Restoration of endodontically
treated tooth
• Amalgam, resin composite, and glass ionomer in
combination with a prefabricated post
• Amalgam had the lowest failure rate,
• Glass ionomer core buildup materials caused the
greatest number of failures
R. E. Kovarik, L. C. Breeding, and W. F. Caughman, “Fatigue life of three core materials under simulated chewing conditions,” The Journal of Prosthetic Dentistry, vol. 68, no. 4, pp. 584–590, 1992
• Some studies supported the use of amalgam
dowels in the root canals
Tamse compared 49 mesial roots extracted due
to vertical fractures with 52 mesial mandibular
roots without fractures,
• and found that 67.3% of the vertically fractured
roots had an amalgam dowel in the coronal part
(1-2mm) of the root.
• In another study, endodontically treated teeth
not crowned after obturation were lost 6
times more often than teeth crowned after
S. A. Aquilino and D. J. Caplan, “Relationship between crown placement and the survival of endodontically treated teeth,” The Journal of Prosthetic Dentistry, vol. 87, no.
3, pp. 256–263, 2002.
• A 10-year prospective clinical trial, showed
94% survival rate of metal post-and-cores with
a crown
G. Heydecke andM. C. Peters, “The restoration of endodontically treated, single-rooted teeth with cast or direct posts and cores: a systematic review,” The Journal of
Prosthetic Dentistry, vol. 87, no. 4, pp. 380–386, 2002.
• Another 17-year controlled prospective study
showed that the type of core restorations
under the crowns had no effect on the survival
rate of 307 endodontically treated teeth
W. A. Fokkinga, C. M. Kreulen, E. M. Bronkhorst, and N. H. J. Creugers, “Up to 17-year controlled clinical study on postand- cores and covering crowns,” Journal of
Dentistry, vol. 35, no. 10, pp. 778–786, 2007.
• The use of posts does not reinforce
endodontically treated teeth and some
reports even show that teeth which were
restored without a post and core are less
susceptible to fracture than teeth with post
and core
A. Smidt and E. Venezia, “Techniques for immediate core buildup of endodontically treated teeth,” Quintessence International, vol. 34, no. 4, pp. 258–268, 2003
• Its success relies on the success of the entire
system and vice versa.
• For anterior restorations, consider using a
ceramic or light-colored fiber post made of
quartz, silicone or glass fibers.
Post Shape
• Posts come in three basic shapes: parallel,
tapered, and parallel-tapered
• Parallel posts are more retentive than tapered
• They seem less likely to cause root fractures,
distributing stresses evenly along their length.
• However, parallel posts require removal of
more tooth structure than tapered ones and,
therefore, may not be suitable for roots with
thin walls.
• Tapered posts allow for minimal dentin removal
since most roots themselves are tapered.
• The stresses absorbed by these posts are
concentrated in the apex
• Creating a wedging effect and increasing the risk
of vertical root fracture.
• Because of this increased risk when tapered
posts fail, they are more likely to leave the tooth
• Advantages of both designs with few reported
• This post has a parallel shaft, tapering at the
apical end.
• This mix achieves retention associated with
parallel sides, while allowing tooth
preservation at the apex.
Length and Diameter
• Post retention improves with increases in post
length, rather than diameter.
• An increase in post length with a minimum
diameter preserves tooth structure and
reduces shear stresses and risk of fracture.
• Diameter is important for strength and
resistance to post fracture
• Sequential use of post twist drills, starting
with narrowest and working up to the desired
post diameter, can be useful in minimizing
tooth loss during post-space preparation.[
The groove is normally located where the root
is bulkiest, usually on its lingual aspect.
Rotational resistance in
an extensively damaged
tooth can be obtained
by preparing a small
groove in the root canal.
This must be in the path
of placement of the post
and core.
Influence of post and cores on light
transmission through all-ceramic
• Some ceramic systems are semi-translucent
(IPS Empress®, Ivoclar Vivadent)
• Others are semi-opaque (In-Ceram®, Vident,
Brea, CA).
• A traditional metal post (gold or titanium)
results in poor esthetics because of the lack of
light transmission.
• . Metallic posts also create a light blue/gray
appearance at the gingival margin, possibly as
a result of shadows.
Metal post
Corrosion reactions
Oral burning
Oral pain
Sensitization and other allergic reactions
Hayashi Y, Nakamura S. Clinical application of energy
dispersive x-ray microanalysis for nondestructively
confirming dental metal allergens. Oral Surg Oral Med
Oral Pathol 1994; 77: 623-626
FRC Postec shows reduced
Used in conjunction with
Variolink II provides
additional x-ray identification
FRC Postec can be removed
with a rotary instrument if
retreatment is required
Zirconia posts
Good chemical stability
Mechanical strength
High toughness
Color similar to that of natural teeth
Ahmad I. Yttrium–partially stabilized zirconium dioxide
posts: an approach to restoring coronally compromised
nonvital teeth. Int J Periodontics Restor Dent 1998; 18:
Zirconia posts
• Nearly impossible to remove
• Removal of zirconia post by ultrasonic causes
temperature rise of the post and on the root
Zirconia post
• Cormier et al: fracture strength of zirconia post varied according to
the different stages of tooth restoration.
• When the post alone was bonded into tooth, fracture strength was
101.5 N;
when the post was bonded into tooth with core buildup, fracture
strength was 179.7 N;
with post and core buildup as well as full veneer restoration,
fracture strength was 238.8 N
Cormier CJ, Burns DR, Moon P. In vitro comparison of the fracture resistance and failure mode of fiber, ceramic and conventional post systems at various stages of restoration. J Prosthodont 2001; 10: 26-36.
• The bond strengths of luting agents to
zirconia posts were measured without
bonding to any tooth structure, and it was
shown that a dual-cured resin cement,Panavia
(Kuraray, Osaka), produced better results than
other cement types
Sahmali S, Demirel F, Saygili G. Comparison of in vitro tensile bond strengths of luting cements to metallic and tooth-colored posts. Int J Periodontics Restor Dent 2004; 24: 256-263.
• The reviewed studies suggested that FRC and
zirconia posts might be the preferred clinical
choice for preventing coronal microleakage
Jung SH, Min KS, Chang HS, Park SD, Kwon SN, Bae JM. Microleakage and fracture patterns of teeth restored with different posts under dynamic loading. J Prosthet Dent 2007; 98: 270-276
Reid LC, Kazemi RB, Meiers JC. Effect of fatigue testing on core integrity and post microleakage of teeth restore with different post systems. J Endod 2003; 29: 125-131
Usumez A, Cobankara FK, Ozturk N, Eskitascioglu G, Belli S. Microleakage of endodontically treated teeth with different dowel systems. J Prosthet Dent 2004; 92: 163-169
• zirconia posts showed the highest
radiodensity level, followed by metallic posts,
carbon fiber posts, glass fiber posts, and
carbon fiber post covered with quartz fiber.
• In a study by Dietschi et al.
• It was reported that the carbon fiber post
presented the lowest marginal gap proportion
(7.11%) compared to other post types which
• presented higher degrees of marginal gap
• titanium post at 11%, zirconia post at 16.5%, and
• stainless steel post at 17.4%
Dietschi D, Ardu S, Rossier-Gerber A, Krejci I. Adaptation of adhesive post and cores to dentin after in vitro occlusal loading: evaluation of post material influence. J Adhes Dent 2006; 8: 409-419.
• A) a flame heated endo plugger,
• B) GatesGlidden drills
• C) GPX drills
sixty-six extracted maxillary central
Removed from CEJ
Six teeth were used as positive and negative
• other sixty teeth were divided into 3 groups, each
group containing 20 teeth
• apical dye leakage in each group was measured
by astereomicroscope
• Minimal mean dye leakage was related to the
hot plugger group
• Maximum mean leakage was observed in
Gates glidden drill group
• Kwan and Harrington (1981) and Madison and
Zakariasen (1984) found that post space
preparation with Gates Glidden drills
immediately after obturation actually
decreased the amount of apical leakage.
endo pluggers
don‘t cause canal shape alterations
Burn potential for the dentist, dental assistant
or the patient
• did not cause any permanent damage to the
• periodontium
Peeso reamers
• Very fast
• Creates parallel walls which provide optimal
retention form for the post
• possiblity of creating root perforation, canal
transportation, overenlargement of the canal
• Only in straight canals
• The gates glidden drills are more conservative
instruments compared with Peeso reamers
• match standardized endothontic file sizes # 25
• Slight frictional heat which softens the GP
before removal
• Fast and effective
• The bur does not engage the dentin so canal
shape remains unaltered and the frictional
heat generated is minimal

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