COLLEGE OF DENTAL SCIENCES

DEPARTMENT OF CONSERVATIVE DENTISTRY AND

ENDODONTICS
Seminar On

Presented by : -
Dr. Niju Aelias
2

CONTENTS
Introduction
History
Indication
Definition
Classification
Retentive Features of Post
Types of Post
Core and Core Material
Technique
Post selection
Root selection
Post embedment depth
utta Percha removal
Channel preparation
Post installation
Cro!n preparation
Preparation of "rifice
Preparation of Ferrule
Fabrication of custom cast post
Direct
Indirect
Tempori#ation
Cementation
Recent $dvances
Carbon fibre post
%sthetic post and core
References
Conclusion
INTRODUCTION :
$ll the teeth that have under&one root canal therapy !ill require some
form of restoration to enable them to function a&ain' (ecause endodontic
treatment removes the vital contents of the canal) !hich subsequently leads to
reduction in elasticity) dessication and increases brittleness of remainin& tooth
structure' The ob*ective is to return them to full occlusal and cosmetic
function'
It is the manipulation of the pulp chamber that leads to the &reatest
!ea+ness of a treated tooth' The roof of the pulp chamber has the
confi&uration of an arch) !hich e,tremely resist to pressure and stress' -hen
the roof of the pulp chamber is removed for endodontic access) the inherent
resistance of the treated tooth is &reatly reduced' This !ea+enin& leads to the
need for stron& interior as !ell as e,terior support that is achieved by post core
system' "ften due to mechanical reasons) the prepared tooth is reinforced by
post core systems'
HISTORY :
Durin& ./
th
century Pieree Fauchard used a !ooden post to retain
cro!ns'
'0' (lac+ 1./234 used a porcelain cro!n held by a scre! inserted into
a canal filled !ith &old foil'
.//5 Richmond Cro!n 6 Threaded tube in the canal !ith a scre!
placed throu&h the cro!n'
.333 Fibre reinforced composite and stren&thened ceramics'
INDICATIONS :
.' $ root canal treated tooth) if any pro,imal surface is involved'
2' 7oss of 2 incisal an&les to&ether !ith more than half of the pro,imal
surfaces of the tooth'
8' 7oss of more than 95: of the tooth structure'
;
;' 7oss of more than one a,ial an&le to a depth more than the anticipated
a,ial reduction for the reinforcin& restoration'
9' $ shorted tooth due to nature of destruction or the removal of
undermined undesirable tooth structure'
2' -hen a root canal treated tooth is to be used as a brid&e abutment'
<' Discoloured tooth) malali&ned tooth) overdenture'
DEFINITIONS :
Dowe !Post" =
The do!el is a metal post or other ri&id restorative material placed in
the radicular portion of a non vital tooth'
Core =
Refers to properly shaped and !ell restored substructure) !hich
replaces missin& coronal structure and retains the final restoration'
Ferr#e !Rosenstie":
Is defined as a metal band that encircles the e,ternal dimension of the
residual tooth'
Ferr#e !$eine" :
$ ferrule is a metal rin& or cap placed around the end of a cane or tool)
&ivin& it added stren&th' The ferrule around the circumference of the tooth
stren&thens it by increasin& resistance to !ed&in& forces'
Do!el functions primarily to aid retention of the restoration and
secondarily to distribute force alon& the len&th of the root) thus do!el has a
retentive role but doesnot stren&then a tooth) instead the tooth is !ea+ened if
dentin is sacrificed to facilitate lar&e do!el placement'
Roe o% t&e Dowe ' Post :
.' "cclusal forces are transferred throu&h the core to the post and
ultimately alon& the len&th of the root' The post must be desi&ned in
9
such a !ay that it serves its retention function !ithout endan&erin& the
root or coronal inte&rity'
2' The do!el must remain in the root for successful restoration but must
not dama&e the root in attempts to achieve the ma,imum retention'
8' Do!els must be retained by cementation to the dentin !alls of the root)
active en&a&ement of the do!el spaces by scre! threads is
contraindicated'
C(ASSIFICATION :
%ndodontic posts can be classified into 2 broad cate&ories >
Custom cast post
Prefabricated post
o $ctive retention post
o Passive retention post
C#stom Cast Post :
.' Fabricated at the chair or laboratory from a ne&ative reproduction of the
prepared canal'
2' -a, or cold cure resins are used to ma+e these patterns'
Type I = Medium -a, 1Direct technique4
Type II = ?oft !a, 1Indirect technique4
8' @ses a castin& procedure to ma+e a one piece metal do!el and core'
;' Technique can be direct in patients mouth or indirect !ith impression
stones and dies'
Pre%abri)ated Post :
This is classified as follo!s >
.' Ta*ered smoot& sided *ost systems =
They are cemented into a channel prepared !ith endodontic files or
reamers of matchin& si#es'
%&' Aerr %ndo Post 1Prefabricated &old alloy do!el4
2
2' Parae sided serrated or +ented *ost system =
Cemented into a matched channel prepared by t!ist drill of matchin&
si#e'
%&' -haledent para post'
8' Ta*ered se% t&readin, *ost system =
?cre!ed into a channel prepared !ith matched reamers'
%&' Dentatus scre! post'
;' Parae sided =
Threaded post systems = %n&a&es dentin by self threadin& or !ith the use
of matched taps'
%&' Radi, $nchor 6 ?elf thread
Aurer $nchor 6 First tapped then threaded into dentin'
9' Parae sided = T&readed s*it s&an- *ost =
%n&a&es the dentinal !all in a channel prepared !ith matched reamers'
%&' Fle,i post
2' Parae sided. ta*ered a*i)a end =
Cemented into matched channels'
%&' De&ussa) @nitech (CH
RETENTI/E FEATURES OF POST ' FACTORS AFFECTIN0
RETENTION OF POSTS :
These are >
.' Do!el len&th
2' Taper
8' Diameter
;' ?urface confi&uration
9' Cement type
2' %mbedment depth
<' Bumber of posts
<
12 Dowe (en,t& :
Do!el or post retention is proportional to len&th of post' Increased
len&th Increased retention'
The standard parameter for selectin& post C do!el len&th in a tooth !ith
normal PD7 support is
$' 2C8
rd
len&th of canal'
(' $n amount equal to coronal len&th of tooth'
C' Half the len&th of root supported by bone'
Final len&th of do!el in periodontally healthy tooth is limited by 2
ma*or variables'
o The root morpholo&y
o The need for sufficient apical seal in root canal system'
Root morpholo&y is dictated by >
Root taper
Root curvature and
Cross sectional root form
Root should have more than . mm of tooth structure remainin&
circumferentially around the apical end of the do!el to avoid perforation and
fracture 1This concept dictates shorter do!el in a tapered root so that apical end
of the do!el doesnot impin&e on conver&in& root !alls4'
Root Morpholo&y =
In root morpholo&y furcations and developmental depressions should be
considered'
Ma,illary Molars =
3;: deep concavities on the furcal surface of mesiobuccal roots'
8.: of distobuccal roots
.<: of palatal roots'
Mandibular Molars =
/
Root concavities on furcal surface of
o Mesial roots .55:
o Distal roots 33:
$pical ?eal =
8D9 mm of fillin& material is adequate to maintain apical seal'
Most preferred roots for Do!el'
Ma,illary molars 6 Palatal roots
Ma,illary premolars 6 Palatal roots
Mandibular molars 6 Distal roots
Clinical uidelines for 7en&th Include the Follo!in& =
.' Ma+e the post appro,imately three quarters the len&th of the root !hen
treatin& lon& rooted teeth'
2' -hen avera&e root len&th is encountered) then post len&th is dictated by
retainin& 9 mm of apical &utta percha and e,tendin& the part to the &utta
percha'
8' -henever possible) post should e,tend atleast ; mm apical to the bone
crest to decrease dentin stress'
;' Molar post should not be e,tended more than < mm into the root canal
apical to the base of the pulp chamber'
32 Dowe S&a*e :
Ta*ered Post Parae Sided Post
.' 7ess Retentive More retentive than tapered post
2' Creates a !ed&in& effect !ith
&reatest stress created at
coronal shoulder'
Creates less stress) smooth parallel
post creates stress at the ape, of
preparation'
8' @neven distribution of stresses
alon& the len&th'
Resist tensile) shear) and torquin&
forces better then tapered and
distribute stresses more evenly alon&
their len&th durin& function and
provides &reatest protection a&ainst
dentin fracture'
3
Ta*ered Post Parae Sided Post
;' (ecause of taper these post are
self ventin& and can be easily
cemented) taper doesnot act as
a position' "nly area !here
stress occurs durin&
cementation is irre&ularities in
post channel'
Hydrostatic pressure develops durin&
cementation if no ventin& because
post act as a piston'
9' The !ed&in& effect of tapered
post is related to the flare of
the post channel' reater the
flare more !ill be the !ed&in&
effect'
2' Tapered do!el that is more
closely adapted to the internal
shape of root canal is more
li+ely to result in e,tensive
root fracture'
Than parallel sided post'
Parallel side posts are more retentive than parallel posts !ith tapered
ends' This dual desi&n post creates higher wedging stresses than
parallel sided post'
42 Post Diameter :
Post must be of sufficient diameter to resist functional forces' Retention
is not increased by increasin& the diameter beyond a critical point' Prevention
of dentin fracture in radicular area ta+es a upper hand over lar&e diameter of
post'
?u&&ested !idth of post preparations 1-eine4 =
Toot& !5a6iary" Enar,e to Si7e
Central incisor /5D.55
7ateral Incisor <5D/5
Canine /5D.55
(icanaled bicuspid /5
?in&le canal bicuspid /5D.55
Molar 1palatal canal4 /5D..5
.5

Toot& !5andib#ar" Enar,e to Si7e
Incisors <5 6 /5
Canines /5 6 .55
?in&le canal premolars /5 6 .55
Molar 1Distal Root4 /5 6 ..5
Post diameter should not increase 1/3 of the root diameter'
82 S#r%a)e Con%i,#rations ' S#r%a)e Te6t#re:
?urface te,ture of post has a dramatic effect on post retention and stress
distribution'
Retention decreases as !e pro&ress from Threaded serrated
smooth surface post'
This serrated surface provides mechanical undercut for cement More
retention' These serration can be hori#ontal !ith a sin&le vertical vent'
Cuttin& a ventin& channel alon& the len&th of serrated or cast post !ith a
carborundum disc or a fine lon& tapered diamond reduces the hydraulic
forces produced durin& cementation by allo!in& air and cement to
escape coronally'
The surface of the cast post can be sandblasted to improve retention'
Parallel sided serrated post are cemented in the canal passively' They
are retentive and produce less stress in the root dentine than threaded
system'
Parallel sided post are recommended for conservatively prepared root
canals in teeth !ith roots of circular cross section'
%,cessively flared canals 1e&' Those found in youn& persons or on
individual after retreatment of endodontic failure4 or oval in cross
section then a custom cast post are used'
Threaded post produce &reater stresses !ithin the root dentin'
Pretappin& the scre! thread and avoidin& over ti&htenin& reduces these
forces'
..
Parallel threaded post can be useful in situations !here there is limited
root len&th available'
Tapered threaded post should be avoided since they produce !ed&in&
forces !ithin the root canal that can result in fracture'
92 Cementation :
The type of cement used also has little effect on retention) cement type
does affect retention of tapered smooth sided post'
:2 Rotationa Resistan)e :
Post preparation in teeth such as ma,illary anterior and mandibular
premolars !ould ma+e the post space circular in cross section) !hich !ould
rotate durin& function' This !ould not occur in areas !here sufficient coronal
tooth structure remains) because rotation is usually prevented by a vertical
coronal !all'
In areas !here coronal dentin has been completely lost) a small &roove
placed in the canal serve as an anti rotational element'
The &roove is normally located !here the root is bul+iest usually on the
lin&ual aspect
$lternatively rotation can be prevented by an au,iliary pin in the root
face'
;2 Pre*aration 0eometry :
?ome canals particularly ma,illary central incisors have a nearly circular
cross section' These can be prepared !ith a t!ist drill or reamer to prepare a
cavity !ith parallel !alls allo!in& the use of a prefabricated post of
correspondin& si#e and confi&uration'
Canals !ith elliptical cross section must be prepared !ith a restricted
amount of taper 12 to /
o
4 to ensure adequate retention !hile eliminatin&
undesirable undercuts' In this canal parallel sided post !ill not be effective
unless the canal is considerably enlar&ed !hich !ould si&nificantly !ea+en the
.2
root' In this situation a custom made post !ill best fit into the shape of the
canal'
TYPES OF POSTS :
Posts or do!els can be &enerally classified as >
D Passive retention post
D $ctive retention post
Passi+e Retention Post = Retention depends upon their close pro,imity to the
dentinal !alls) but mostly by adherence of the cementin& medium'
%&' Cast posts) ?mooth tapered posts) ?errated parallel posts'
A)ti+e Retention Post = Retention depends primarily on en&a&in& the dentin
directly' Consist of threads that either scre! into the dentin) such as a !ood
scre! or threads that fit into threaded channels EtappedF into dentin much li+e a
bolt'
%&' Fle,i post) Aurer $nchor'
PASSI/E RETENTION POST :
Tapered Smooth Sided Posts :
%&' $ll custom cast post) Aerr %ndopost) Mooser Post 1Mallifier4'
-idely used) as tapered form is easy to use in tapered canal) !hich is
the natural shape of an endodontic canal'
Parallel Sided Posts :
Posts !ith parallel sides !hen cemented into prepared parallel channels)
provide much &reater retention !ith less stress than tapered post'
%&' -haledent para posts
(oston post
Par+ell parallel post
The para post) parallel and serrated is the most !idely used'
.8
Para Post System :
Introduced by -haledent
Has 8 desi&ns
o "ri&inal para post
o Para post plus and
o @nity system
$ll these are passive) parallel) vented) posts made of either stainless
steel or titanium'
Cement retention is &ained by
o Hori#ontal serrations on the para post
o ?piral flutes and &rooves on para post plus and
o Raised diamond pattern on the unity post
$ny cementin& medium can be used
Has &reater retention than the smooth tapered desi&n
Can be used effectively in areas !here hi&her applied forces are
e,pected'
0ent allo!s for easy escape of cementin& medium and reduces stresses
that may be induced in the dentin by other cemented parallel posts'
Bo !ed&in& effect'
Transfer of occlusal forces occurs throu&h the cement layer This
buffer the forces @niform distribution of stresses'
Parallel) serrated vented post produces stresses that are distributed more
evenly alon& its len&th and is betable to protect the dentin'
<oston Post System :
In physical desi&n) the (oston post is similar to parapost but no vertical
ventin&'
It has 33'29: titanium !ith hori#ontal) non en&a&in& serrations'
.;
In .338 (oston post !as redesi&ned !ith deeper &rooves and an etched
and rou&hened surface to allo! &reater retention'
?mear layer removal is recommended'
?tudies have sho!n that the use of unfilled (I?M$ resin !as the best
cementin& medium than #inc phosphate or polycarbo,ylate cements or a
filled resin'
Par-e Parae Post System :
This is a stainless steel passive) vented) serrated post !ith an
antirotational loc+ that fits into a seat prepared in the root surface'
?upplied !ith plastic core former that come !ith the posts' These allo!
the dentist to build up an immediate composite resin cro!n core'
Cementin& the post and core !ith ; M%T$ adhesive) bondin& both to
the tooth surface) mi&ht allo! for the lac+ of a ferrule'
The parallel post also comes in a plastic burnout pattern for a cast
version' This model !ould encoura&e root preparation to receive a
ferrule in the core castin&'
Parallel Sided Posts with Tapered Apical End :
Parallel post in tapered roots ris+ perforation and !ea+enin& of dentin
!all) parallel post !ith tapered ends has been developed'
These posts are desi&ned for &reater retention of parallel post plus &ood
adaptation to tapered apical portion of canal'
$vailable in 2 variations'
De,#ssa =
Completely smooth sided
The strai&ht and tapered apical portions are equal in len&th
Unite- <CH System :
.9
7ess serrations alon& the parallel sides and a smooth apical taper of
about 2 mm'
(CH post has a lar&e coronal portion to provide retention for core build
up materials'
Disadvantages :
D Parallel post !ith tapered ends has a lo!er retention potential than
re&ular parallel posts of comparable len&th and diameter'
D Produces !ed&in& forces in area of apical taper) more prone for root
fracture than parallel sided post'
ACTI/E RETENTION POST :
These are of t!o types >
.' Those !ith self threadin& scre!s 6 %n&a&es the dentinal !alls of a
prepared post channel) cuts their o!n counter threads'
%&' Dentatus post
Radi, $nchor post
Fle,i post
2' Those that bolt into preformed threads 6 These are tapped in dentin' %&'
Aurer $nchor post'
Posts wit& Se% T&readin, S)rews :
Self Threading Tapered Post
Ta*ered Dentat#s :
"ne of the earliest of the self threadin& tapered posts'
More retentive than passive C cemented posts
It &ains its retention by spreadin& the dentin as it self threads May
cause root splittin&'
$ct as a tapered !ed&e and cause stress concentration) !hich become
!orse on occlusal loadin&'
.2
@sually used in molars) dimension 6 2'2 mm lon& and .'2 mm across) so
not preferred in anterior teeth'
@sed on teeth !ith a minimum of coronal tooth structures and multiply
diver&ent canals'
Ta*ered Fe6i Post :
Fle,i post is a prefabricated) split shan+) parallel sided) threaded post
that absorbs the stresses of insertion 1by &radually closin& durin&
placement4 !hile providin& ma,imum retention'
$s apical G collapses it becomes a tapered post'
It &ains its retention by its threads cuttin& into dentin by 5'. mm 6 2
mm'
Further retention can be &ained by cementin& the post !ith a titanium
reinforced composite'
Channel is prepared by drill sli&htly lar&er than the diameter of the shaft
of the post'
The blades 1thread4 e,tend beyond the shaft by 5'2 mm and en&a&e into
the dentin'
It is first scre!ed into the prepared canal !ith a tiny -rench then
removed counter cloc+!ise and reinserted !ith cement into the same
dentin threaded &rooves'
Fle,i post comes in 9 si#es) from 55 to 8'
Self Threading Parallel Post :
2 desi&ns are available
0 6 7oc+
Radi, $nchor system
(oth have lo! frequency sharp threads and both are vented to reduce hydraulic
cementation stress' They differ in the len&th of the threads do!n the shaft'
.<
Parae / (o)- Dri and Post System :
This is a parallel sided micro threaded post'
Micro threads e,tend 5'9 mm from the shaft and continue its full len&th'
0D7oc+ drills are supplied !ith precise drills that prepare a parallel
!alled canal *ust sli&htly lar&er than the post shaft' They can be
cemented !ith any cement or adhesive'
0D7oc+ post !as more stressful than fle,i post !hen threaded and
cemented'
Parae Radi6 An)&or System :
Radi, anchor posts &ain their primary retention by self cuttin& counter
threads in the dentin'
Differ from 0 loc+ post by number of its threads) !hich are sharp) lo!
frequency helical blades that e,tend only partly do!n the shaft'
It is vertically vented'
It is desi&ned to fit snu&ly in a channel prepared for it in the root'
It can be cemented !ith any cement'
(ecause of limited number of threads) the radi, anchor has less retention
than other actively retained posts'
Parallel Threaded Post with Pretapped Channels :
=#rer An)&or Post
These are the only do!els in the mar+et that fit into pretapped counter
threads in the dentin'
Most retentive post available'
Parallel in desi&n !ith no vertical vent'
They have rounded hi&h frequency thread that fit into counter threads
EtappedF into the dentin !ith a manual thread cutter'
They come in a number of confi&urations'
o ?tandard anchor
./
o Cro!n saver
o Fin loc+ anchor
o Press 6 ?tud Denture retainer'
Kurer root facer prepares a flat seat in the root face 1counter sin+4 into
!hich the coronal portion is to fit perfectly'
Parallel sided threaded posts) cemented into tapped channels are
superior in retention than all other post desi&n'
Aurer anchor post is more retentive than the Radi, anchor because of
hi&her frequency of threads'
(ecause of increased retention it is preferred in areas of hi&h load such
as partial denture abutments) overdenture abutments) lon& span brid&es
etc'
$lso very useful !hen only short embedment depths are possible
because of root len&th and shape'
Aurer post produce severe apical stress) if the ape, of the post fully
en&a&es the bevel produced by the t!ist drill at the channel ape,' In
that it is similar to the Radi, anchor'
This can be prevented by trimmin& the post len&th short of the apical
bevel in the canal'
-hen cemented it should be fully seated !ith the end of the threaded
shan+ *ust short of the tapered post of the channel'
The coronal seat in the root facer preparation should be *ust touchin&) no
scre!ed do!n so ti&htly as it produces strains 1Counter Rotation of Post
"ne G turn4'
Disadvantage :
Aurer cro!n anchor system include) removal of a considerable amount
of dentin that cause root perforation and hi&h ris+ of splittin& the root by
rotation of the scre! causin& a !ed&e type action'
CORES :
.3
The core consists of a restorative material placed in the coronal area of a
tooth) !hich replaces carious) fractured or missin& coronal structure and retains
the final cro!n'
The core can be anchored to tooth structure by e,tendin& into coronal
aspect of the canal or throu&h the endodontic do!el' $ttachment bet!een
tooth) Do!el and Core is mechanical or chemical' Remainin& tooth structure
can also be altered to add retention of the core or to prevent rotation of core
durin& function' These modifications are pins) channels) &rooves placed a!ay
from do!el'
Desirabe P&ysi)a C&ara)teristi)s o% Core are >
.' Hi&h compressive stren&th'
2' Dimensional stability
8' %ase of manipulation
;' ?hort settin& time for cement
9' $n ability to bond both to tooth and do!el
Ty*es o% Core :
.' Cast metal cores
2' $mal&am cores
8' Composite resin core
;' lass Ionomer core
9' lass Ionomer resin core
Cast Metal Cores :
Core is an inte&ral e,tension of do!el'
Core doesnFt depend on mechanical means of retention to do!el'
It can provide antirotational features'
Indications are
o ?mall anterior teeth
o Premolars
25
o Teeth !ith ma*or coronal destruction
Disadvantages are
o Increased cost
o More appointments required
o More lab !or+ required
o Chances of fracture at do!el and core interface are hi&h'
Amalgam Cores :
Fast settin& hi&h copper alloy has to be used'
Hi&her retention !hen used !ith preformed do!els in posterior teeth'
Retention is enhanced by usin& dentin bondin& a&ents) au,iliary pins)
irre&ular preparations'
Transmit minimal stress to tooth structure'
Advantages =
.4 Hi&h compressive stren&th'
24 Hi&h tensile stren&th'
84 ?table under functional stress
Disadvantages :
Potential for corrosion Discoloration of &in&iva or dentin'
Composite Resin Core :
Advantage :
%asy to manipulate and sets rapidly'
$nti rotational effect and additional retention can be achieved by pins)
dentin bondin& a&ent'
Disadvantage :
Polymeri#ation shrin+a&e and contraction a!ay from tooth structure'
If non fluoride releasin& 6 no anticario&enic property'
2.
Microlea+a&e more than amal&am) IC) IC 6 Resin'
Dimensionally unstable in !et conditions'
7o!er modulus of elasticity) hi&her coefficient of thermal e,pansion'
Glass Ionomer Core :
Hi&h viscosity IC or IC silver core material can be used'
Advantages :
.' $nticario&enic 6 fluoride release'
2' Forms ionic bond
8' Microlea+a&e is less
Disadvantages :
.' ?oluble and sensitive to moisture'
2' 7o! fracture tou&hness 6 lo! stren&th and brittle cannot be use d in
anterior teeth or replace unsupported cusp'
Indications :
For posterior teeth
D $ bul+ of core material is possible if sound dentin remains'
D If addition retention is available !ith pins and dentin preparation'
Glass Ionomer Resin Core (RMGIC) :
Moderate stren&th) &reater than conventional IC'
?olubility is bet!een composite and IC
%,hibits properties of both the materials
Release fluoride
Insoluble) minimal lea+a&e
Titanim Core Composite Material (E!tensi"e #ental S$stem) :
Fluoride releasin&'
22
Reinforced by titanium and lanthanide' Increased stren&th !ithout
potential by products that results from o,idation of silver filled &lass
ionomers'
Hi&h compressive and tensile stren&th'
CAST /ERSUS PRE-FA<RICATED POST AND CORE:
Prefa%ricated Post Core :
Advantages :
.' ?imple to use
2' 7ess time consumin&
8' Can be completed in one appointment
;' %asy to tempori#e
9' Cost effective
2' ?tron&
Disadvantages :
.' Root is desi&ned to accept the post rather than post desi&ned to fit the
root'
2' $pplication is limited !hen considerable tooth structure is removed'
8' Possibility of chemical reaction !hen post and core are of dissimilar
materials'
;' $ttachment for removal prosthesis cannot be applied to post and core
unless a separate castin& is fabricated to place over it'
Cast Post Core :
Advantages :
.' Custom fit to root confi&uration'
2' $daptable to lar&e) irre&ularly shaped canals and orifices'
8' Can be used !ith !rou&ht post and prefabricated plastic pattern'
Disadvantages :
.' %,pensive
28
2' Require multiple appointments
8' 7ess retentive
;' Tempori#ation bet!een appointment is difficult'
9' Chances of corrosion because of castin& procedure or use of dissimilar
metals'
2' Ris+ of castin& inaccuracy
Amo#nt o% toot& Str#)t#re Remo+a :
Custom cast post core 6 Minimal amount of dentin removal' Canal
enlar&ed !ith reamers and files durin& endodontic treatment for shapin& the
canal' Final post core preparation done !ith peeso reamers'
Para post 6 Conservative tooth preparation 17ess removal of tooth structure
!hen compared to Aurer anchor4'
Aurer $nchor 6 More amount of tooth structure removal because of
counter sin+ leads to perforation and root splittin& 1!hen compared to all
other post4'
DO$E( AND CORE SE(ECTION :
This depends on 8 important factors'
.' $mount of tooth structure remainin&'
2' Functional stresses anticipated
8' Morpholo&y of root
TECHNI?UES :
Post Selection :
Depends on
Root morpholo&y'
Remainin& coronal tooth structure
"cclusal forces
Post core selection should be done after cro!n preparation'
Root 5or*&oo,y :
2;
Most roots &radually taper from the cemento enamel *unction to the
ape, of the tooth' The use of parallel post in these teeth may come dan&erously
close to perforatin& the lateral surface of the root'
Consideration should be &iven to use a tapered or a parallel post of
shorter len&th' (oth these alternatives have their dra!bac+s'
The use of a tapered post could introduce !ed&in& durin& load transfer)
!hereas a shortened parallel post reduces the protective function of the post by
spreadin& occlusal stresses over a shorter root len&th'
-hen the outline of the canal is oval or ribbon shaped) it is difficult to
prepare a circular post channel to receive a parallel post' In these situations) a
custom post formed to the shape of the canal conserves tooth structure and
involves less preparation in the apical re&ion of the root' This custom post !ill
also have the coronal core attached) allo!in& antirotational component to be
incorporated into the post preparation'
If it is possible to prepare cylindrical channels equal to or lon&er than
the clinical cro!n of the tooth) a parallel cemented post in combination !ith a
coronal core !ill best fulfill restorative requirements' The coronal core can be
formed !ith amal&am or composite or as part of a post castin&'
Remainin, Corona Toot& Str#)t#re :
The retentive and protective function of a post depends upon the amount
of tooth structure remainin& after caries and previous restoration have been
removed'
The use of a post should be considered'
.' For anterior teeth !hen one or both pro,imal !alls are missin&'
2' For posterior teeth !hen t!o or more ad*acent pro,imal !alls are
missin&'
Type of Post =
29
.' Preformed post and core combination used !hen no dentinal !alls
remains on cro!n and shorter root D Kurer Anchor system'
2' Preformed metal post) combined !ith a composite or amal&am core
!hen one or more dentinal !alls remain'
Endo post
Para post system
B! post system
Boston post
"le#i post
8' ast core additions to a preformed metal post !hen no dentinal !alls
remains) such as castin& a core addition to a $etal Para Post'
;' %hreaded post 6 limited root len&th is available'
O))#sa For)es :
"cclusal forces on individual teeth are influenced by tooth type and
position) the presence or absence of ad*acent teeth) the function the tooth must
serve 1for e&) the sin&le unit or partial or brid&e abutment4 and the patients
occlusal habits'
%ach of these variables) either sin&ly or in combination) determines the
selection of a post system that satisfies the retentive and protective criteria the
individual clinical situation demands'
Root Selection :
Post should be placed in area !here there is &reatest amount of lost
tooth structure' Mesial roots of mandibular molars and buccal roots of
ma,illary molars are often curved and narro! and cause perforations !hen
these roots are chosen for post placement'
Distal roots of mandibular molars and palatal roots of ma,illary molars
are best suited for post placement'
Post Em%edment #epth :
22
More len&th) more !ill be the retention and more even stress
distribution alon& the root surface'
Gidelines for Post Em%edment #epth :
Gtta&Percha Remo"al :
Coronal portion of &utta percha is removed to provide a post space' To
maintain the inte&rity of apical seal &utta percha removal is delayed until the
root cement is set ;/ hours or !ait a !ee+'
Recent studies have sho!n that post space can be prepared immediately
after condensation if hot instrument is used to remove &utta percha'
More recent studies reported no difference in apical lea+a&e bet!een the
use of heated plu&&ers) chloroform !ith files or Peero drills) or bet!een heated
plu&&ers and atesDlidden drills' $mon& the solvents) chloroform !as found
to be more effective than ,ylene'
$fter removin& the &utta percha it is necessary to &o bac+ and
recondense the face of the remainin& &utta percha fillin&'
There is additional advanta&e in immediately preparin& the post space'
The clinician !ho has *ust filled the canal has clearly in mind the len&th and
shape of the preparation' Moreover) additional vertical condensation of the
remainin& &utta percha !ill result in a !ell condensed apical seal'
If the endodontic status of the treated tooth is uncertain) immediate &utta
percha removal and post space preparation is best delayed'
5et&ods o% Remo+a :
Root Canal Plugger = The rapid placement and removal of a !ell heated root
canal plu&&er removes &utta percha as it softens and adheres to the plu&&er'
This process is repeated until the desired depth is achieved'
2<
$t least 8'5 mm but preferably 9'5 mm of apical &utta percha should
remain' This should be verified by radio&raph after a final recompaction usin&
vertical condensation'
Peeso Reamers = Have also been used to remove &utta percha' The reamers
non cuttin& tip facilitates centerin& the reamer in the &utta percha'
Pro&lems encountered during preparation of post space include'
.' Canal over enlar&ement'
2' Perforations 6 Deviation of the reamer) caused by the remainin& &utta
percha can lead to perforation'
8' Dislod&ement of the master point from the apical area) if post space is
prepared !ith a reamer or rotary instrument immediately follo!in& the
obturation'
Channel Preparation :
Can be prepared by endodontic reamers) files peeso reamers and
specified drills !ith prefabrication post +its'
The prefabricated post system use endodontic reamers or files) peeso
reamers or specified drills !ith prefabricated post +its to establish proper
channel !idth for each post si#e' Measurement of the post space len&th from
the occlusal or incisal landmar+s from the radio&raph is transferred to the
appropriate file) reamer or drill for the post system selected' The !alls of the
canal are then reamed to the proper !idth'
$s previously started) post diameter has much less influence on
retentive capability than the embedment depth in the canal' Therefore) canals
should not be overly enlar&ed at the e,pense of surroundin& dentin) especially
in the apical portion !here the root diameter is severely reduced'
It is recommended that preparation !idths should be +ept as narro! as
possible) never e,ceedin& one third the root diameter' $t least .'5 mm of root
structure must remain alon& side the post'
2/
The space provided by removin& the &utta percha serves to centre the
reamer or drill and &reatly reduces the ris+ of perforation' Peeso reamer
because of their non cuttin& tips are less li+ely to cause deviation from the
canal center' Therefore) in post system !here a drill is used to shape the final
post space) pro&ressively lar&er peeso reamers may be used initially to ma+e
the canal close to parallel' Then) the t!ist drill or thread cutter used to form the
final channel !ill have much less cuttin& to do and more precise channel !ill
result' Deviation of drill and possible perforation are most unli+ely'
Post Installation :
Cemented post should not bind !hen inserted nor should they be so
loose that retention is questionable if the post binds) it should be removed and
the channel redefined !ith the appropriate drill'
Complete seatin& can usually be ascertained !ithout ta+in& a
radio&raph' This is accomplished by comparin& the measurement of the last
used files or reamer !ith the measurement of the post seated !ithin the canal'
The coronal e,tension of the post should be ad*usted to !ell belo! the
occlusal plane but !ith sufficient len&th to retain the core material' The
coronal portion of the post may also be bent to position it more strate&ically for
core retention' This is done out of the mouth and prior to cementation' -hen
the fit and len&th of the post have been verified) it is cemented !ith permanent
cement or resin'
Crown Preparation :
$ll mar&ins of the final restoration should al!ays be on sound tooth
structure) and apical to mar&in of any internal core build up' This allo!s for
control over mar&in desi&n) minimi#es lea+a&e at the final mar&in and
facilitates continuation of the internal core'
23
-ith endodontically treated teeth) e,tension of the final cro!n belo!
the internal core provides a more even stress distribution of functional forces
and serves to minimi#e the ris+ of coronal radicular fractures'
The cro!n should e,tend) !here possible .'9 to 2 mm on tooth structure
beyond the tooth core *unction to ensure a protective ferrule effect 1Cro!n
ferrule4' This surroundin& band of metal helps to prevent vertical fractures in
the root or hori#ontal fractures of the cro!n'
Ferrule can also be used in do!el core castin& 1core ferrule4' Ho!ever
care should be ta+en to avoid dama&e to the epithelial attachment'
Preparation of 'rifice :
For cast post in some teeth such as ma,illary anterior and mandibular
premolars) post preparation around the orifice leads to symmetrical shape' ?o
to avoid purely round preparation orifice is modified by placin& slots or
cloverleaf !ith tapered diamond stone or carbide bur'
Antirotational groove :
@se a Bo'.<5 carbide bur to ma+e a +ey !ay or &roove in the orifice of
the canal'
rooves should be ple,ed in the area of tooth !here there is &reatest
bul+'
The +ey!ay should be +ept to the depth of the diameter of the bur
1appro,imately 5'9 mm4 and up to the canal to the len&th of the cuttin&
blades of the bur 1appro,imately '; mm4'
"n a premolars second canal serves the same anti rotational features'
Re&ardless to the type of post used all internal desi&ns should be
smooth) free of debris) caries and old restoration'
In teeth !ith lar&e pulp chamber occlusal inlay preparation is made to
increase retention'
85
If core is build directly around prefabricated post orifice it is notched
alon& the post to!ards the ape,' This act as undercut and aids in retention plus
the space for core material'
Preparation of (errle :
Ferr#e :
It is defined as a metal rin& or cap placed around the end of a cane or
tool) !hich &ives it) added stren&th' Ferrule increases the resistance to !ed&in&
forces'
Ferrule is an encirclin& band of restoration that is metal or ceramic
!hich encircles the e,ternal aspect of the residual tooth'
There are t!o types of Ferrule =
a' Cro!n ferrule
b' Core ferrule
ro(n "errule:
-hen less than 8 mm of circumferential sound tooth structure remains 6
desirable core is full cast copin&' This produces an apron of metal
around tooth' This distributes the forces equally) produces a ferrule as a
part of core copin& and thus &ives ma,imum protection'
ore "errule:
Impartin& a ;9 bevel to the occlusal or incisal portion of the preparation
&uards the preparation a&ainst fracture from lateral forces of
mastication) since the core portion of castin& !ill incorporate and hold
in the top portion of the preparation'
This contrabevel !ill provide a collar around the occlusal circumference
of the preparation) !hich aids in holdin& the tooth to&ether and prevents
fracture' This serves as a safe&uard on a precision fittin& do!el) !hich
can e,ert lateral forces durin& cementation'
%he cro(n and ro(n preparation together must meet ) re*uirements :
.' $ minimum of .D2 mm of dentin a,ial !all hei&ht is required'
8.
2' $,ial !alls must be parallel
8' The metal must totally encircles the tooth'
;' The metal must be on solid tooth structure'
9' The metal must not invade the attachment apparatus'
Advantages of "errule :
.' Reduces the incidence of fracture by reinforcin& the tooth and
dissipatin& the forces'
2' Resist lateral forces from tapered do!els and levera&es from the cro!n
in function'
8' Increases resistance and retention of restoration'
Effectiveness of ferrules in preventing tooth fracture:
Differences of opinion e,it re&ardin& the effectiveness of ferrules in
preventin& tooth fracture' Ferrules have been tested !hen they are part of the
core and also !hen the ferrule is created by the overlyin& cro!nDen&a&in&
tooth structure' Most of the data indicate that a ferrule created by the cro!n 6
encompassin& tooth structure is more effective than a ferrule that is part of the
post and core' Ferrule effectiveness is enhanced by &raspin& lar&er amounts of
tooth structure' The amount of tooth structure en&a&ed by the overlyin& cro!n
appears to be more important than the len&th of the post in increasin& a toothFs
resistance to fracture' Ferrules are more effective !hen the cro!n encompasses
relatively parallel prepared tooth structure than !hen it en&a&es beveled C
slopin& tooth surfaces'
(est 2 mm or more of tooth structure is covered as ferrule
Ferrule len&th more important than post len&th in increasin& the fracture
resistance'
CUSTO5 CAST POST AND CORE :
Can be fabricated by
D Direct Technique
D Indirect technique
82
Dire)t Te)&ni@#e :
In this technique a cast able do!el and core pattern is fabricated directly
on the prepared tooth in the patients mouth'
The pattern can be made of inlay !a, or self cure acrylic resin
reinforced !ith a plastic rod) a bur) metal pin or a paper clip) nails) tooth
pic+'
$lso !a, and acrylic resin can be combined' The use of resin allo!s
the pattern to be formed into a !ell adapted) solid do!el that can be
manipulated easily in the mouth !ithout becomin& distorted or loose in
the canal'
This technique can be used for sin&le rooted teeth or multirooted teeth'
For Sin,e Rooted Teet& :
This is done in the follo!in& steps =
.' Preparation of a tooth for a cast restoration 1for anterior teeth metal
ceramic cro!n4'
This determines the amount of sound dentin remainin& 1$ll undermined
thin) !ea+ened tooth structure is removed4'
2' Preparation of a Ferrule 1825
o
Collar4' (uccal and lin&ual surfaces are
slopped'
8' Preparation of Post space
o Placement of anti rotational &roove
o %lliptical canal 6no antirotational &roove'
;' Post preparation =
Follo!in& materials are available !hich can be used as post'
.' %ndo Post =
o Hi&h fusin& precision metal alloy'
o $vailable in si#es bet!een <5D.;5 correspondin& to standardi#ed
endodontic instruments'
88
o Can be cast !ith &old or other precious metals'
2' %ndo!el =
o %ndo!el is a plastic pin'
o $vailable in standard si#es /5D.;5
o -hen fitted a post preparation and incorporated in a !a, or resin
pattern) it !ill burn out of the investment and yield a castin& of one
metal'
8' Para Post =
@nli+e endodontic instruments) it has no taper and requires the use of
rotary instruments for canal preparation' Bot available in standardi#ed si#e'
Do!el is chec+ed for fit at the base of the prepared canal'
The canal is lubricated 1eu&enolCpetroleum *elly4'
If smooth plastic do!el is used it is rou&hened or sli&htly notched to
facilitate retention of acrylic resin'
$crylic resin is applied to the do!el and prepared canal' $fter the resin
reaches the dou&hy sta&e the do!el is inserted in the canal'
Do not allo! the resin to completely harden !ithin the canal' The
do!el is pumped in and out in the canal to prevent interloc+in& of do!el
in the canal'
Remove the polymeri#ed pattern and inspect the resin for inte&rity and
lac+ of voids' Repeat the post and test for adaptation and passivity'
$crylic resin is added !ith brush to reconstruct the coronal aspect' $
sli&ht e,cess of core resin is added so that the hardened core can be
prepared !ith a hi&h speed diamond and !ater spray to the desired
form'
The core is then removed) invested and cast'
The pattern can also be developed usin& inlay !a, 1Type I4) !hich can
be carved !ith a carver'
8;
$fter removin& the pattern) do!el orifice is protected !ith cotton
pled&et and provisional cro!n is cemented 1no cement in canal4'
For m#tirooted teet& :
Parallel +alls =
Palatal for ma,illary and distal canal for mandibular is selected for
primary post'
?econdary post is placed !hich is 8D; mm in len&th shorter than primary
post'
Technique is same as above mentioned'
,on-Parallel +alls :
If a severely dama&ed tooth is to be sub*ected to the stresses of actin& as
an abutment for a fi,ed brid&e or removable partial denture) more resistance
and retention are required' (ecause of the root diver&ence found in most
molars) usin& a do!el core !ith t!o or three parallel do!els e,tended into
multiple roots can be quite ha#ardous' Therefore) a multipleDpiece do!elDcore
!ith separate do!els should be employed' The do!elDcore for a mandibular
molar is usually divided into mesial and distal se&ments' The ma,illary molar
do!elDcore is composed of facial and lin&ual components) !ith the do!els in
the t!o facial canals parallelin& each other' -hen the mesiofacial and
distofacial canals are too diver&ent to permit parallel do!els) a separate third
do!el is required'
For a t!oDpiece do!el core to achieve ma,imum stren&th and retention
from the do!els in diver&ent canals) the pieces must be ri&idly bound to&ether
after insertion' $ number of in&enious methods have been proposed for
accomplishin& this' The core can be made in t!o halves held to&ether by
interloc+in& lu&s !hich can be formed from a commercially available nonDri&id
connector pattern or by cuttin& a +ey !ay or dovetail in one half of the core
pattern' Hori#ontal bolts have also been described for this purpose'
89
These interloc+in& methods can be fabricated by the direct technique) or
by the indirect technique'
Indire)t Te)&ni@#e :
$ custom do!el core can also be fabricated by ma+in& a !a, or resin
pattern on a cast of the prepared tooth'
$n impression of the prepared canal 1elastomeric impression material4
can be made by in*ectin& impression material into the canal'
In order to prevent distortion C displacement of impression material)
durin& removal from the mouth and pourin& of the cast) the impression
is reinforced !ith some type of ri&id do!el' These include paper clips)
orthodontic !ire) plastic post and root canal instruments'
"nly use plastic posts !hen they are totally passive and do not bind on
any tooth structure'
-hen a safety pin or orthodontic !ire is selected the coronal portion of
!ire should be bent over to form a handled to help retain it in the
impression material'
Botch the !ire and coat it !ith adhesive'
Fill the prepared canal !ith impression material usin& a slo!ly rotatin&
lentulo spiral instrument accompanied by up and do!n motion to reduce
voids and uniform coatin&'
$lternatively) an anesthetic needle can be placed to the full depth of the
canal' ?yrin&e additional impression material around the post as !ell as
the prepared tooth and seat the impression tray'
Remove the impression) evaluate it and pour a cast'
7i&htly lubricate the canal of the !or+in& cast !ith die lubricant'
Place notches on the side of a plastic post 1tooth pic+ can also be used4
that seats to the full depth of the canal preparation'
$pply a very thin layer of stic+y !a, to the plastic post and then add
soft inlay !a, 1Type II4 in small increments) fully seatin& the plastic
post after each increment of !a, is added 1$lso beadin& !a, can be
82
used because it is soft and can be easily removed from irre&ularities and
undercuts in canals4'
$fter the post pattern has been fabricated) the !a, core is added and
shaped and then the pattern is removed from the cast) inverted and cast
in metal'
The cat post and core are then cemented in the tooth and the definite
tooth preparation completed'
PRO/ISIONA( RESTORATIONS !TE5PORIAATION" :
$ temporary restoration plays an important role in the successful
restoration of a tooth'
"unctions :
.' It protects the tooth from further dama&e'
2' It prevents mi&ration or driftin& of opposin& or ad*acent teeth'
8' Provides occlusal function
;' %sthetic role
Poly carbonate cro!ns are !ell suited for the routine sin&le cro!n'
$ custom made plastic shell !ill probably provide the best result in
shortest time'
Polycarbonate Cro!n =
In most cases the polycarbonate cro!ns !ill not adapt the e,istin& tooth
structure' %,cess len&th is removed from &in&ival mar&in of cro!n !hile
incisal area is left intact'
$ paper clip of appropriate diameter is selected and is placed to the full
depth of the post space' -ire is cut above 2D; mm of coronal tooth
structure'
Place a bend near the end of the !ire' -hen embedded in the temporary
cro!n) this bend !ill prevent the post from pullin& out and rotatin&'
The root surface is hi&hly lubricated !ith petroleum *elly to prevent any
acrylic resin from stic+in& to the tooth durin& polymeri#ation'
8<
$ thin mi, of temporary acrylic resin is placed around the canal orifice)
avoid pushin& resin deep into canal space) because this can ma+e cro!n
difficult to remove'
Insert the paper clip post into the canal'
Fill the polycarbonate cro!n !ith the same acrylic resin'
?eat the cro!n and confirm it to proper position !ith the ad*acent teeth'
%,cess acrylic is removed !ith a sharp e,plorer) the temporary cro!n is
finished and polished'
Temporary cement is placed only in the coronal position of restoration'
$void &ettin& cement in canal space'
?eat the pin temporary cro!n and hold it in place !ith firm fin&er pressure
until the cement is set'
CE5ENTATION :
Do!els can be cemented !ith >
Hinc phosphate
lass Ionomer
lass Ionomer Resin
Resin Cements
Non Ad&esi+e Cements :
Zinc Phosphate Cement :
Provides retention by interloc+in& of small mechanical undercuts in the
tooth structure and restorative material'
Inability to bond chemically is a disadvanta&e'
It retains the restoration) but doesnot increases resistance to fracture) does
not inhibit mar&inal lea+a&e'
Bo anticario&enic properties'
Ad&esi+e Cements :
(ond to dentin !ithin the root) residual tooth and do!el'
8/
Glass Ionomer Cement :
Fluoride releasin& $nticario&enic'
Moisture sensitive) slo! settin&) soluble'
GIC Resin
Moderate retention) hi&h stren&th
7o! or no solubility
Hi&h fluoride release
%asy to use
Resin Cements :
Ma,imum retention) but retreatment difficult
7ess microlea+a&e
Cementation Pro)ed#re :
Mi,ed cement is delivered into post space by either lentulo spiral or
endo instruments' Do!el or do!el and core are coated !ith thin layer of
cement' The post and core is inserted &ently to reduce hydrostatic pressure
!ith little fin&er pressure'
The e,cess cement is removed) allo! some time for cement to set' Then
impression of coronal restoration 1cro!n4 is made'
Coronal Radiclar Restoration :
$lternative to traditional post and core technique for posterior teeth'
-hen posterior teeth are lar&ely intact) a coronal radicular restoration may
be used'
This restoration consists of a core that e,tends 2 to ; mm into the coronal
portion of the canals'
The core is retained by a combination of the diver&ence of the canals in a
multirooted teeth) natural undercuts in the pulp chamber) adhesion !ith
dentin bondin& a&ents) retentive channels or preparation in dentin'
83
Materials used = $mal&am) (onded $mal&am) Composite) IC'
Restoration has equal stren&th to Pin $mal&am'
Technique =
utta percha is removed from 2D; mm of the canals'
@ndercuts and irre&ularities found in the canal !all increase retention of
the restoration'
Restorative materials should be bonded to the available tooth structure to
increase retention) decrease microlea+a&e and increase fracture resistance
of tooth'
The tooth is no! ready for final coronal restoration'
Re)ent ad+an)es :
Car%on (i%re Post
Carbon fiber posts are made of unidirectional carbon fibers embedded in
an epo,y matri,' Carbon content is 2;:'
The system !as developed to reduce the occurrence of root fracture due
to !ed&in& of metal posts'
%sthetic versions of this post have a quart# e,terior that ma+es the post
tooth coloured'
Desi&n = ?mooth sided cylindrical !ith tapered apical portion'
Diameter = .D .'2 mm
7en&th = 22 mm
Advantages :
(etter mechanical properties !hen compared to metal posts'
Increased stren&th
Increased stiffness
Increased li&htness and
Resistance to corrosion) Chemical bondin& !ith resins'
;5
Chemical bondin& !ith resins D Modulus of elasticity similar to
dentin) hi&h fati&ue and tensile stren&th'
Disadvantages :
Carbon fibre post is &rey in appearance'
Replacin& carbon !ith quart# fibre results in a tooth coloured
restoration'
Esthetic Post And Core :
Disad+anta,es o% Non Est&eti) ' 5eta Posts :
Metal post and core decreases the translucency of coronal restoration
and the post may shine throu&h in the cervical re&ion'
Bon biocompatible
Tendency to corrode
@nequal stress distribution because difference in elasticity bet!een
dentin 1./'2 MPa4 and metal 1255MPa4
Advantages of Esthetic Post and ore :
Ma,imum esthetic benefit'
$s its elasticity is similar to dentin structure) it acts as a shoc+ absorber
and thereby equal distribution of stress'
Resistance to corrosion
(iocompatible
Indication :
-hen patient desires increased esthetic benefit'
C(ASSIFICATION
Cerami) Post and Core Fibre Rein%or)ed Post and Core
;.
D lass ceramic post and core
D lass infiltrated aluminum o,ide
ceramic'
D Pre fabricated #irconia
endodontic posts
D $esthetic post 1carbon and quart
fibers4
D $esthetic plus post 1quart# fibers4
D Fiber Aor post 1&lass fibers in
resin4
D Para post fibre !hite technique
D ?no! post 1silica #irconium &lass
fibers in epo,y resin4
D 7i&ht post
D 7uscent anchor
D lassi,
D Mirafit !hite
D ?tyle post
D Double taper post system 1quart#
fibers and epo,y4
Cerami) Post :
lass ceramic post and core'
lass infiltrated aluminous porcelain post and core
Air)onia *ost : !Tetra,ona 7ir)oni) *oy )rystas"
-hen heated under&oes structural chan&es enlar&ement of crystal lattice
Increases tou&hness'
Desi&n is parallel sided post'
Fle,ural stren&th 1.;55 MPa4 and fracture tou&hness 12D.. MPa4 increase
(iocompatible
Te)&ni@#e :
Prior to cementation the apical tip of the post is rounded or reduced !ith the
help of diamond bur to reduce the mechanical stress durin& and after
cementation' Post is then sand blasted !ith 95 m aluminium o,ide and
cleaned !ith chloroform'
Dentin bondin& a&ent is applied and post is cemented !ith chemical cure
composites'
Core semi translucent hybrid composite'
;2
Cosmo Post :
Cylindrical shape !ith a conical tip'
Disadvantages of eramic Post :
0ery stiff and stron& !ith no plastic behaviour'
Fiber Rein%or)ed Com*osite Post :
The addition of fibers to a polymer matri, can result in a si&nificant
improvement in the mechanical properties of stren&th) fracture tou&hness)
stiffness and fati&ue resistance'
Fibers may be composed of =
Carbon or &lass
?ilica -oven polyethylene
Ribbon fibre'
%(o categories of fi&er reinforced posts are availa&le.
Chair side fabricated and prefabricated
Chair side fabricated posts are custom desi&n that uses polyethylene
nonDpreDimpre&nated !oven fibers or &lass fibers to reinforce the root
and hold a composite core'
Prefabricated post are constructed of t!o +inds of fiber
o Carbon fibers embedded in an epo,y matri, and
o ? type &lass fibers embedded in a filled resin matri,
Prefa%ricated (i%er Reinforced Post :
Ty*es :
a2 Aest&eti) Post :
Central core of carbon fibers bundle
?urrounded by quart# fibers
$rran&ed lon&itudinally'
;8
b2 Aest&eti) P#s Post
%ntirely of quart# fibres'
)2 (i,&t *ost
Translucent quart# fiber desi&ned to permit li&ht curin& material to be
used for lutin&'
d2 Snow Post :
25: lon&itudinally arran&ed ?iDHr &lass fibers in epo,y resin matri,
1?urface treated !ith silane to increase bondin& !ith resin cements4'
e2 Para Post %iber w&ite :
7on&itudinally arran&ed &lass fibers'
%2 0assi6 :
(raided fibre arran&ement
For increase resistance to bendin& and torsion'
,2 5ira%it $&ite :
lass fibre version of mirafit carbon'
&2 (#s)ent An)&or :
Translucent lon&itudinal &lass fibres in resin matri,'
i2 Fiber =or :
7on&itudinal &lass fibres in filled composite resins'
B2 Stye Post :
Parallel sided) tapered end quart# fibre post system'
-2 Do#be Ta*er Post System :
Made up of quart# fibre and epo,y'
Iuart# fiberCepo,y post is available in translucent 1DT li&ht post4 for
7'C' composite and off !hite for 1DT -hite Post4 chemical cured
composite'
Consist of 8 post system =
I?" 35) .55) .25
$pical 9 mm 2
o
for all 8 si#es'
;;
Middle section sho!s increase chambers from post . to 8'
Advantages :
Minimal tooth structure removal durin& canal shapin&'
reater post to canal adaptation in the apical and coronal half of the
canal'
ood retention'
7o!er modulus of elasticity 6 7ess incidence of root fracture'
Cini)a Te)&ni@#e :
(#mine6 (i,&t Transmittin, System :
In case of !idely flared canals simply placin& a post inside the canal
!ill leave a thic+ layer of cement' Therefore intraradicular reha&ilitation is
required' Canal is reamed to the desired depth !ith a si#e matched reamer'
Procedure :
First etchin&) rinsin&) dryin&) then bondin& a&ent applied and li&ht
cured' Then composite resin is placed inside the canal and li&ht post placed
inside this resin' 7i&ht curin& of both post and resin is done for 25 seconds'
Then !ith hemostat li&ht post is removed canal orifice is shortened C
narro!ed C rehabilitated'
?elf cure resin is in*ected into the canal and luscent anchor is placed into
this self cure resin' ?ome self cure resin 1lu,acore4 sets !ithin ; minutes' The
self cure resin is shaped into the desired core shape'
Advantages :
7i&ht passes throu&h post so adequate curin& is done all throu&h the
canal'
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Advantages of "i&er /esin 0ystem :
The modulus of elasticity of post similar to tooth tissues' ?o better
shoc+ absorber'
Disadvantages :
Fibre post can under&o de&radation in the form of repeated mechanical
loadin& and also in condition of moisture' Therefore decrease in modulus of
elasticity and decrease in fle,ural stren&th !ith increased ris+ in debondin&'
Advantages of eramic Post:
?tiffer material'
Disadvantages =
(rittle material
Difficult to remove a fractured ceramic post'
CONC(USION :
Reinforcin& and restoration of badly bro+en root canal treated teeth can
be done !ith post core system' Due to the availability of prefabricated posts of
various desi&ns and surface confi&uration) the fabrication time and costs has
been reduced'
For a successful post core system) the clinician should +eep in mind
re&ardin& proper obturation) post space) post len&th) post diameter) ferrule
desi&n and should preserve the root dentin as much as possible'
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