RESTORATION OF THE

ENDODONTICALLY TREATED

TOOTH
EVALUTION OF AN ENDODONTICALLY TREATED TOOTH

 Good apical seal

 No sensitivity to pressure

 No exudate

 No fistula

 No apical sensitivity

 No active inflammation

Contemporary Fixed Prosthodontics – Rosenstiel 4rd edition

 INDICATIONS FOR POST AND CORE

 >1/2 crown height remain – only core

 >1/2 coronal structure lost – prefabricated

fiber post

 >2/3 coronal structure lost – prefabricated

metal post

 >3/4 coronal structure lost – cast post

COHEN’S PATHWAYS of the PULP – First South Asia Edition

 IDEAL REQUIRMENTS OF A POST

 Maximal retention of core

 Protection of the root from fracture

 Resistance to displacement

 Radio opacity

 Biocompatibility

Easy retrievability

Grossman’s Endodontic Practice 13th edition

 CLASSIFICATION OF POST

Different types of posts available can be grouped as:

 Prefabricated or custom made

 Active or passive

 Parallel or tapered

 By material composition

Nandini VV, Venkatesh V. Current concepts in the restoration of endodontically treated teeth. J Indian Prosthodont Soc 2006;6:63-7
AVAILABLE CAST POST SYSTEMS
AVAILABLE CAST POST SYSTEMS
FEATURES INCORPOATED IN A TOOTH PREPARATION
FOR POST AND CORE

1. Apical seal

2. Minimal enlargement

3. Length

4. Stop

5. Vertical wall

6. Marginal extension
 PRINCIPLES OF TOOTH PREPARATION
1. Preservation of tooth structure
a) preparation of the canal
b) preparation of the coronal tissue

2. Retention form

3. Resistance form

4. Structural durability

5. Marginal integrity

6. Preservation of the periodontium.

PREPARATION OF THE CANAL
 PREPARATION OF THE CORONAL TISSUE

Ferrule is defined as a band or ring used to encompass the root

or crown of a tooth; (or ) any short tube or bushing for making a
tight joint. ( GPT – 9 )
 PREPARATION OF THE CORONAL TISSUE

TYPES OF FERRULE

 Core ferrule
 Crown ferrule

Ingle’s EndodonticS: 7th Edition

Ferrule effect: a literature review - Jelena Juloski et al – J Endod. 2012
FERRULE

Ingle’s EndodonticS: 7th Edition

Ferrule effect: a literature review - Jelena Juloski et
al – J Endod. 2012
Tjan AH et al, J Prosthet Dent: 1985

Sorensen JA, Engelman MJ, J Prosthet Dent: 1990

Looney RW et al, J Prosthet Dent: 1990
Saupe WA et al, Quintessence Int: 1996
 RETENTION FORM

Post retention is affected by:

1. Preparation geometry

2. Post length

3. Post diameter

4. Post surface texture

5. Luting agent
 PREPARATION GEOMETRY

 Circular cross section canals should be prepared with parallel

walls or minimum taper, allowing use of parallel-prefabricated
post.

 Elliptical or excessively flared canals cannot be prepared to

give parallel walls and require custom cast posts or tapered
prefabricated posts.
 POST LENGTH

 Retention increases with

increase in post length.

 Post length is dictated by

retaining 5 mm of apical gutta
percha.

 In short root or tall clinical

crown compromise of
mechanics, the apical seal or
both is prevalent, then the
acceptable apical seal is of 3
mm.
POST DIAMETER
POST SURFACE TEXTURE
 LUTING AGENT

 The luting agent seems to have an effect on post retention or

the fracture resistance of dentin.

 In order to enhance retention, it is advised that before the

cementation of a post, the canal space should be irrigated with
ethanol or etching with 37% phosphoric acid.
 RESISTANCE FORM

 Post and core improves resistance to laterally directed forces

by distributing them over as large an area as possible.

 The post design should distribute stresses as evenly as

possible.

 The incidence of radicular fracture increases with the use of

threaded posts that actively engage radicular dentin, and
threaded flexible posts do not appear to reduce stress
concentrations during function.
 RESISTANCE FORM

ANTIROTATIONAL GROOVE

 When sufficient coronal tooth structure

remains, rotation is prevented by a vertical
coronal wall.

 Where coronal dentin has been completely

lost, a small groove placed in the canal
wall can serve as an antirotational element.

 The groove is normally located where the

root is bulkiest, usually on its lingual
aspect.
TOOTH PREPARATION FOR ENDODONTICALLY TREATED TEETH

1. Removal of the root canal filling material to the appropriate

depth.

2. Enlargement of the canal.

3. Preparation of the coronal tooth structure.

4. Post fabrication
a. Prefabricated post
b. Custom made post
i. Direct technique
ii. Indirect technique
POST SPACE PREP OR TOOTH PREP?
POST SPACE PREP OR TOOTH PREP?

COHEN’S PATHWAYS of the PULP – First South Asia Edition

Ingle’s ENDODONTICS: 7th Edition

COHEN’S PATHWAYS of the PULP – First South Asia Edition
STEPS IN POST SPACE PREPARATION
PREFABRICATED POST WITH COMPOSITE CORE
CUSTOM MADE POST ( DIRECT TECHNIQUE)
CUSTOM MADE POST ( DIRECT TECHNIQUE)
CUSTOM MADE POST ( DIRECT TECHNIQUE)
CUSTOM MADE POST ( DIRECT TECHNIQUE)
INTERIM RESTORATION
CUSTOM MADE POST ( INDIRECT TECHNIQUE)
CUSTOM MADE POST ( INDIRECT TECHNIQUE)
CUSTOM MADE POST ( INDIRECT TECHNIQUE)
CEMENTATION OF THE CAST POST
CEMENTATION OF THE CAST POST
 RETRIEVABILITY

 Vibrating the post first with an ultrasonic scaler weakens

brittle cement and facilitates removal.

 A thin scaler tip or special post removal tip is recommended.

 If sufficient length of post is exposed coronally, the post can

be retrieved with thin-beaked forceps.
 REFERENCES
 Contemporary Fixed Prosthodontics – Rosenstiel 4rd edition

 Fundamentals of Fixed Prosthodontics - Shillingburg 3rd edition

 Grossman’s Endodontic Practice 13th edition

 Cohen’s pathways of the pulp – first south asia edition

 Ingle’s Endodontics: 7th edition

 Summitt’s fundamentals of Operative Dentistry – 4th Edition

 Nandini VV, Venkatesh V. Current concepts in the restoration of

endodontically treated teeth. J Indian Prosthodont Soc 2006;6:63-7