Restoration / dental crown & bridge courses

INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

CONTENTS
• INTRODUCTION
• HISTORY
• CHANGES IN ENDODONTICALLY TREATED TEETH
• PRE-TREATMENT EVALUATION
• TREATMENT GOALS
• POSTS/DOWEL AND ITS CLASSIFICATION
• CORE

• FABRICATION OF POST
• PROVISIONAL RESTORATION
• INVESTING AND CASTING
• POST REMOVAL SYSTEM
• CONCLUSION
• BIBLIOGRAPHY

INTRODUCTION
• Initially only extraction
• From past 20 – 30 years, increased interest in restoring.
• It is well known that with proper endodontic treatment and
adequate restoration, pulpless teeth can serve indefinitely as
an integral part of the dental apparatus, provided the
supporting structures are not compromised.

• From the time of Pierre Fauchard till date a wide range of
materials, techniques and designs have been described to
restore endodontically treated teeth.
• However, there is no clear consensus regarding an ideal
system, this is because each tooth presents with a unique
requirement.
• A thorough understanding of the proper use of posts and cores
will enable clinicians of today to provide an optimum
restoration that uniquely balances between maximizing
retention of the tooth while minimizing the risk of failure.

HISTORY AND EVOLUTION
• Restoration of endodontically treated tooth by a post to retain a
crown dates back more than 250 years.
• In 1747, Pierre Fauchard a French dentist used “Tenons”
which were metal posts (Gold or silver) into the roots of teeth to
retain bridges. He used heat softened adhesive called MASTIC.

• Later wood replaced metal as the post material, and the “Pivot
Crown”, a wooden post fitted to an artificial crown and to the
root canal became popular. But they led to repeated episodes of
swelling and pain.
• In mid 1800 –Dr.F.H.Clark – developed a “spring loaded
dowel” a retentive device consisting of a metal tube in the
canal and a split metal dowel which was inserted into it. They
also had channels for continuous suppuration from the
underlying tissues.

• G.V. Black developed porcelain fused to metal crown held in by
a screw inserted into a canal filled with gold foil.
• In 1878 , the “Richmond Crown”, a single piece post-retained
crown with a porcelain facing was engineered to function as a
bridge retainer.

• During the 1930s, the custom cast post and core was developed
to replace the one piece post crowns, because of their drawback
of using in diverging roots and difficulty in removal and
replacement of FPD crowns.
• In 1960s prefabricated posts were introduced.
• 1990 Duret et al described a non metallic material for the
fabrication of posts based on carbon fibres reinforcement
principle.

Are endodontically
treated teeth different

• Moisture loss
• Architectural changes
• Dentinal toughness
• Collagen alteration
• Altered esthetic characteristics
• Loss of Neuro-sensory feedback

EVALUATION OF ENDODONTICALLY TREATED
TEETH
• ENDODONTIC EVALUATION
• PERIODONTAL EVALUATION
• RESTORATIVE EVALUATION
• ESTHETIC EVALUATION

ENDODONTIC EVALUATION
• Good apical seal as revealed by radiographs.
• No tenderness on percussion
• No apical sensitivity
• No exudate
• No fistula
• No active inflammation.

• Periodontal health is critical to the long term success of teeth that
have been endodontically treated and restored.
• Periodontal condition must be assessed before endodontic
treatment, and the effect of planned restoration on the attachment
apparatus must be considered.
• Any structural defects of teeth should be considered that jeopardize
coronal restoration.
• Extensive caries, tooth fracture, previous restoration, perforation
and external resorption can destroy tooth structure at the level of
the periodontal attachment.
PERIODONTAL EVALUATION

RESTORATIVE EVALUATION
Depends on,
• Amount of remaining tooth structure
• Tooth type
• Morphology
• Occlusal and prosthetic forces
• Periodontal support

ESTHETIC EVALUATION
• Potential esthetic complication should be investigated before
initiation of endodontic therapy.
• Thin gingiva may transmit a shadow of dark root through the
tissue.
• Metal or dark carbon fiber post and amalgam placed in the canal
can result in unacceptable gingival discoloration from the
underlying root.

• The translucency of All-ceramic crowns must be considered in
the selection of dowel and build-up materials.
• Tooth colored carbon fiber glass-reinforced composite resin, or
zirconia posts can be used in esthetic areas. Similarly, tooth
colored, rather than opaque, composite core material should be
selected for esthetics.
• An intact endodontically treated tooth requires critical control of
endodontic materials in the coronal third of the canal and pulp
chamber in order to maintain its color and translucency.

• Gutta percha discoloration can be visible in the coronal aspect
of an endodontically treated tooth and should be limited to an
apical level in the root.
• Endodontic and restorative materials in these esthetically
critical cases must be selected to provide the best health service
with the minimum of esthetic compromise.

TREATMENT GOALS
• to maintain the coronal and apical seal of the root canal
filling material
• to protect and preserve remaining tooth structure
• to provide a supportive and retentive foundation for the
placement of a definite restoration
• To restore function and esthetics.

Post
The post is defined as a relatively rigid, metallic or non metallic restorative material
inserted into the root canal of a nonvital tooth to aid in retention of a core
component and to transmit the forces .

INDICATIONS FOR POST
• To retain the restoration
• To protect remaining tooth structure
• Marginal integrity
• To stabilize radicular fractures

CONTRAINDICATIONS FOR POST
• Abnormal root anatomy.
• Extensive caries including root caries.
• Perforations.
• External resorption.
• Short roots.
• Dilacerated roots.
• Blunderbuss canal.
• Young patients with coronal fracture, with incomplete root
formation.
• Patients with poor oral hygiene.

Ideal requirements of post
• Simple and safe.
• Biocompatible.
• Should support the core and crown.
• Should provide resistance for stresses.
• Maximum protection of root.
• Adequate retention within the root.
• Pleasing esthetics, when indicated.
• High radiographic visibility.
• Easily removable.
• Less expensive.

Classification
Various classifications given by,
- Ingle and Bakland
- Shillinburg and Kessler
- Robbins

depending upon the preparation
– custom made posts
– pre-fabricated posts
.

depending upon the flexibility
– stiff
– flexible – flexi post
depending upon the esthetics
• esthetic
• non-esthetic
depending upon the retention
 Active –eg; flexi-post, Kurer anchor
• passive – cast post, smooth tapered post, parapost

depending upon the design
a. tapered
- Smooth sided posts
- Serrated posts
- threaded posts
b. parallel
- Smooth sided
- Serrated posts
- threaded post

• Shillinburg and Kessler
• I. Custom-cast Posts
• II. Prefabricated posts
• a) Tapered, smooth-sided posts
• b) Tapered, serrated posts
• c) Tapered, threaded posts
• d) Parallel, smooth-sided posts
• e) Parallel, serrated posts
• f) Parallel, threaded posts

CLINICAL PROTOCOL FOR RESTORING
ENDODONTICALLY TREATED TEETH
• Anterior teeth
• Pulp less anterior teeth can also be conservatively
restored with a bonded composite resin restoration rather
than artificial crown.
• A laminate veneer offers a conservative alternative if the
facial surface is intact with moderate discolouration. .

• Anterior teeth that exhibit mesial and distal restoration should
be restored with a post and core prior to the placement of a
crown.
• Mandibular incisors and maxillary lateral incisors would
always require a post and core before placing an artificial
crown.

Posterior teeth
• The need for a core or a post
and core is determined on
the basis of remaining tooth
structures as well as
expected occlusal and
prosthetic forces that will be
applied

• Clinical consideration
• The apical seal, alveolar bone support, and root
morphology are all important considerations when determining
post size and depth. Anatomy and morphology of teeth also
should be considered when planning for a post
• When posts are to be used in maxillary molars, the palatal
canal should be used because of its relatively large and straight
configuration

• . In mandibular molars, the distal canal should be used
because of the root morphology and size of the canal.
• The buccal roots in maxillary molars and the mesial root of
mandibular molars are not good candidates to receive a post
because of their size, morphology and curvature

• When feasible, post placement should be carried out under the
aseptic conditions provided by rubber dam isolating the post
and prevents bacterial contamination of the radicular space by
salivary leakage.

• Post length
• The length of apical seal remaining after post preparation
and the degree to which it was disturbed during post hole
preparation can influence the long term success of the
restoration. When ever mechanical preparation of the post hole
is required, 4-5 mm of undisturbed apical gutta percha should
remain after post preparation

• Traditional view of post length have advocated that the post be
 Equal to the height of the clinical crown.
 One and one half times the length of the clinical crown and
 Two third the length of the remaining root

• Post Width
• The size of a post is dependent on the root width and
canal morphology. In general, the width of a post should not
be larger than one third of the root width at its narrowest
dimension. In addition, the post should be surrounded by at
least 1 mm of sound dentin

• This point is especially critical in the apical area where the
root narrows and stresses are concentrated. Small diameter
posts provide greater resistance to fracture as compared with
larger diameter posts, and evidence exists indicating that the
post diameter has no significance effect on retention.

FACTORS AFFECTING RETENTION OF POST SYSTEMS
• Variables reported to affect retention include length, diameter
and design of the post, canal shape and preparation, luting
medium, method of cementation, and location in the dental
arch.

. Post Length
• The post should equal the inciso-cervical or occluso-cervical
dimension of the crown.
• The post should be larger than the crown.
• The post should be 1/3rd the length of the crown.
• The post should be a certain fraction of the length of the root
such as one half, two thirds, or four fifths.
• The post should end halfway between the crestal bone and the
root apex.
• The post should be as long as possible without disturbing the
apical seal.

• The length of the post has a significant effect on its retention
and in most instances, the more deeply the post is placed, the
more retentive it becomes

• posts with a length of at least 3- quarters of the length of the
root offered the greatest rigidity and least root deflection
(bending) when compared with posts that were a half or a
quarter the root length.
• Short posts are especially dangerous and have a much higher
failure rate.

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.

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

• . Post Design
• 6 basic commercial systems available as follows:
1. Tapered, smooth-sided posts.
2. Parallel-sided, serrated, and vented posts.
3. Tapered, self-threaded posts.
4. Parallel-sided, threaded, split-shank posts.
5. Parallel-sided, threaded posts.
6. Carbon-fiber posts

Posts systems
• Tapered post, Non threaded
• A tapered post is less retentive than a parallel post.
Tapered posts generally will have a wedging action on the root
and have a relatively low retention rate.
• These posts also have been shown to be less successful than
placement of no post at all

• . For these reasons, this type of post is only recommended for
very tapered canals in which parallel sided posts would require
excessive tooth preparation.
•

Parallel sided posts, Threaded or Non threaded and inactive
 Parallel sided post design
offer increased retention
over tapered design.
 These have excellent
clinical retention and
failures are caused most
often by dislodgement.

advantages
 ease of placement,
 minimal stress production within the root,
 and good retention,
 as well as offering the added advantage of allowing final tooth
preparation during the same appointment.

• . Parallel sided posts, Threaded, Active.
• They rely on some form of mechanical engagement of
cutting flute into dentin to gain increased retention.
• These are the most controversial type of post category.
• Posts in this group have been shown to induce increased
stresses with in the root, which may later lead to root fracture.

• If a threaded post is selected for use, there must be an attempt
to minimize internal stresses from thread placement
• This category of posts is indicated only for very short root in
which use of a nonthreaded post would result in failure due to
lack of length for retention.

Amalgam Coronal – Radicular Dowel Core
• It is not an absolute requirements that an endodontically
treated tooth should have a dowel placed in the root. As
already pointed out, this decision should be made after careful
evaluation of the previously described criteria of remaining
tooth structure, tooth type and morphlogy arch position,
occlusal forces, and periodontal status

• Auxillary pins should be employed with this technique only if
additional retention is deemed absolutely necessary

• Luting Agents
• Luting agents, including zinc phosphate, polycarboxylate,
glass ionomer, and filled and unfilled resin cements
• The choice of dental cement for post cementation is essentially
one of operator preference

• Glass ionomer, resin, and zinc phosphate cements all have
been shown to the acceptable for post placement.
• The cementation of custom cast or prefabricated dowel and
core foundations must be carried out in an isolated
environment to minimize entry of bacteria into the prepared
canal and aid to moisture control.

• . Any moisture remaining in the prepared canal will
significantly diminish retention of the post.

• Canal Shape
• Because the predominant canal shape is ovoid and the
walls of prefabricated posts are commonly parallel, the
majority of luted prefabricated posts are unlikely to adapt well
along their entire interface with the canal walls.
• As a result, the post may not fit the preparation closely, and the
luting agent may not totally fill the interface.

Preparation Of The Canal Space And Tooth
• When necessary, gutta percha should be 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.

• twist drills should not be used to remove filling materials.
Twist drills also should not be forced but should passively
follow the course of the previously established canal. Stops
should be placed on engine-mounted drills at the desired depth
as an added precaution.

Location in the dental arch

PREFABRICATED POSTS

.
Carbon fiber reinforced epoxy resin posts
• Most prefabricated posts are metallic, but there are several
newer nonmetallic system available.
• A post fabricated from a carbon fiber reinforced epoxy resin
was developed in France by Duret and Renaud, and became
commercially available in Sweden in 1992

• Carbon fiber reinforced epoxy resin is a recently introduced
dental restorative material composed of unidirectional carbon
fibers that are 8 μm in diameter embedded in a resin matrix.
The material is radiolucent and appears to be biocompatible

• In vitro studies have indicated that these carbon fiber posts
possessed inferior strength compared to metal posts
• their ability to bond to adhesive dental resins appears
unremarkable, and their bond can be improved with
mechanical retention such as serrations.

Zirconia posts.
• With recent advances in ceramic technology, the all ceramic
crown has become more popular
• The response to the need for a post that possesses optical
properties compatible with an all ceramic crown, an all
ceramic post has been developed.
• This post is composed of zirconium oxide

• The post is made from fine grain, dense tetragonal zirconium
poly-crystals (TZP), and the zirconia post has been reported to
possess high flexural strength and fracture toughness
• zirconia post was designed for use with an adhesive resin
cement.
• Ceramics are tough materials with high compressive strengths,
but are brittle when subjected to shearing forces

Woven fiber composite materials
• The manufacturer of a cold glass plasma treated polyethylene
woven fiber has suggested this material in a resin composite to
provide corono-radicular stabilization for pulp less teeth.

• These prefabricated posts
embedded in the woven
fiber composite were not as
strong as cast posts and
cores, but were less likely to
cause fracture of the roots
when subjected to failure
loads

CORE MATERIALS
• When prefabricated posts are used, the core build up should be
either in amalgam, glass ionomer, or composite resin

• Ideal properties of the core material
• High compressive and tensile strength.
• High modulus of elasticity (rigidity).
• High fracture toughness.
• Dimensional stability.
• Ease of manipulation.
• Short setting time.
• The ability to bond to both tooth and post.
• Biocompatibility.
• Inert (no corrosion).
• Natural tooth color, when indicated.
• Low plastic deformation.
• Low cost.

Composite resin
• Composite resin cores are commonly used in the anterior
region. The final strength of these cores ranges from good to
excellent and they offer the option of preparation immediately
after placement
• They also lead to water sorption. Which results in core
breakdown. This expansion of composites due to water is a
potential concern due to generation of internal stresses.

• . It is further seen that mechanical properties of composite
degrade with thermocycling and exposure of water.

Amalgam
• The most commonly used core material with prefabricated
posts is amalgam. Amalgam is relatively easy to use, provides
a corrosion interface with the tooth, and has an excellent final
strength. Its coefficient of thermal expansion is almost double
of that of dentin and it is relatively stable in the presence of
water.

• Amalgam is classified as to the shape of its particles.
• Spherical
• Spheroidal, or
• A blending of the two types known as an admix

• . Fast setting amalgam is necessary if the practitioner wants to
prepare for the final restoration at the same appointment, and
the spherical alloys best meet this requirement.
• This type of amalgam gains strength rapidly and will allow
careful preparation after 15 to 20 minutes

Glass Ionomer
• Increased use of glass ionomer has been reported recently to
restore the endodontically treated teeth
• The major drawback to their use is the question of adequate
strength to support the final restoration.
• They also require good isolation for placement. Which may
present a clinical challenge.

• Their use is indicated primarily for blocking out small
undercut areas for crown preparation

Cast Post and Core
• Cast post and core can be fabricated by direct and indirect
methods.
• Customs post and core patterns should be casted in Type III
and Type IV gold alloys or high noble alloys.
• They possess adequate strength and minimize corrosion.
• If a patient is not allergic to nickel, then nickel chromium
alloys should be used

• nickel chromium alloys offer an acceptable strength
component, they also exhibit low resilience to loading and
may undergo corrosive change, making them less desirable as
gold substitutes.
• . It does not absorb water and has a coefficient of thermal
expansion very close to that of dentin

• Advantages of the cast post and core include
• Preservation of the maximum tooth structure as the post is
fabricated to fit the radicular space.
• Provision of anti-rotational properties and
• Core retention, because the core is an inherent part of post and
does not need to be retained by the post.

• Disadvantages include
• The appointments necessary to fabricate a pattern and then seat
the post.
• The decreased retention of the tapering design, and
• The wedging effect exerted on the root.

ROLE OF THE FERRULE EFFECT
• The ferrule has been defined as a circumferential band to cast
metal at the margin of a crown which is placed on solid tooth
structure.
• A post and core in a pulpless tooth can transfer occlusal forces
intraradicularly with resultant predisposition to vertical
fracture of the root.
• “hugging action” of a subgingival collar of cast metal provided
extracoronal bracing that could prevent fracture of tooth
structure.

• describe this 360-degree ring of cast restoration at least 2mm
apical to junction of the core and remaining tooth structure.

CORROSION
• Recommendation have been made that the post and core, and
possibly the crown, be fabricated of the same metal as the
prolonged electrolytic reaction between dissimilar post and
core metals (stainless steel, silver, or brass posts reacting with
the tin in the amalgam core) may result in longitudinal and
oblique root fractures.
• The products of this reaction, deposit in the root canal, induce
volumetric changes and cause root fracture.

CRITERIA FOR CAST POST AND CORE DESIGN
• maxillary incisors, requires locking notches or keyways
incorporated into the canal to resist rotational movements.
• The post should closely approximate the walls of the canals
without a wedging effect
• If the fit is too tight the forces of cementation may be
sufficient to fracture the root.

• The cast post is roughened prior to cementation with a
sandpaper disk to remove the oxide layer of the casting and
increase the retention.
• The post is vented by flattening a small portion of the buccal
or lingual post along the length allow cement to escape
•

PROCEDURES
• three stage operation.
1. removal of the root canal filing material to the appropriate
depth.
2. enlargement of the canal and
3. Preparation of the coronal tooth structure.

Removal of the endodontic filling material
• It is recommended that the root canal system first be
completely obturated and then space made for a post.
• This will ensure that lateral canals are sealed.

• There are two commonly used methods for removing gutta
percha –
1. with a warmed endodontic plugger
2. and with a rotary instrument
. Of these techniques, the warmed condenser is preferred because
it eliminates the possibility of the rotary instrument’s
inadvertently damaging the dentin.

• calculate the appropriate length of the post.
• Select and endodontic condenser large enough to hold heat
• Mark it at the appropriate length heat it, and place it in the
canal to soften the gutta percha.
• If the gutta percha is old and has lost its thermoplasticity, use a
rotary instrument,
• . Gates glidden drill. Para Post drill.

• shape the canal as needed
• This is accomplished with endodontic hand instruments or a
low speed drill.

Enlargement of the canal
• Prior to enlargement of the canal, a decision must be made
regarding the type of post system that will be used for
fabrication of the post and core
• Parallel sided prefabricated posts are recommended for
conservatively prepared root canals in teeth with roots of
circular cross section
• Excessively flared canals we use custom made posts

For prefabricated posts
• Enlarge the canal one or two sizes with a drill, endodontic file,
or reamer that matches the configuration of the post.
• In the case of a threaded post, the appropriate drill is followed
by a tap.
• Use a prefabricated post that matches standard endodontic
instruments.

For custom made posts
Use custom made posts in canals that have a non-circular
cross section or extreme taper.
 Enlarging canals to conform to a preformed post may lead
to perforation.
 Often very little preparation will be needed for a custom
made post.
 However, undercuts within the canal should be removed
and some additional shaping usually is necessary.
• Be most careful on molars to avoid root perforation

Procedures for custom made posts
I. 1- by direct method:
I. by self-cure resin
II. By thermo plastic material
• 2- by in-direct method: laboratory method

By thermo plastic material

laboratory method

For multi rooted tooth

Preparation of the coronal tooth structure
• Ignore any missing tooth structure
• Remove all under cuts that would prevent withdrawal of the
pattern.
• Remove any unsupported tooth structure, but be careful to
preserve as much of the crown as possible.
• Be sure also that part of the crown is prepared perpendicular to
the post.

• This will create a positive stop to prevent overseating and
possible splitting of the tooth. Similarly rotation of the post
must be prevented by preparing a flat surface parallel to the
post
• Complete the preparation by eliminating sharp angles and
establishing a smooth finish line.

Custom made posts
• A custom made post can be cast from a
• direct pattern or –with auto polymerising resin resin for single
root canals
• an indirect one. –for multi rooted tooth

• Direct procedure
• Indirect procedure

Core fabrication
• The core of a post-and –core restoration replaces missing
coronal tooth structure, and thereby forms the shape of the
tooth preparation
• . It can be shaped in resin or wax and added to the post pattern
before the assembly is cast in metal.

Plastic filling materials
• The advantages of amalgam, glass ionomer or resins are that
• (1) maximum tooth structure can be conserved because
undercuts do not need to be removed, (2) treatment requires
one less patient visit,
• (3) there are fewer laboratory procedures, and
• (4) testing generally shows good strength characteristics,
possibly because of the good adaptation to tooth structure.

Step-by-step procedure for amalgam
• Apply the rubber dam and remove gutta-percha-2to4mm
• Remove any existing restoration, undermined enamel, or
carious or weakened dentin
• if cusps are missing-adequate retention can be gained by
extending the amalgam into the root canals
• floor of the pulp chamber is thin-protect it from condensing
pressures with a cement base.

• Condense the first increments of amalgam into the root canals
with an endodontic plugger
• Carve the alloy to shape. The impression can be made
immediately.

Direct pattern for multirooted teeth
• A direct pattern can be used for multirooted posterior teeth,
although limited access may make the indirect approach easier
• . A single-piece core with auxiliary posts is used as opposed to
the multisection core recommended for indirect posterior cast
post-and cores

• The core is cast directly onto the post of one canal.
• The procedure is simple, as long as smooth parallel sided or
tapered posts are used
1. Fit prefabricated posts into the prepared canals. One post is
roughened; the others are left smooth and lubricated.
2. Build up the core with auto polymerizing resin by the bead
technique.
3. Shape the core to final form with carbide finishing burs.
4. Grip the smooth lubricated posts with forceps and remove
them.

6. Remove, invest, and cast the core with the roughened single
post.
7. When this has been done, the holes for the auxiliary posts can
be refined with the appropriate twist drill.
8. After verifying the fit at try –in, cement the core and auxiliary
posts to place.

Indirect pattern for posterior teeth
• Wax the custom-made posts as described previously.
• Build part of the core around the first post.
• Remove any undercuts.
• Wax additional sections and cast them.
• The use of dovetails to interlock the sections

INVESTING AND CASTING
• A cast post-and –core should fit somewhat loosely in the
canal. A tight fit may cause root fracture. The casting should
be slightly undersized, which can be accomplished by
restricting expansion of the investment (e.g., by omitting the
usual ring liner or casting.

Review of litrature
• RETENSION STRENGTH OF 5 LUTING CEMENTS
ON PRE FABRICATED DOWELS AFTER ROOT
CANAL OBTURATION WITH ZOE SEALER
• Para posts cemented with panavia 21 and 4
different cements into dowel spaces prepared
one week after obturation with guttaparcha/
or zoe sealer

• IN VITRO EVALUATION OF RETENTION OF
COMPOSITE FIBER AND STAINLESS STEEL
POSTS
• The stainless steel posts luted with zinc
posphate cement provided significantly
greater tensile resistance than all composits
fiber dowel group

• RETENTION OF CUSTOM CAST AND PARALLEL
SIDED SERRATED POSTS AS INFLUENCED BY
CEMENTING MEDIA
• When the mean retentive values were compared
between custom cast posts and parallel sided
serrated posts the diff was stastically significant
• The parallel sided serrated posts recorded
significantly higher retentive values than custom
cast posts

SUMMARY AND CONCLUSION
• Although restoration of endodontically treated teeth has been
rationalized, information from controlled long term clinical
trials is still needed.
• As much tooth structure must be preserved as possible and
post and core is basically used to provide retention and support
for a cast restoration.
• There is not one post , core or final restoration that can be
used in all – clinical situations. So we have to learn with these
variables and understand the basic concepts of how to use
them to maximum advantage

References:
• Rosenstiel SF, Land MF,Fugimoto:Contemporary fixed
Prosthodontics,3rd edition,St louis ,2001 Mosby.
• Shillinburg HT, Hobo S, WhitSett LD, Jacobi R, Brackett SE:
Fundamentals of fixed Prosthodontics, 3rd edition, Illinios
Quintessence.
• WFP Malone, DL Koth, E Cavazos Jr, Da Kaiser, SM
Morgano: Tylman’s Thoery and practice of fixed
Prosthodontics, 8th edition. Ishiyaku EuroAmerica, inc.
publishers. Tokyo. St Louis.

• RETENSION STRENGTH OF 5 LUTING CEMENTS
ON PRE FABRICATED DOWELS AFTER ROOT
CANAL OBTURATION WITH ZOE SEALER mark
s. Hagger etal jpd vol 11 no 3 2003 168-175
• IN VITRO EVALUATION OF RETENTION OF
COMPOSITE FIBER AND STAINLESS STEEL
POSTS john r.gallo atal jpd vol 1,1 no 1, 2002,
25-29

Restoration / dental crown & bridge courses

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