POST ENDO
RESTORATIONS
Dr S.Lata
6TH ONLINE THEORY CLASS
8th May 2020
INTRODUCTION
• A successful endodontic treatment has to be
complemented with an adequate postendodontic
restoration to make the pulpless tooth function
indefinitely as an integral part of the oral masticatory
apparatus.
• Endodontically treated teeth fail principally due to one
of the following two reasons:
1. Persistent intraradicular infection
2. Postendodontic restorative difficulties
Assessment of Restorability
Definitive ENDO treatment SHOULD NOT HAVE
1.Poor root canal filling
Active inflammation
Pressure sensitivity
Exudate
Fistula (or parulis)
Periodontal disease
Severe loss of sound tooth structure
The choices of treatment for POOR ENDO TREATMENT:
1. Retreatment
2. Periodontal retreatment (tooth will require
stabilization)
3. Monitoring (time to assess progressive healing)
4. Extraction (unrestorable)
•I
Anatomical,
Biological, and
Mechanical Considerations
IN ENDODONTICALLY TREATED
TOOTH
1. Moisture Loss
• Pulpless teeth may have increased brittleness from
moisture loss.
• It was thought that the dentin in endodontically
treated teeth was more brittle due to loss of
collagen crosslinking and loss of water.
• Dehydration of dentin and degradation of collagen
are no longer considered to be a cause for
endodontically treated teeth requiring specific
restorative procedures.
2.Architectural Changes
The decrease in the strength of endodontically
treated teeth due to altered coronal structure.
3.Biomechanical Behavior
• The biomechanical behavior of endodontically
treated teeth has been found to be functionally
different from that of vital teeth.
• Teeth have a proprioceptive feedback mechanism
that is lost when the pulp is removed.
• Loss contributes to the endodontically treated
teeth to be subjected to greater loads than normal
vital teeth and ultimately leading to failure.
4.Biological Width
ABSOLUTE MINIMUM OF 2.5MM FROM RESTORATIVE
MARGIN TO CRESTAL BONE
5.Protecting the Remaining Coronal
Tooth Tissue— BY Creating the Ferrule
A ferrule is defined as a band of
extracoronal material at the cervical
margin of a crown preparation that
encompassess the tooth and provides
resistance form to the tooth.
Core
• The core consists of restorative management of the
coronal portion of a tooth after the completion of
endodontic treatment.
• Replaces carious, fractured, or otherwise
missingcoronal structure and retains the final
crown.
The desirable physical The most commonly
characteristics of a core used core materials are
include the following:
High compressive Resin-based
strength composite
Dimensional stability Silver amalgam
Ease of manipulation Cast gold
Short setting time Glass ionomer
Ability to bond cement
Evaluation of Teeth -
Anteriors
Evaluation of Teeth -
Posteriors
Principles to be considered during treatment
planning for a post and core restoration are as
follows:
• Post length
• Tooth anatomy
• Post width
• Canal configuration and post adaptability
• Post design
• Luting cement
I. Post Length
II. Tooth Anatomy
IV. Canal Configuration and
Post Adaptability
• the post should closely fit or should conform to the
canal size. to increase in resistance form tooth and
retention of post
• Tapered canals use a custum made tapered post
that closely adapts to the canal wall OR OUTLiNE.
• Custom cast has a 90 % success in 5 years
V. Post Design
A. Based on shape
Parallel
Tapered
Parallel and tapered
B. Based on surface characteristics
Active
Passive
C. Based on fabrication methods
Custom-cast post and cores
Prefabricated post and cores
Metal post and core
Zirconia post and core
A. Based on Shape
1. Parallel
• Parallel-sided serrated and vented posts
• Parallel-sided threaded posts
• Parallel-sided threaded split shank posts
2. Tapered
• Tapered smooth-sided posts
• Tapered self-threading posts
3. Parallel and tapered combination
glass fibre post
Glass fiber posts are
esthetic and clinically
popular and can be made
of:
• Electrical glass (E-glass)
• High-strength glass (S-
glass)
• Quartz fiber (this is pure
silica in a crystallized
form and provides better
esthetics)
Glass fiber posts are popular for the following reasons:
• Post, core, and cement are resin based and
constitute a homogenous ensemble
• More homogenous stress distribution than other
metallic post systems
• Better biomechanical performance with greater
fracture loads
• Mode of failure is favorable allowing repair and
restoration
• Excellent esthetics when compared to other post
systems
• Good adhesion to the cementing medium
VI. Luting Cement
• Resin luting cement
• Glass ionomer cement (Type I)
• Resin-modified glass ionomer cement
• Zinc phosphate cement
The current trend is to employ resin luting cement.
• Advantages of resin luting agents are as
follows:
• Increased retention
• Strengthening of the root (short term atleast)
• Reduced leakage
• More resistant to cyclic loading
• Ability to bond with resin-based posts to form
one unit (monoblock)
Conclusion
• If these principles are followed, most post systems
will perform well.
• The clinician should be knowledgeable in selecting
the right type of post and core systems to meet the
biological, mechanical, and esthetic needs for each
individual tooth.
