Professional Documents
Culture Documents
DIVYAM GIRDHAR
INTRODUCTION
Goals for restoration of endodontically treated teeth
Functions Of A Post-endodontic Restoration
Objectives Of Restoring Endodontically
Treated Teeth
Restorative treatment planning for endodontically
treated teeth
THE POST :-
indications classification
contraindications principles
Different types of post
Core materials
Impression of post and core
Final restoration
Conclusions
References
Restoration of endodontically treated teeth
replaces missing tooth structure, maintains
function and esthetics and protects against
fracture and infection.
Healthy tooth
Little or no tooth structure extending above the
gingival tissue
Post and core
Esthetic zone
Function:
The post has got 2 main functions:
Retention of core
Protection of the tooth by dissipation of forces along
its long axis to the surrounding periodontal tissues
and the alveolar bone.
Ideal properties:
Retentive to the tooth and the core
Strong and provide protection to the tooth
Radiopaque
Biocompatible
Inert
Economical
Esthetic wherever required
Extensive coronal tooth structure loss/ >50% loss of
tooth structure including important landmarks such
as marginal ridges, cingulum, reciprocating walls etc.
Retention is influenced by :-
1. Post’s Length,
2. Diameter And Taper,
3. The Luting Cement Used, And
4. Whether A Post Is Active Or Passive.
Resistance refers to the ability of the post and tooth
to withstand lateral and rotational forces.
Short post
Prognosis – unfavorable
Stress is generated over a smaller surface area, increasing
probability of radicular fracture
Too long post
Damage the seal of the root canal fill
Risk of root perforation if apical 3rd is curved or tapered
According to cohen 10th edition :-
Length of the post should be:-
Post width should not exceed 1/3rd of the root width at its
narrowest diameter .
The aim of this study is to measure
fracture resistance of extracted premolar teeth
restored with 2 different diameter posts.
Advantages Disadvantages
Zinc phosphate cement
Advantages Disadvantages
Resin cements & Resin modified glass
ionomer cement
Advantage:
Greater retention with dentin bonding agent.
Disadvantage –
Expansion ,cause undue pressure.
Technique sensitive ,
short working time
Polycarboxylate
1. Provides a weak chemical bond to dentin.
2. Undergoes plastic deformation after cyclic loading.
3. Less retentive in comparison to zinc phosphate;
(low compressive strength).
The objective of this study was to investigate the
tensile bond strength and failure mode of glass fiber
posts luted with different cements.
Disadvantage:
Lack of control over polymerization reaction.
Bonding agent
is applied
Cured &Post space filled
with resin composite
Luminex post inserted
through composite to cure it
Composite core
Quartz fiber post is build up
is cemented
Post removed,space
is modified
Glass fibers bundled in resin matrix.
Advantage:
White color blends with dentin.
Modulus of elasticity close with dentin
Method:
Fiberkor tried in post space
Canal prepared
Light cure
Core is built
2)Poor aesthetics
3)Two appointment
4)Corrosion .
1) Chemical removal
Oil of eucalyptus
Oil of turpentine
Chloroform
Disadvantages
Dimensional change in gutta percha
Difficult to control the depth of softening of the GP
Potential leakage of the solvents into the periradicular
tissues
2)Thermal removal
Lateral compactor
System B spreader
Placed for 2-3 sec
Takes 7-10sec to cool down
3) Mechanical removal
Gates-Glidden
Peeso reamer
Disadvantages
It can weaken the root
Damage the periodontium
Lead to root perforation
Before removing gutta percha ,Calculate the length of
the post.
Direct method
Acrylic Resin
Plastic dowels (prefabricated plastic patterns)
are used.
Available to carry acrylic resin or wax to form
pattern of the canal.
Final restoration
PRESENTED BY:-
DIVYAM GIRDHAR
Indications:
Disadvantages:
1)Less strength
2)Root is designed to accept post
3)Limited application when considerable tooth structure is
lost.
Carbon fiber –reinforced epoxy resin posts
One manufacturer
covered the CFP with a
white zirconium coating,
AesthetiPost (Bisco).
Nocci et al (1998) reported in a 3-year clinical study
comparing CFPs and custom cast post. Only one CFP
failed because of post dislodgment, whereas 10 of the
custom cast posts failed due to root fractures.
Composition
Glass fibre embedded in resin matrix
Composition :
Ultrahigh molecular weight polyethylene woven fiber
ribbon
coated with DBA & packed into the canal, where it is light
polymerized in position
Not required:
Enlarging the root canals
Removing the undercuts in the root canal
Advantage: flexibility
Zirconia posts
Composition :
Zirconium oxide
Fine grained tetragonal zirconium polycrystals (TZP)
Smooth surface
May have grooves , serrations to enhance mechanical
retention
May not bond well to composite resins
CORE
It consists of the restorative material placed in the
coronal area of the tooth that replaces carious,
fractured or otherwise missing tooth structure.
Properties
• High compressive strength
• Dimensional stability
• Ease of manipulation
• Short setting time
• An ability to bond to both tooth and post
• Low plastic deformation
• Bio compatibility
• Cariostatic and low cost
CAST CORE
One piece post and core
Advantages
Easy retrieval
Can be prepared on an angle with post.
Disadvantage
More number of appointments
Laboratory expenses and time
Technique sensitive in the laboratory phase
AMALGAM CORE
Disadvantage
Corrosion & discoloration of the gingiva.
COMPOSITE CORE
Disadvantages
Polymerization shrinkage & contraction- marginal
discrepancy & micro cracks
At least 2mm coronal tooth structure - for build up
Technique sensitivity
Glass ionomer core
For small build ups.
Adhesive failure
Disadvantage:
Moisture sensitivity
Limited for building up of small area
Low strength and fracture toughness
Resin modified glass ionomer core
Advantage
Improved properties than conventional GIC
Minimal micro leakage.
Disadvantage
Dimensional instability in the presence of moisture
Can fracture/ failure of the ceramic crowns
Impression for post & core
Two stage spaced – space is created for the wash. It is made by:
Removing away the putty and providing escape channels for the
wash.
Preparation of the coronal tooth structure
Guiding grooves:
Shoulder finishing
Finishing
End cutting bur & hand
instruments
Occlusal reduction:.
Round-end tapered diamond and 171L bur
Functional cusp bevel: Round_end tapered diamond
and no. 171Lbur
Functional cusp – 1.5 mm
Non functonal – 1.0 mm
Buccal and lingual axial reduction: Torpedo diamond
Proximal axial reduction: Short needle
diamonds.tapered diamond and torpendo
Chamfer and axial finishing: Torpedo bur
Metal ceramic
Planar occlusal reduction:
Round-end tapered diamond and no. 1 71 L
Functonal cusp bevel: Round end tapered diamond and no.
171 bur
2mm of functional cusp bevel.
Depth-orientation grooves: Flat-end tapered
diamond
Facial reduction, gingival half Flat end tapered
diamond
Facial reduction, gingival half: Flat-end tapered
diamond
Proximal axial reduction: Short needle diamond.
Lingual axial reduction and finishing: Torpedo
diamond and bur
Facial axial and radial shoulder finishing: Radial
fissure bur
Proper restoration of ET teeth begins with a good
understanding of their physical and biomechanical
properties, anatomy, and a sound knowledge of the
endodontic, periodontal, restorative and occlusal
principles.
PROSTHODONTIC MANAGEMENT OF
ENDODONTICALLY TREATED TEETH; Dr. Reem Al-
Dhalaan journal of prosthetic dentistry 2006.
Restoration of Endodontically Treated Teeth, joe
VOL. 30, NO. 5, MAY 2004.
Factors affecting retention of post systems: A
literature review, Lawrence W. Stockton THE
JOURNAL OF PROSTHETIC DENTISTRY. 81, 4