Post and core
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Post and core
some studies have indicatedthat minimally damaged endodontically treated teeth
without posts are more resistant to fracture than teethrestored with posts and cores
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DefinitionDowel
•a post, usually made of metal that is fitted
•into a prepared root canal of a tooth that has
•had endodontic therapy
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Core
the coronal aspect of the post foundation
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Choice of Restorative Technique for the Endodontically Treated tooth
•1-Type of Tooth ( Anterior V.S. Posterior 2-amount of remaining coronal tooth structure
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Case evaluation
•Endodontic Considerations
•Periodontal Considerations
•Prosthetic Considerations
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Endodontic Considerations
•1 .Good apical seal•2 .No sensitivity to pressure
•3 .No exudate•4 .No fistula
•5 .No apical sensitivity•6 .No active inflammation
•7 .Retreatment should occur if there are signs•or symptoms indicating failure
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Periodontal Considerations
•1 .Extensive coronal destruction may require Crown Lengthening:
•a.to Re-establish biologic width
•b .to Provide coronal tooth structure to
•incorporate ferrule into cast restoration
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Ferrule effect 1.5-2mm of coronal tooth structure to achieve
resistance form
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Prosthetic Considerations
•1 .Extent of coronal destruction
2 .Other factors to evaluatea. Tooth type (anterior vs. posterior)b. Position in archd. Occlusal and prosthetic forces applied toTooth
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Factors affecting the retentionof prefabricated post restorations .
•POST LENGTH
•POST DIAMETER
•POST DESIGN
•LUTING AGENTS
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POST LENGTH
•1 .The post should be longer than the crown.
•2 .The post should end halfway between the crestal
•bone and the root apex.
•3 .The post should be as long as possible without
•disturbing the apical seal
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Optimal conservative postplacement, with appropriate
length, width and fit, for amaxillary canine that
required a crown due to theamount of lost tooth
structure
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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.
;
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Therefore post diameter must be controlled to preserveradicular dentin, reduce the potential for perforations,
and permit the tooth to resist fracture
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.
Overly wide post and resultant root fracture.
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POST DESIGN
•smooth
•Serrated
•threaded
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POST DESIGN
•Prefabricated•Custom made
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POST DESIGN
•Tapered
• .Parallel-sided
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LUTING AGENTS
•Luting agents, including zinc phosphate, polycarboxylate,
•glass ionomer
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PREPARATION OF THE CANAL SPACE
AND TOOTH
•1 -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
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2-root canal reamers can beused to widen the canal space by a reaming action to
ensure a relatively round preparation
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3-twist drills arethen used to shape the canal
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Methods of placement of custom made posts
•Direct method
•Indirect method
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Custom Made Post: Direct Technique
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Custom Made Posts: Indirect
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Core material
•Amalgam
•Composite
•Glass ionomer
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