This document discusses factors to consider when restoring endodontically treated teeth, including whether to use posts and cores. It notes that some studies found teeth without posts were more resistant to fracture. It then defines dowels/posts and cores, and outlines considerations for the choice of restorative technique, including tooth type, remaining structure, and endodontic, periodontal and prosthetic factors. It discusses factors that affect retention of prefabricated post restorations like post length, diameter, design and luting agents.

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

10. 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

11. Factors affecting the retention
. of prefabricated post restorations
POST LENGTH •
POST DIAMETER •
POST DESIGN •
LUTING AGENTS •

12. 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 •

13. 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

14. 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 •

15. Therefore post diameter must be controlled to preserve
,radicular dentin, reduce the potential for perforations
and permit the tooth to resist fracture

16. .
.Overly wide post and resultant root fracture

17. POST DESIGN
smooth •
Serrated •
threaded •

18. POST DESIGN
Prefabricated •
Custom made •

19. POST DESIGN
Tapered •
Parallel-sided.
•

20. LUTING AGENTS
Luting agents, including zinc phosphate, •
,polycarboxylate
glass ionomer •

21. 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

22. root canal reamers can be-2
used to widen the canal space by a reaming action to
ensure a relatively round preparation

23. twist drills are-3
then used to shape the canal

24. Methods of placement of custom
made posts
Direct method •
Indirect method •

25. Custom Made Post: Direct Technique

26. Custom Made Posts: Indirect

27. Core material
Amalgam •
Composite •
Glass ionomer •