Dent &><EQ E=:
B=&.B=B.
BE. 2tern N, 0irshfeld M. #rinciples of preparing endodontically treated teeth for dowel and core
restorations. @ #rosthet Dent &>'=Q =9: &B8.&BE.
BB. 2trassler 0+, Cloutier #C, 3 New $i*er #ost for +sthetic Dentistry. Copend Contin +du Dent
899=Q 8(: '(8.'E=.
B'. Tait C?, Richetts DN, 0iggins 3@. Aea/ened anterior roots.intra radicular reha*ilitation. Cr Dent
@. 899E ?ay 8<Q&><5&96:B9>.&'.
57
B<. Tidarsh C;. Restoration of endodontically treated posterior teeth. @ +ndod &>'BQ 8: ='(.='E.
B>. To/sa!ul 2, Toan ?, Uyolgan C, 2chage D, Nergi4 I. +ffect of luting agents and reconstruction
techni-ues on the fracture resistance of pre.fa*ricated post systes. @ Oral Reha*il. 899E
@un:=85B6:(==.(9.
'9. 7erilyea 2;, ;ardner $?, ?oergeli @R. Coposite dowels and cores : +ffect of oisture on the
fit of cast restoration. @ #rosthet Dent &><'Q E<: (8>.(=&.
'&. Aeins $2. +ndodontic Therapy. E
th
+dn. 2t Houis. ?o : ?os*y Tear*oo/Q &>'B p. ''9.''&.
'8. Aillershousen C, Te/yatan 0, Iruenauer $, Criseno ?arro-uin C. 2ur!i!al rate of
endodontically treated teeth in relation to conser!ati!e !1s post insertion techni-ues a retrospecti!e
study. +ur @ ?ed Res. 899E ?ay 89Q&95E6:89(.<.
'=. Aillias 7D, C)orndal 3?. The ?asserann techni-ue for the reo!al of fractured posts in
endodontically treated teeth. @ #rosthet Dent &><=Q (>: (B.(<.
'(. Tolds O, 3/o!a, Uysal 0. 3n e,periental analysis of stress in siulated flared root canals
su*)ected to !arious post core applications. @ Oral Reha*it. 899E @unQ=85B6:(8'.=8.
'E. Mener O. +ffect of dowel preparation on the apical seal of endodontically treated teeth. @ +ndod
&><9Q B:B<'.B>9.
Products( Pins & Posts )) Fiber Glass Posts
Sort Al!habetically
Glassix
Whaledent Fiber Glass Post System
Morita Glass Fiber Posts
Luscent Anchors
Twin Luscent Anchors
Snow Posts
Mirafit Blac ! White
"ore#Post
Fibreor Post
$xatec Pilot %rill
"ytec Blanco Post System
"ytec Blanco "alibration %rill
"ytec $nlar&in& %rill
Fibre'leer Post(
Sybron$ndo Fiber Post
)ahnenratt Fiber Glass Posts
*ce Post
%MG %ental Fiber Glass Post
58
Achromat( $sthetic Fiber Post System
P% Fiber&lass Posts
F+" Postec
$xatec Blanco Post System
$xatec "alibration %rill
"ure#Thru *nte&raPost
Parell Fiber Glass Posts
Polydentia Posts
$%S Post System
G" Fiber Post
;lassi,
The &lass fibre will ,re-ent from breain& and maes it -ery resilient and will not lie a hard and
numb metal ,ost transmit stress and shoc to the dentine. it will wor to&ether with the dentine to
absorb any stress or shoc as it has about the same elasticity as the dentine itself.
/uality made in Swi0erland
Whaledent Fiber Glass Post System
$sthetic Post System The newest addition to the Para#Post family of endodontic ,osts fills the
&rowin& need in esthetic dentistry for a hi&h retenti-e 1metal#free 1,arallel sided 1,assi-e ,ost
system
Morita Glass Fiber Posts
"arbon fiber is the latest ! most ad-anced material in dental ,osts. Glass fiber is the ,erfect
material when you want to obtain the ad-anta&es of carbon fiber combined with su,erior esthetic
results.
Luscent Anchors
2Tranmits ,olymer0in& li&ht within the confines of canals 2Pro-ides the one#sto, core anchor
foundation with all restorati-e material. 2+eflects natural hues. -isible radiolucency.
Snow Posts
The white1 radio,a3ue fiber reinforced ,ost
2A hi&her ,ercenta&e of fiber fill allows use of smaller ,ost diameters
24nidirectional fibers and flexular modulus close to that of dentin assures e3ual distribution of
stress
2White translucent system offers enhanced radio,acit
1I%A"IT /+ACK N JHITE (Hager)
Blac for Posteriors ! White for Anteriors
CO%E,#OST (Denmat)
*t is desi&ned to flex with teeth under normal conditions1 thus
eliminatin& tooth stress and fractures that can occur with standard
metal ,osts.
"I/%EKO% #OST (Pentron)
Fibre'ore Post System allows an inte&rated bond between tooth
structure1 bondin& a&ent1 resin cement and com,osite core material
ACH%O1ATS ESTHETIC "I/E% #OST S'STE1 (Axis)
This radio,a3ue ,ost is a-ailable in two styles1 one with an
5arrowhead5 desi&n for more core retention and an 5non#arrowhead5
desi&n. Both desi&ns are ,arallel#sided1 serrated and ha-e a
machined surface to ,ro-ide maximum surface atea fro increased
bondin& stren&th.
#) "I/E%*+ASS TA#E%E) C%OJN #OSTS (PD)
Braided Glass Fiber6 in a multi#axial arran&ement and in a com,osite
bondin&1 ,ro-idin& hi&h resistance to bendin& and torsion forces.
Matrix6 $,oxy resin with a,x. 789 &lass fiber content
Features6
2Physico#chemical com,atibility and hi&h bondin& between ,ost1
cement and dentine
2Pre-ents root fracture1 oxidation and corrosion
2Flexibility and hi&h resistance
2Aesthetic thans its white color
Swiss Made
"%C #OSTECT (Ivoclar Vivadent)
Fiber reinforced1 esthetic1 endodontic ,ost.
2+einforced &lass fibers in a com,osite matrix creatin& excellent li&ht
transmittance ! translucency.
2Stren&th ,ro,erties com,arable to dentin allows for the &entle
introduction ! e-en distribution of forces on the remainin& tooth
structure.
59
2Ta,ered desi&n reduces the amount of tooth structure that needs to
be remo-ed when ,lacin& the ,ost.
2Two si0es with matchin& reamers to meet all clinical indications.
2$xcellent radio,acity when ,aired with :ariolin ** esthetic resin
cement.
2"om,osite base material allows for retrie-al with rotary instruments
if further endodontic treatment is re3uired.
EPATEC /+ANCO #OST S'STE1 (Hahnenkratt)
)i&h 3uality carbon fiber and &lass fiber ,osts with rounded retention
&roo-es for better bondin&. The $xatec Posts comes with a bi&&er
head for core build#u,. Post is ta,ered from ;.8mm down to .<=mm.
Made in Germany.
C'TEC /+ANCO #OST S'STE1 (Hahnenkratt)
)i&h 3uality carbon fiber and &lass fiber ,osts with rounded retention
&roo-es for better bondin&. Made in Germany.
"I/%EK+EE% #OSTS (Pentron)
The ideal ,ost for esthetic restorations su,erior stren&th. 4nbeatable
esthetics and effecti-e li&ht transmission.
Parallel body desi&n with retenti-e head1 ideal for core build u,1
offers increased mechanical core retention.
a!ered desi&n re3uires less tooth remo-al1 offers o,tion for
conser-ati-e dentistry.
#EE%+ESS #OST ("#bron$ndo)
A fully customi0able fiber ,osts. Ad>ustable on both ends1
PeerlessPost ,ro-ides a custom fit that is both esthetic and
radio,a3ue
2 )as a uni3ue 5eystone5 lins that are ,ro-en more retenti-e than
other ,o,ular ,osts 2 $xhibits a low elastic modulus similar to that of
dentin1 there by decreasin& the ris of root fracture
CONTEC /+ANCO (Hahnenkratt)
+adio,a3ue Fiber Glass Post ?White@
ICE #OST
he %hite& radio!a'ue (iber rein(orced !ost
A A hi&her ,ercenta&e of fiber fill allows use of smaller ,ost
diameters
+3PA#OST
Trans,arent &lass#fiber#reinforcement com,osite ,ost with a flexural
modulus that reacts to ,ressure and stress1 much lie natural dentin.
The endodontic ,ost combines hi&h 3uality with ease of use.
Luxa,ostta,,ered form corres,onds extremely to the tooth root1
,ro-idin& a ,re,eration that is &entle. comfortable1 and beautifully
conformed to the tooth surface.
C3%E,TH%3 INTE*%A #OST (Premier)
Li&ht#transmittin& Birconia Glass Fiber Post
A Safe and Sim,le to 4se
A $sthetic
A Stron& and Flexible
A Factory Silanated for Secure Adhesion
A Li&ht Transmittin&
A Ta,ered Ti, %esi&n
C,I JHITES #OSTS (Parkell)
Glass Fiber ,osts for maximum cosmetics. Fiber reinforced e,oxy#
resin ,ost with best combination of cost1 radio,acity and stren&th.
Post is o,a3ue white.
#O+')ENTIA *" #OSTS (Pol#dentia)
White o,a3ue ,osts with =C9 &lass fibers stren&th1 reliability and hi&hest aesthetics. GF Posts ,ro-ide an excellent alternati-e to
metal ,osts1 and are the ideal solution for aesthetic restorations on both anterior and ,osterior teeth. The white o,a3ue color of
Polydentia GF Posts ensures excellent aesthetic results without undesirable colorin& in the cer-ical area of the tooth.
"+EPI,"+AN*E "I/E%
Tooth colored for the ,erfect aesthetic restoration. The ,atened s,lit
ta, used ,rior to ,ost ,lacement ,ro-ides retenti-e &roo-es without
stress
60
Item No. #
*C "I/E% #OST (G) America)
The excellent fati&ue resistance is attributable to the uni3ue
chemistry and hi&h filler content of G" Fiber Posts1 reducin& ris of
restoration failure. The ta,er desi&n of G" Fiber Posts maximi0es
ada,tation and minimi0es dentin remo-al1 ,reser-in& root structure
and stren&th. *ts radio,acity enables easy checin& of the ,ost
len&th at try#in.
61