Post and core

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  • 1. Post and core some studies have indicated that minimally damaged endodontically treated teeth without posts are more resistant to fracture than teeth restored with posts and cores
  • 2. Definition Dowel a post, usually made of metal that is fitted • into a prepared root canal of a tooth that • has had endodontic therapy •
  • 3. Core the coronal aspect of the post foundation
  • 4. Choice of Restorative Technique for the Endodontically Treated tooth Type of Tooth ( Anterior V.S. Posterior -1 • 2-amount of remaining coronal tooth structure
  • 5. Case evaluation Endodontic Considerations • Periodontal Considerations • Prosthetic Considerations •
  • 6. Endodontic Considerations Good apical seal. 1 • No sensitivity to pressure. 2 • No exudate. 3 • No fistula. 4 • No apical sensitivity. 5 • No active inflammation. 6 • Retreatment should occur if there are signs . 7 • or symptoms indicating failure •
  • 7. Periodontal Considerations Extensive coronal destruction may. 1 • :require Crown Lengthening a.to Re-establish biologic width • b .to Provide coronal tooth structure to • incorporate ferrule into cast restoration •
  • 8. Ferrule effect 1.5-2mm of coronal tooth structure to achieve resistance form
  • 9. Prosthetic Considerations Extent of coronal destruction. 1 • Other factors to evaluate. 2 (a. Tooth type (anterior vs. posterior b. Position in arch d. Occlusal and prosthetic forces applied to Tooth
  • 10. Factors affecting the retention . of prefabricated post restorations POST LENGTH • POST DIAMETER • POST DESIGN • LUTING AGENTS •
  • 11. POST LENGTH The post should be longer than the. 1 • .crown The post should end halfway. 2 • between the crestal .bone and the root apex • The post should be as long as. 3 • possible without disturbing the apical seal •
  • 12. Optimal conservative post placement, with appropriate length, width and fit, for a maxillary canine that required a crown due to the amount of lost tooth structure
  • 13. POST DIAMETER Increasing the diameter of the post does • not provide a significant increase in the • retention of the post ; however, it can ; increase the stiffness of the post at the expense of the remaining • dentin and the .fracture resistance of the root •
  • 14. Therefore post diameter must be controlled to preserve ,radicular dentin, reduce the potential for perforations and permit the tooth to resist fracture
  • 15. . .Overly wide post and resultant root fracture
  • 16. POST DESIGN smooth • Serrated • threaded •
  • 17. POST DESIGN Prefabricated • Custom made •
  • 18. POST DESIGN Tapered • Parallel-sided. •
  • 19. LUTING AGENTS Luting agents, including zinc phosphate, • ,polycarboxylate glass ionomer •
  • 20. PREPARATION OF THE CANAL SPACE AND TOOTH gutta percha should be- 1 • removed with an endodontic heat carrier • until the desired length is reached. A minimum of 4 • to 5 mm of gutta percha must remain to preserve the • apical seal
  • 21. root canal reamers can be-2 used to widen the canal space by a reaming action to ensure a relatively round preparation
  • 22. twist drills are-3 then used to shape the canal
  • 23. Methods of placement of custom made posts Direct method • Indirect method •
  • 24. Custom Made Post: Direct Technique
  • 25. Custom Made Posts: Indirect
  • 26. Core material Amalgam • Composite • Glass ionomer •