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RESTORATION OF ENDODONTICALLY TREATED

TEETH
CONTENTS:
INTRODUCTION
ORIGIN AND DEVELOPMENTS
TREATMENT PLANNING
BASIC COMPONENTS OF POST AND CORE
o POST
o CORE
CLINICAL TECHNIQUES
FAILURE AND REMOVALOF POSTS
INTRODUCTION:
Endodontic thera! ha" ro#ided denti"tr! $ith the a%i&it! to retain teeth that '("t
a )e$ decade" a*o $o(&d ha#e %een e+tracted $itho(t he"itation, -hen the endodontic
treat.ent ha" %een co.&eted/ ho$e#er/ 0(e"tion" ari"e a" ho$ to re"tore and rotect the
tooth "tr(ct(re that re.ain", Here i" $here the ro&e o) ot endodontic re"toration co.e"
into &a!, The o%'ecti#e o) o"t endodontic re"toration i" to re"tore the nor.a& tooth
"tr(ct(re/ )(nction and e"thetic"
ORIGIN AND DEVELOPMENTS;
The 0(e"tion" that ari"e d(rin* the re"toration o) a tooth are not ne$ one", The
re&ace.ent o) .i""in* tooth "tr(ct(re ha" %een racticed %! #ario(" c(&t(re" )or
tho("and" o) !ear", There are n(.ero(" re)erence" to the i.ortance o) hea&th! teeth in
the O&d Te"ta.ent/ .(ch o) $hich dea&" $ith the eriod antedatin* 1222 BC, No $onder
than that .an ha" .ade e#er! e))ort to re"tore &o"t tooth "tr(ct(re, Atte.t" to re"tore
(&&e"" teeth ("in* o"t" and cro$n" ha#e %een recorded )or .ore than 322 !ear",
18
th
19
th
cent!": P#$t$ %ec#&e '#'()!
1*+* 4 Pierre Fa(chard *a#e the )ir"t doc(.ented roced(re, He ("ed o"t" )a%ricated o)
*o&d or "i&#er tho"e $ere he&d in &ace $ith the heat5"o)tened adhe"i#e ca&&ed 6.a"tic
Wooden vs. metal posts: There $a" .(ch contro#er"! o#er the t!e o) o"t to %e ("ed,
-ooden o"t"/ .ade o) hic7or! or %o+ tree/ $ere o(&ar a" the! $ere "e&)5retenti#e
%eca("e the! "$e&&ed ( a)ter $ater a%"ortion, The! a&"o ca("ed &e"" $ear to the cana&,
On the other hand/ .eta& o"t" retained $ith cotton or "i&7 thread or $ith $ed*e" $ere
detri.enta& to the root, Their intracana& .o#e.ent" ca("ed a%ra"ion o) the cana& $a&&",
Ne#erthe&e""/ roonent" o) .eta& o"t" re)erred )ine *o&d or &atin(. that corroded &e""
than coer/ %ra"" or "i&#er,
Poor endodontic treatment Poor prognosis: Sad&!/ endodontic thera! %! the"e denta&
ioneer" e.%raced on&! .ini.a& e))ort" to c&ean/ "hae and o%t(rate the cana&", Fre0(ent
("e o) $ooden o"t" in e.t! cana&" &ead to reeated ei"ode" o) "$e&&in* and ain, A
*roo#e in the o"t" or root cana& ro#ided a ath$a! )or contin(a& "((ration )ro. the
eriradic(&ar ti""(e",
18,9 4 Chain Harri" in 8The Dental Art9 reorted 8pivoting9 or 8posting9 o) arti)icia&
cro$n" to nat(ra& root" a" the %e"t .ethod that can %e e.&o!ed )or in"ertin* arti)icia&
teeth and thi" %eca.e co..on ractice18*-$ 4
Richmond Crown :inte*rated do$e& cro$n; *i#en %! T,-, Rich.ond er"i"ted )or
n(.%er o) !ear", Thi" ori*ina&&! con"i"ted o) a threaded t(%e in the cana& that he&d the
"cre$ :do$e&; &aced thro(*h the orce&ain cro$n, Later/ $ith the ad#ent o) ce.ent"/ thi"
de"i*n $a" "i.&i)ied to e&i.inate the t(%e and .a7e the do$e&/ %! then (nthreaded/ and
inte*ra& art o) the )ina& *o&d5orce&ain re"toration,
Logan Crown $a" a #ariation o) the Rich.ond cro$n and had an a&& orce&ain cro$n
in"tead,
Davis Crown :detached do$e& cro$n; de"i*ned %! -,C, Da#i" $a" an a&& orce&ain
cro$n $ith a o"t that co(&d %e detached :"earated; and co(&d %e )i+ed into the reared
root end %! ce.entation o) the o"t to the root and cro$
.-
th
Cent!": The &#/e!n 0)ce
191- 4 Focal Infection Theory *i#en %! -i&&ia. H(nter &ed to the %e&ie) that non5#ita&
teeth $ere etio&o*ic a*ent" o) .an! co..on di"ea"e", The ("e o) endodontic roced(re
dec&ined raid&! d(rin* thi" eriod and it too7 a%o(t <2 !ear" )or denti"tr! to o#er co.e
thi" %ia",
In the ne+t =2 !ear" the "tandardi>ation o) in"tr(.ent "i>e"/ the %io.echanica&
rearation o) the cana& and .odern har.aco&o*ic a*ent" &ed to a hi*h "(cce"" rate o)
endodontic treat.ent in .(&ti rooted/ a" $e&& a"/ "in*&e rooted teeth, Thi" re"(&ted in it"
*enera& accetance %! the ro)e""ion and atient"/ and it" co..on ("e in denta& ractice,
191-$ 4 There $a" a chan*eo#er )ro. the "in*&e orce&ain cro$n ce.ented to the o"t to
the "earate/ $e&&5retained co.onent/ 8the core9/ $hich re&aced the .i""in* corona&
tooth "tr(ct(re
1911 4 Ro"en de"cri%ed the e+tra corona& %race a" 6a "(%*in*i#a& co&&ar o) *o&d $hich
e+tended a" )ar a" o""i%&e %e!ond the *in*i#a& "eat o) the core and co.&ete&! "(rro(nd"
the eri.eter o) the tooth/ th(" re#entin* tooth )ract(re?, Thi" &ater ca.e to %e 7no$n a"
the 8ferrule9, He a&"o de"cri%ed the "&it ca"tin* techni0(e )or .(&ti5rooted teeth $ith
di#er*ent cana&"
191* 4 @(rer Po"t/ %! Peter @(rer/ $a" a re)ine.ent o) the re#io("&! ("ed threaded
o"t",
19*- 4 The Parao"t S!"te. de"cri%ed %! Bara%an $ent on to %eco.e the .o"t o(&ar
re)a%ricated o"t and core "!"te.
198- 4 Ar(n Na!!ar de"cri%e the a.a&*a. corona& 4 radic(&ar do$e& and core "!"te.,
Here/ a.a&*a. $a" conden"ed 35A.. into cana&"/ (& cha.%er and corona& ortion o)
tooth
199- 4 D(ret/ Re!na(d and D(ret introd(ced the Co.o"io"t, Thi" non5.eta&&ic o"t/
%a"ed on car%on5)i%er rein)orce.ent rinci&e"/ had hi*h ten"i&e "tren*th and .od(&(" o)
e&a"ticit! "i.i&ar to dentin
199+ 4 Sandha(" and Pa"che introd(ced the re)a%ricated >irconia o"t,
-ith ad#ance" in .ateria&" techno&o*! *&a"" )i%er and cera.ic o"t" ha#e %een
introd(ced, The"e non5.eta&&ic o"t" are tooth co&o(red and hence .ore e"thetic than
car%on )i%er and .eta& o"t", A&"o/ i.ro#e.ent" in re"in &(tin* ce.ent" ha#e re"(&ted in
o"t" %ein* che.ica&&! %onded to the dentin,
In "(..ar!/ o#er 322 !ear" o) re"earch %! #ario(" c&inician" and in#e"ti*ator"
ha" increa"ed the &on*e#it! and "er#icea%i&it! o) endodontica&&! treated teeth, A #ariet! o)
.ateria&" and techni0(e"/ %a"ed on "o(nd %io&o*ica& rinci&e"/ a&&o$ the conte.orar!
denti"t to treat di))erent c&inica& "it(ation" $ith )a#o(ra%&e re"(&t",
TREATMENT ASSESMENT:
H#2 )!e en/#/#nt3c)((" t!e)te/ teeth /300e!ent4
53#(#63c C#nce!n$ E00ect$ #0 En/#/#nt3c$ #n Teeth
(Gutmann)
Endodontica&&! treated teeth ha#e "ecia& need" that e+ceed the re0(ire.ent" o) teeth $ith
#ia%&e (&", The tooth "tr(ct(re that re.ain" a)ter endodontic treat.ent ha" %een
$ea7ened and (nder.ined %! carie"/ )ract(re/ tooth rearation and re"toration,
Endodontic roced(re" )(rther re.o#e i.ortant intra5corona& and intra5radic(&ar dentin,
A&"o/ endodontic treat.ent chan*e" the act(a& co.o"ition o) dentin,
The co.%ined re"(&t o) the"e chan*e" i" increa"ed )ract(re "("ceti%i&it! and decrea"ed
tran"&(cenc! in non5#ita& teeth, The .a'or chan*e" in the"e teeth inc&(deB
1, Lo"" o) tooth "tr(ct(re
3, A&tered h!"ica& characteri"tic"
<, A&tered e"thetic characteri"tic"
L#$$ #0 t##th $t!ct!e
Decrea"ed tooth "tren*th in endodontica&&! treated teeth i" ri.ari&! d(e to &o"" o)
corona& tooth "tr(ct(re, Endodontic roced(re" ha#e %een "ho$n to red(ce tooth "ti))ne""
%! on&! =C/ $herea" a .e"io5occ&("o5di"ta& :MOD; rearation red(ce" tooth "ti))ne""
%! D2C/ .ain&! %eca("e o) &o"" o) .ar*ina& rid*e :Reeh et a&/ 1EFE;,
Endodontic acce"" into (& cha.%er de"tro!" "tr(ct(ra& inte*rit! ro#ided %! the corona&
dentin o) the (&a& roo) and a&&o$" *reater )&e+in* o) the tooth (nder )(nction, -ith
red(ction o) the inner c("a& "&oe"/ that (nite and "(ort the c("" d(rin* )(nction %!
re#entin* e+ce""i#e de)or.ation/ *reater chance" o) )ract(re e+i"t, In ca"e o)
"i*ni)icant&! red(ced re.ainin* tooth "tr(ct(re/ nor.a& )(nctiona& )orce" .a! ca("e the
tooth to )ract(re in the area o) the ".a&&e"t circ(.)erence/ )re0(ent&! the CEG, In
addition/ e+ce""i#e re.o#a& o) radic(&ar dentin d(rin* cana& c&eanin* and "hain* and
o"t "ace rearation $ea7en" the root,
A(te!e/ 'h"$3c)( ch)!)cte!3$t3c$
The tooth "tr(ct(re re.ainin* a)ter endodontic thera! e+hi%it" irre#er"i%&! a&tered
h!"ica& roertie", Ca&ci)ied ti""(e" o) (&&e"" teeth ha#e EC &e"" .oi"t(re content than
in #ita& teeth :He&)er et a&/ 1EH3;, The co&&a*en too ha" )e$er .at(re and .ore i..at(re
cro""&in7" :Ri#era et a&/ 1EFF;,
Chan*e" in co&&a*en cro""&in7in* and deh!dration o) the dentin re"(&t in 1AC red(ction in
"tren*th and to(*hne"" o) endodontica&&! treated .o&ar"/ $ith .a+i&&ar! teeth "ho$n to
%e "tron*er than .andi%(&ar teeth and .andi%(&ar inci"or" to %e the $ea7e"t :Carter et a&/
1EF<;,
The co.%ined &o"" o) "tr(ct(ra& inte*rit!/ &o"" o) .oi"t(re and &o"" o) dentin to(*hne""
co.ro.i"e" the"e teeth and nece""itate" "ecia& care in their re"toration,
A(te!e/ e$thet3c ch)!)cte!3$t3c$
A dar7ened endodontica&&! treated tooth i" a co..on c&inica& heno.enon,
Bioche.ica&&! a&tered dentin .odi)ie" &i*ht re)raction thro(*h the tooth and chan*e" it"
aearance, Inade0(ate endodontic c&eanin* and "hain* o) the corona& area a&"o
contri%(te" to thi" di"co&oration %! "tainin* the dentin )ro. de*radation o) (& ti""(e &e)t
in the (& horn", Medica.ent" ("ed in denta& treat.ent and ce.ent" o) root cana&
)i&&in*" can a&"o a))ect the aearance o) the"e teeth,
Endodontic treat.ent and re"toration o) teeth in the e"thetic >one re0(ire" care)(& contro&
o) roced(re" and .ateria&" to retain a tran"&(cent/ nat(ra& aearance,
Another .a'or chan*e that .a! .a7e the"e teeth ore "("ceti%&e to )ract(re" i" (#$$ #0
'!#'!3#ce't3#n7
INDICATIONS:
Why do we need posts?
Ear&ier concet "tated the need )or o"t and core re"toration i" .ain&! )or re"i"tance
(ro"e, B(t no$ c&inica& "t(die" and ("e ha#e indicated that o"t" do not add
"i*ni)icant&! to the !e$3$t)nce o) the teeth to )ract(re, R)the! 3n ce!t)3n c)$e$ the" &)"
e8en 2e)9en the t##th %" c)$3n6 the 2e/63n6 e00ect7
Accordin* to the ne$ concet the .ain (ro"e o) ("in* the '#$t$ 3$ &)3n(" 0#!
!etent3#n #0 the c#!e t# the !##t7
Be)ore initiation o) re"torati#e thera! the tooth .("t (nder*o thoro(*h endodontic/
eriodonta&/ re"torati#e and e"thetic e#a&(ation", The ro*no"i" o) the tooth/ ad'acent
teeth/ oo"in* teeth and atient de"ire" )or treat.ent "ho(&d %e con"idered,
17 En/#/#nt3c e8)()t3#n
The 0(a&it! o) e+i"tin* endodontic treat.ent "ho(&d %e e#a&(ated,
Ne$ re"toration"/ artic(&ar&! co.&e+ re"toration"/ "ho(&d not %e &aced on
a%(t.ent teeth $ith 0(e"tiona%&e ro*no"i", Endodontic re5treat.ent .a! %e
indicated )or teeth that e+hi%it radio*rahic atho&o*! or c&inica& "!.to." o)
in)&a..ation,
Cana&" )i&&ed $ith "i&#er cone" or other inaroriate )i&&in* .ateria&" "ho(&d %e
re5treated $ith *(tta5ercha/ $hich i" ea"i&! re.o#ed )or cana& "ace rearation
and ro#ide" an ade0(ate aica& "ea&,
.7 Pe!3#/#nt)( e8)()t3#n
Maintenance o) eriodonta& hea&th i" critica& to the &on*5ter. "(cce"" o) teeth that ha#e
%een endodontica&&! treated and re"tored, The eriodonta& condition o) the tooth .("t %e
deter.ined %e)ore initiation o) endodontic thera!/ and the e))ect o) the &anned
re"toration on the attach.ent aarat(" .("t %e con"idered,
E+ten"i#e carie"/ tooth )ract(re/ re#io(" re"toration"/ er)oration" and e+terna&
re"ortion can de"tro! tooth "tr(ct(re at the &e#e& o) the eriodonta& attach.ent,
An atte.t to &ace re"torati#e .ar*in" on "o&id tooth "tr(ct(re %e!ond the"e
de)ect" )(rther in#ade" the %io&o*ic attach.ent >one,
Vio&ation o) the %io&o*ic $idth can ca("e )ai&(re o) the c&inica& re"(&t", A
.(ti&ated tooth in $hich re"torati#e treat.ent $o(&d co.ro.i"e the '(nctiona&
eithe&i(. or connecti#e ti""(e attach.ent &e#e&" "ho(&d %e con"idered )or
eriodonta& cro$n &en*thenin* "(r*er! or orthodontic e+tr("ion,
Teeth .(ti&ated )ro. carie" or )ract(re o)ten ha#e e+ce&&ent %one "(ort/
e+traction o) "(ch teeth and re&ace.ent $ith i.&ant" "ho(&d %e con"idered,
,7 Re$t#!)t38e e8)()t3#n
It i" e""entia& to deter.ine i) the tooth i" re"tora%&e %e)ore endodontic treat.ent i"
er)or.ed, S(cce"")(& endodontic treat.ent i" o) no #a&(e i) the tooth i"
e+ten"i#e&! da.a*ed to %e re&ia%&! re"tored,
The "trate*ic i.ortance o) the tooth "ho(&d %e deter.ined/ e,*, the di"ta& .o"t
tooth in a 0(adrant can %e critica& to a#oid a di"ta& e+ten"ion artia& dent(re, S(ch
teeth re0(ire redicta%&e endodontic and re"torati#e treat.ent, Con#er"e&!/
e+ten"i#e&! da.a*ed teeth o) no "trate*ic i.ortance/ e,*, $hen ad'acent hea&th!
teeth are a#ai&a%&e or i.&ant" can %e *i#en/ "ho(&d %e e+tracted,
The tooth to %e re"tored "ho(&d %e a%&e to $ith"tand )(nctiona& )orce" &aced (on
it a)ter recon"tr(ction, Ri"7 o) root )ract(re increa"e" $ith the a.o(nt o) .i""in*
corona& or interna& radic(&ar tooth "tr(ct(re, A critica& a.o(nt o) "o&id corona&
dentin i" re0(ired/ $hich .("t %e enca"ed in the )ina& re"toration :the ferrule; )or
"tr(ct(ra& inte*rit! o) the re"tored tooth, I) "())icient tooth "tr(ct(re i" not
a#ai&a%&e/ the tooth "ho(&d %e eriodonta&&! or orthodontica&&! e+tr(ded or
e+tracted,
+7 E$thet3c e8)()t3#n
Potentia& e"thetic co.&ication" "ho(&d %e e#a&(ated %e)ore initiation o) endodontic
thera!,
Thin *in*i#a .a! tran".it a "hado$ o) dar7 root co&or thro(*h the ti""(e, Meta&
or dar7/ car%on5)i%er o"t" or a.a&*a. &aced in the cana& can re"(&t in
(nacceta%&e *in*i#a& di"co&oration )ro. the (nder&!in* root,
The tran"&(cenc! o) a&& cera.ic re"toration" .("t %e con"idered in the "e&ection o)
o"t and core .ateria&", Tooth co&ored re"torati#e .ateria&" "ho(&d %e "e&ected,
An e"thetic tooth that $i&& not need a cro$n a)ter endodontic thera! re0(ire"
critica& contro& o) endodontic )i&&in* .ateria&" in the corona& third o) the cana& and
(& cha.%er, Oa0(e "(%"tance" $i&& ad#er"e&! a))ect the co&or and tran"&(cenc!
o) the"e teeth, There)ore/ *(tta5ercha .("t %e &i.ited to a .ore aica& &e#e& and
(& cha.%er "ho(&d %e thoro(*h&! c&eaned o) re.o#e *(tta5ercha and "ea&er,
E"thetic .ateria&" "ho(&d %e ("ed to re"tore the acce"" ca#it!,
Ca"e" in $hich endodontic treat.ent .a! "(cceed %(t re"torati#e or eriodonta& )ai&(re
$o(&d occ(r "ho(&d %e identi)ied and their re&ace.ent "ho(&d %e inc&(ded in the o#era&&
treat.ent &an,
The &)3n 3n/3c)t3#n$ 0#! th3$ !e$t#!)t3#n c)n %e 6!#'e/ n/e! the 0#((#23n6
he)/3n6$:
S36n303c)nt t##th $t!ct!e (#$$
o AnteriorB )(&& co#era*e
o Po"teriorB c("a& co#era*e
H36h 0nct3#n)( /e&)n/$
E$thet3c /e&)n/$ :anteriors)
F)8#!)%(e )n)t#&" #0 t##th
E8)()t3#n #0 the t##th 3$ /#ne #n the 0#((#23n6 %)$3$:
A&#nt #0 !e&)3n3n6 t##th $t!ct!e
An)t#&3c)( '#$3t3#n #0 the t##th
Fnct3#n)( (#)/ #n t##th
E$thet3c !e;3!e&ent$ #0 t##th
C#n$3/e!)t3#n$ 0#! !e$t#!3n6 )nte!3#! teeth:
a, Anterior teeth do not a&$a!" need co.&ete co#era*e a" "t(die"
ha#e "ho$n that intact root treated anterior teeth are "tron*er than tho"e re"tored
$ith o"t and core,
%, Po"t and core i" not re0(ired $hen there i" &3n3&)( c#!#n)(
/)&)6e/ intact .ar*ina& rid*e"/ intact cin*(&(./ intact inci"a& ed*e and one or t$o
".a&& ro+i.a& &e"ion", Here/ the treat.ent "ho(&d %e re"toration o) acce"" oenin*
$ith co.o"ite re"in or GIC, I) the tooth i" di"co&ored a non5#ita& %&eachin*
techni0(e i" ad#i"ed o#er co.&ete cro$n, Ho$e#er a&& ca"e" .a! not %e
"(cce"")(&&! treated $ith %&eachin*/ "(ch teeth need )(&& co#era*e,
c, -hen a )(&& co#era*e re"toration i" to %e *i#en in intact
endodontica&&! treated anterior" a o"t and core i" reco..ended %eca("e a)ter
cro$n rearation )or a .eta& cera.ic or a&& cera.ic cro$n/ the a.o(nt o)
re.ainin* tooth "tr(ct(re i" decrea"ed and the tooth $o(&d %e "("ceti%&e to )ract(re
a" anterior teeth are "(%'ected to "hear :&atera&; )orce",
d, A o"t and core )o&&o$ed %! )(&& cro$n i" indicated $hen there i"
"i*ni)icant corona& da.a*e and (nder.ined .ar*ina& rid*e"/ or corona& )ract(re"
in#o&#in* a&& o) inci"a& ed*e and .a'or art o) cro$n, It i" i.ortant that at&ea"t
3.. o) tooth "tr(ct(re "ho(&d %e re"ent aica& to the re"in core to ro#ide
re"i"tance )or.,
e, F#! $&)(( c3!c()! c)n)($ ) '!e0)%!3c)te/ '#$t )n/ !e$3n c#!e 3$
'!e0e!!e/, B(t $hen cana& i" e&&itica& or )&ared a c("to. ca"t o"t and core i"
indicated, In "(ch ca"e" intra5radic(&ar reha%i&itation i,e, %(i&d( o) the cana& $a&&"
$ith co.o"ite and ("e o) )i%er5rein)orced o"t" can a&"o %e done a" an a&ternati#e
to ca"t o"t and core,
C#n$3/e!)t3#n$ 0#! '#$te!3#! teeth:
a, A&& endodontica&&! treated o"terior teeth re0(ire a )(&& occ&("a&
co#era*e re"toration, Thi" i" %eca("e d(e to &o"" o) the roo) o) the (& cha.%er
:$hich ro#ide" "tr(ct(ra& inte*rit!; the occ&("a& )orce" tend to $ed*e the c(""
aart/ $hich .a! &ead to tooth )ract(re,
%, A *o&d or cera.ic on&a! i" "())icient $hen there i" .ini.a&
corona& da.a*e/ &o$ ri"7 o) )ract(re :i,e, occ&("ion rotect" tooth )ro. hea#!
&atera& occ&("a& )(nctionin* contact"; or .ini.a& occ&("a& )orce" :a" $hen
oo"in* teeth are arti)icia&; and )acia& and &in*(a& c("" are intact,
c, A )o(ndation :core; re"toration $ith co.&ete occ&("a& co#era*e
i" indicated $hen there i" .oderate corona& da.a*e or e+tre.e c(r#at(re o) root,
Here one o) the )o&&o$in* )o(ndation" .a! %e ("edB
1, A.a&*a. corona&5radic(&ar core,
3, Pin5retained a.a&*a. or re"in co.o"ite,
d, In o"terior teeth the (& cha.%er and cana&" ro#ide ade0(ate
retention )or )o(ndation %(i&d( and hence *enera&&! do not re0(ire a o"t/ (n&e""
corona& da.a*e i" e+ten"i#e,
e, Mo&ar" re"i"t ri.ari&! #ertica& )orce"/ $herea" re.o&ar" are
.ore &i7e&! to %e "(%'ected to &atera& )orce" d(rin* .a"tication, Their cro""
"ectiona& area" at the CEG i" ".a&&er than that o) .o&ar" and "o are .ore rone to
)ract(re, Tho(*h the! are %(&7ier than anterior"/ the! are o)ten "in*&e rooted $ith
".a&& (& cha.%er" that .a! not ro#ide ade0(ate retention and re"i"tance, For
the"e rea"on"/ the! re0(ire o"t" .ore o)ten than .o&ar", The re.ainin* tooth
"tr(ct(re and )(nctiona& de.and" are the deter.inin* )actor",
), The cana& anato.! a*ain dictate" the choice o) o"t, For circ(&ar
cana&" a re)a%ricated o"t $ith co.o"ite or a.a&*a. core i" acceta%&e,
E+tre.e&! taered or o#a& cana&" re0(ire c("to. ca"t o"t and core,
An)t#&3c C#nce!n$ (Gutmann)
For re"torin* endodontica&&! treated teeth $ith o"t and core re"toration" care)(& attention
to root anato.! "ho(&d %e aid in order to "e&ect the aroriate o"t de"i*n in ter." o)
&en*th and "hae and it" .ethod o) &ace.ent, To achie#e thi" end a thoro(*h 7no$&ed*e
o) root anato.! i" i.ortant a&on* $ith eriaica& radio*rah" at di))erent an*(&ation" to
deter.ine the n(.%er o) root"/ their "tr(ct(re and c(r#at(re", Ho$e#er/ di))erent teeth
o"e certain ro%&e." (ni0(e to their anato.!B
M)<3(()!" Teeth
Central and lateral incisors 4 Nor.a&&!/ their %(&7! root" ea"i&! acco..odate a o"t,
B(t e+ce""i#e o"t &en*th" are to %e a#oided in root" that taer raid&! to the ae+
%eca("e the thinned o(t root $a&&" at the aica& e+tent o) the o"t increa"e chance" o) root
)ract(re,
Canines 4 Bein* $ide )acio&in*(a&&! c("to. ca"t o"t" .a! %e de"ired )or %etter
adatation, Pro+i.a& in#a*ination" .a! %e re"entI hence thic7er o"t" "ho(&d not %e
("ed in order to a#oid root er)oration,
Premolars 4 The )ir"t re.o&ar re"ent" .an! cha&&en*in* ro%&e.", It ha" thin root
$a&&" that are )(rther $ea7ened a)ter re.o#a& o) dentin, Root" taer raid&! to the ae+/
e"ecia&&! $hen t$o root" are re"ent, Pro+i.a& in#a*ination" and cana& "&ittin* are
co..on, Facia& c(r#at(re o) a&ata& root and di"ta& c(r#at(re o) the root" .a! re"(&t in
er)oration d(rin* rearation or ce.entation,
The "econd re.o&ar o"e" "i.i&ar ro%&e." %(t d(e to *reater %(&7 o) the root "ho$"
)e$er co.&ication",
Molars 4 On&! a&ata& root i" "(ita%&e )or o"t &ace.ent a" it ha" the &ar*e"t cana&, In
F=C o) ca"e" thi" root i" )acia&&! c(r#ed, In#a*ination" .a! %e re"ent on a&ata& and
)acia& "(r)ace" o) thi" root/ a" a re"(&t o) $hich/ $ea7enin* or er)oration o) the root .a!
occ(r d(rin* &ace.ent o) &on* thic7 o"t" that/ .a! not %e di"c&o"ed on the radio*rah,
Fir"t .o&ar" ha#e dee conca#itie" on the )(rca& "(r)ace o) EAC o) the .e"io%(cca& root"/
<1C o) di"to%(cca& root" and 1HC o) a&ata& root", P&ace.ent o) o"t in the narro$
.e"io%(cca& or di"to%(cca& cana& i" *enera&&! contraindicated,
M)n/3%()! Teeth
ncisors and canines 4 The"e teeth are di))ic(&t to treat, In )act/ "(cce"" rate ha" %een
"ho$n to %e hi*her $itho(t a o"t, The! ha#e thin root $a&&"/ ro+i.a& in#a*ination" and
o)ten .(&ti&e cana&"/ $hich co.&icate o"t &ace.ent, Additiona&&!/ "i*ni)icant %one
&o"" .a! %e re"ent $hich contraindicate" o"t and core re"toration,
Premolars 4 The"e teeth ha#e "())icient root %(&7 )or o"t &ace.ent/ tho(*h
occa"iona&&! .(&ti&e cana&" .a! %e re"ent, In the )ir"t re.o&ar the an*&e o) the cro$n
to the root i" an i.ortant con"ideration, Per)oration .a! occ(r on the )acia& "(r)ace o)
the &in*(a&&! inc&ined root i) rearation i" .ade erendic(&ar to the occ&("a& "(r)ace,
Molars 4 Pro+i.a& in#a*ination" are co..on, Fir"t .o&ar" ha#e root conca#itie" on the
)(rca& "(r)ace o) 122C o) .e"ia& root" and EEC o) di"ta& root", Per)oration" .a! not %e
"een on radio*rah", Their cana&" are narro$ .e"iodi"ta&&! and $ide )acio&in*(a&&! and
.a! %eco.e con"idera%&! $ea7ened i) reared )or &ar*e/ circ(&ar re)a%ricated o"t",
Di"ta& cana& i" re)erred )or o"t &ace.ent a" it i" the &ar*e"t,
Fract(re" .a! occ(r d(rin* ce.entation or atient )(nction, The"e )ract(re" are ter.ed
8odontiatrogenic9 in ori*in and .a! aear radio*rahica&&! a" )(rca& %one &o"" or
ro+i.a& an*(&ar de)ect",
CLASSIFICATION:
ngle and !a"land
I, C("to.5ca"t Po"t"
II, Pre)a%ricated Po"t"
1, Taered/ ".ooth5"ided
3, Para&&e&5"ided
<, Taered/ "e&)5threadin* "cre$"
A, Para&&e&5"ided/ threaded
=, Para&&e&5"ided/ taered aica& end
Weine
I, C("to.5ca"t Po"t"
II, Pre)a%ricated Po"t"
1, Taered/ ".ooth "ided o"t "!"te."
3, Para&&e&5"ided/ "errated and #ented o"t"
<, Taered/ "e&)5threadin* o"t "!"te."
A, Para&&e&5 "ided/ threaded o"t "!"te."
a, Se&)5threadin*
%, Threaded $ith ("e o) .atched ta"
Para&&e&5"ided/ threaded/ "&it5"han7 o"t "!"te."
Cohen and !urns
C&a""i)ication accordin* to de"ired h!"ica& roertie"B
I, Retenti#e Q(a&itie" o) Do$e&"5 to anchor the do$e& to the root and the core
A, Do$e& De"i*n
a, Do$e& to root retention
1, Para&&e&
3, Taered
<, Threaded
A, Che.ica&&! %onded
%, Do$e& to core retention
1, One5iece :inte*rated; do$e& and core
3, Lar*e do$e& head $ith .echanica& inter&oc7in* )eat(re"
<, S.a&& do$e& head
B, Do$e& Co.o"ition
a, Do$e& to root retention
1, Meta& do$e&"
3, Car%on )i%er do$e&"
<, Fi%er rein)orced co.o"ite do$e&"
A, Cera.ic and >irconia do$e&"
%, Do$e& to core retention
1, One5iece do$e& and core
i, C("to.5ca"t .eta&
ii, Jirconia
iii, Cera.ic
i#, Fi%er rein)orced co.o"ite
3, Di""i.i&ar do$e& and core
<, Mono%&oc or Monocore :%onded/ direct co.o"ite do$e&
and core co.%ination";
C, Do$e& Ce.entation
1, Mechanica& retention :e,*, Jinc ho"hate ce.ent;
3, Ce.ent %ondin* to tooth %(t not do$e& :e,*, GIC;
<, Ce.ent %ondin* to tooth and do$e& :e,*, che.ica&&!
adhe"i#e ce.ent";
II, Protecti#e Q(a&itie" o) Do$e&"5 a*ain"t root )ract(re and .icro&ea7a*e
A, Do$e& De"i*n
a, Shae
1, Para&&e&
3, Taered
<, Para&&e& $ith taered aica& end
A, Para&&e&/ $hich increa"e" in corona& dia.eter $ith "erie" o)
ara&&e&5"ided "te"
%, Dia.eter
1, Meta& do$e&" a#ai&a%&e in ".a&& dia.eter"
3, Non5.eta&&ic do$e&" not a#ai&a%&e in ".a&& dia.eter",
There)ore/ a#ai&a%&e a"B
i, Taered
ii, -ith t$o ara&&e& "te" containin* a narro$er/
ara&&e& aica& ortion
c, Len*th5 &on*er do$e&" *i#e %etter retention
B, Co.o"ition
a, Sti))er than dentin
i, Meta&5 Stain&e"" "tee& K Titani(. a&&o! K P(re
titani(.
ii, Jirconia
iii, Cera.ic
%, Mod(&(" o) e&a"ticit! "i.i&ar to dentin
i, Car%on )i%er
ii, Car%on core
iii, Fi%er rein)orced co.o"ite
i#, -o#en )i%er/ ri%%on rein)orced co.o"ite
C, Do$e& De"i*n )or Da.a*ed Root"
a, Li*ht Tran".ittin* do$e&5 to a&&o$ %(i&d( o) cana& $ith co.o"ite and
"(%"e0(ent re"toration $ith re)a%ricated do$e&,
%, C("to. do$e& and inte*rated core .ade o) co.o"ite re"in rein)orced
$ith a $o#en o&!eth!&ene )i%er "!"te.,
III, E"thetic Q(a&itie" o) Do$e&"5
1, Cera.ic do$e&"
3, Jirconia do$e&"
<, Fi%er*&a"" rein)orced co.o"ite do$e&"
A, Car%on core do$e&"
Walton and #ora$ine%ad
I, Accordin* to "hae
1, Para&&e&
3, Taered
II, Accordin* to con"tr(ction
1, C("to. .ade
3, Pre)or.ed
III, Accordin* to nat(re o) )it
1, Pa""i#e
3, Acti#e
IV, Accordin* to "(r)ace con)i*(ration
1, S.ooth
3, Serrated
<, Threaded
&ccording to materials used
Met)($
C("to.5ca"t o"t"
o Go&d a&&o!"
o Chro.e5co%a&t a&&o!"
o Nic7e&5chro.i(. a&&o!"
Pre)a%ricated o"t"
o Stain&e"" Stee&
o Titani(.
o Bra""
N#n=&et)($
Car%on5)i%er
Fi%er5rein)orced
G&a"" )i%er
Q(art> )i%er
-o#en Po&!eth!&ene )i%er
Cera.ic and >irconia
5ASIC COMPONENTS OF A POST AND CORE SYSTEM :
A: +=> && )'3c)( $e)(
5: P#$t
C: Re$3/)( !##t
)tt)ch&ent )'')!)t$
D: C#!e
E: F3n)( !e$t#!)t3#n
&ntirotational 'eatures : Pin
(eyway
THE POST :it i" the "e*.ent o) the re"toration in"erted in the root cana& o) the
endodontica&&! treated tooth to aid in the retention o) the core and the "(%"e0(ent
corona& re"toration;
The o"t i" de)ined a" the "e*.ent o) the re"toration in"erted into the root cana& to
aid in retention o) a core co.onent, It i" a ri*id .ateria& &aced in the root o) a tooth, It
can %e )a%ricated )ro. .eta& or )ro. other non5.eta&&ic "(%"tance", The o"t i" i.ortant
in the re"toration o) non5#ita& teeth that ha#e "i*ni)icant corona& da.a*e and ha#e
in"())icient "o(nd tooth "tr(ct(re re.ainin* a%o#e the eriodonta& attach.ent to "ec(re a
corona& re"toration,
Fnct3#n$:
1, Retention o) re"toration
3, Protection o) re.ainin* tooth "tr(ct(re
The )ore.o"t (ro"e o) the o"t i" to ro#ide retention )or the core and corona&
re"toration, It a&"o "er#e" a rotecti#e )(nction %! di""iatin* the .a"ticator! )orce" a&on*
the &en*th o) the root/ there%! e0(a&&! di"tri%(tin* the "tre""e" and ro#idin* "o.e re&ie)
at the .ar*in", The o"t it"e&) doe" not "tren*then the root, On the contrar!/ the tooth i"
$ea7ened i) dentin i" "acri)iced to &ace a &ar*e dia.eter o"t,
deal properties o' the post:
Ma+i.(. rotection :or L re"i"tance5 Cohen5F2= ; o) the root,
Ade0(ate retention $ithin the root,
Ma+i.(. retention o) the core and cro$n,
Ma+i.(. rotection o) the cro$n .ar*ina& ce.ent "ea&,
P&ea"in* e"thetic"/ $hen indicated,
Hi*h radio*rahic #i"i%i&it!,
Retrie#a%i&it!,
Bioco.ati%i&it!,
M)te!3)($ Re;3!e&ent$:
Se&ection o) .ateria&" )or o"t" i" #er! i.ortant )or c&inica& "(cce"", F(nction" o)
endodontic o"t" can %e rea&i>ed on&! $hen the )o&&o$in* )eat(re" are ade0(ate&!
incororated into their de"i*nB
Sti))ne""
Stren*th
Fati*(e characteri"tic" and
Corro"ion re"i"tance
Stiffness o) the o"t" i" an e+tre.e&! i.ortant characteri"tic, In"())icient o"t "ti))ne""
er.it" e+ce""i#e di"tortion o) the re"toration .ar*in" d(rin* )(nction and/ in the ca"e o)
ca"tin*"/ &ead" to ce.ent %rea7do$n and rec(rrent deca!, In addition to the .od(&(" o)
e&a"ticit!/ the di.en"ion o) the o"t a&"o contri%(te" to o#era&& o"t "ti))ne"", The ".a&&er
the dia.eter/ the &o$er the "ti))ne"", Con"e0(ent&!/ a hi*her .od(&(" o) e&a"ticit! a&&o$"
the ("e o) ".a&&er dia.eter o"t", There)ore? ) &)te!3)( 23th h36he! &#/($ 3$
'!e0e!!e/ 0#! )n en/#/#nt3c '#$t7
Yield strength indicate" the on"et o) er.anent de)or.ation, A .ateria& $ith hi*h !ie&d
"tren*th $i&& $ith"tand a hi*her )orce %e)ore a er.anent chan*e in "hae/ and hence/ the
otentia& )or er.anent chan*e o) "hae o) the o"t and .ar*in" $i&& %e .ini.i>ed
d(rin* )(nction,
Fatigue characteristics o) the .ateria& ("ed )or o"t )a%rication "ho(&d %e *ood %eca("e a
o"t "(ortin* a cro$n $i&& %e "(%'ected to reeated c!c&e" o) &oadin* and (n&oadin*
d(rin* .a"tication, Stre"" concentration"/ inc&("ion" and corro"ion it" $i&& a))ect the
)ati*(e %eha#ior o) o"t",
The i.ortance o) corrosion resistance in .eta&&ic o"t" i" not readi&! rea&i>ed/ a" the
o"t doe" not co.e into direct contact $ith ora& )&(id", The interaction %et$een the o"t"
and dentina& )&(id rod(ce" corro"ion rod(ct" %et$een the o"t and cana& $a&&", Thi"
re"(&t" in the a&ication o) &atera& )orce" to the cana& $a&&"/ $hich "(%"e0(ent&! .a!
)ract(re, Corro"ion o) o"t" ha" %een i.&icated and a.&! doc(.ented in &on*it(dina&
and o%&i0(e )ract(re" o) the teeth, Corro"ion/ ho$e#er/ i" not a concern $ith non5.eta&&ic
and titani(. o"t",
T"'e$ #0 P#$t$
I; Meta&&ic o"t"
1, C("to. ca"t o"t"
3, Pre)a%ricated o"t",
a, Pa""i#e,
i; Taered,
ii; Para&&e&,
%, Acti#e,

II; Non5.eta&&ic o"t"
1, Car%on )i%er o"t"
3, Tooth co&ored o"t"
Fi%er rein)orced o"t
Cera.ic and Jirconia o"t",
Met)( '#$t$
C$t#&=c)$t &et)( '#$t$
The c("to. ca"t o"t and core ha" a &on* hi"tor! o) "(cce"" in re"torati#e denti"tr!,
Ho$e#er/ &a%orator! "t(die" ha#e con"i"tent&! "ho$n that the )ract(re re"i"tance o) teeth
re"tored $ith c("to. ca"t o"t" i" &o$er than that o) teeth re"tored $ith .an! di))erent
re)a%ricated o"t", In addition/ retro"ecti#e c&inica& "t(die" ha#e "ho$n re)a%ricated
ara&&e& o"t" to ha#e *reater c&inica& "(cce"" than c("to. ca"t o"t"7 The3! t)'e!e/
/e$36n e<e!t$ 2e/63n6 0#!ce$ #n the !##t7 Th3$? c#'(e/ 23th the )//e/ e<'en$e?
e<t!) )''#3nt&ent )n/ nee/ 0#! te&'#!3@)t3#n? h)8e &)/e the& 0)(( #t #0 0)8#!,
Nonethe&e""/ there are "t(die" that reort a hi*h rate o) "(cce"" $ith ca"t o"t and core"
and the! o))er ad#anta*e in certain c&inica& "it(ation",
Indications
1, -hen .(&ti&e o"t" and core" are %ein* &aced in the "a.e arch, It i" .ore ti.e and
co"t e))ecti#e to reare .(&ti&e o"t "ace"/ .a7e an i.re""ion and )a%ricate the
o"t" in the &a%orator!,
3, -hen o"t" and core" are %ein* &aced in ".a&& teeth/ "(ch a" .andi%(&ar inci"or", In
the"e in"tance"/ it i" di))ic(&t to retain the core .ateria& on the head o) a re)a%ricated
o"t/ a" .ini.a& "ace i" a#ai&a%&e aro(nd the o"t,
<, -hen the an*&e o) the core .("t %e chan*ed in re&ation to the o"t/ re)a%ricated
o"t" "ho(&d not %e %ent/ there)ore/ the c("to. ca"t o"t %e"t )(&)i&&" thi" re0(ire.ent,
A, -hen an a&&5cera.ic re"toration i" &aced/ it i" nece""ar! to ha#e a core that
aro+i.ate" the co&or o) nat(ra& tooth "tr(ct(re, I) a &ar*e core i" %ein* &aced on in
a hi*h5"tre"" "it(ation/ re"in co.o"ite .a! not %e the .ateria& o) choice d(e to the
)act that it tend" to de)or. (nder a &oad, In thi" circ(."tance/ the o"t and core can %e
ca"t in .eta& and orce&ain can %e )ired to the core to "i.(&ate the co&o(r o) nat(ra&
tooth "tr(ct(re, The core orce&ain can then %e etched $ith h!dro)&(oric acid/ and the
a&&5cera.ic cro$n can %e %onded to the core,
=, In e+ce""i#e&! )&ared and e&&itica& cana&" $here re)a%ricated o"t" .a! %e di))ic(&t
to ("e,
D, Ca"t o"t and core" are *enera&&! ea"! to retrie#e $hen endodontic re5treat.ent i"
nece""ar!,
Perha" the %i**e"t di"ad#anta*e )or ca"t o"t and core" i" in area" that re0(ire an
e"thetic te.orar! re"toration, Te.orar! o"tMcro$n" are not e))ecti#e in re#entin*
conta.ination o) the root cana& "!"te.,
!aterials used
The co..on&! ("ed .ateria&" are T!e III or IV *o&d a&&o!", The .ain con"tit(ent" o)
the"e a&&o!" are *o&d/ coer and "i&#er/ $ith ".a&& a.o(nt" o) a&&adi(./ &atin(. and
>inc, The"e a&&o!" di"&a! e+ce&&ent corro"ion re"i"tance/ hi*h .od(&(" o) e&a"ticit! and
ten"i&e "tren*th, Stren*th o) the"e a&&o!" .a! %e increa"ed %! aroriate heat treat.ent,
Non5recio(" nic7e&5chro.i(. and co%a&t5chro.i(. a&&o!" are a&"o ("ed, The! are
co..on&! ("ed )or endodontic o"t de"i*n" a#ai&a%&e in the )or. o) &a"tic %(rno(t
attern"/ $hich are in#e"ted and ca"t, The"e a&&o!" are .(ch "ti))er than ca"t *o&d and
e+hi%it hi*her !ie&d and ten"i&e "tren*th,
P!e0)%!3c)te/ Met)( P#$t$
Pre)a%ricated o"t" are t!ica&&! .ade o) "tain&e"" "tee&/ nic7e&5chro.i(. a&&o! or
titani(. a&&o!, The! are #er! ri*id and $ith the e+cetion o) titani(. a&&o!"/ are #er!
"tron*, Beca("e the! are ro(nd/ the! o))er &itt&e re"i"tance to rotationa& )orce", Thi" i" not
a ro%&e. i) ade0(ate tooth "tr(ct(re re.ain"/ %(t i) .ini.(. tooth "tr(ct(re re.ain"/
anti5rotation )eat(re" .("t %e incororated into the o"t rearation "(ch a" "&ot" or in",
A %onded .ateria& "ho(&d %e ("ed )or core,
Man! o) the re)a%ricated o"t" are .ade o) titani(. a&&o!" and "o.e are .ade o) %ra"",
Titani(. o"t" $ere introd(ced %eca("e o) concern" a%o(t corro"ion, Mo"t o) the
titani(. o"t" ha#e a radioden"it! "i.i&ar to *(tta5ercha and "ea&er and are "o.eti.e"
hard to detect on radio*rah", Titani(. o"t" ha#e &o$ )ract(re "tren*th/ $hich i.&ie"
that the! are not "tron* eno(*h to %e ("ed in thin o"t channe&", Re.o#a& o) titani(.
o"t" can %e a ro%&e. %eca("e the! "o.eti.e" %rea7 $hen )orce i" a&ied $ith a o"t
re.o#a& in"tr(.ent, E+tended ("e o) (&tra"onic ener*! .a! %e nece""ar! to re.o#e
titani(. o"t" $hich can %e da.a*in* to the tooth or "(rro(ndin* ti""(e", For the"e
rea"on"/ titani(. and %ra"" o"t" "ho(&d %e a#oided %eca("e the! o))er no rea& ad#anta*e"
o#er the "tron*er .eta& o"t",
Po"t" or do$e&" can %e *enera&&! c&a""i)ied a" ')$$38e !etent3#n #! )ct38e !etent3#n,
Pa""i#e retention o"t" deend (on their c&o"e ro+i.it! to the dentin $a&&"/ %(t %!
adherence o) the ce.entin* .edi(., Good e+a.&e" are ca"t o"t"/ ".ooth taered
o"t"/ "errated ara&&e& o"t"/ and #ariation" o) the"e, E,*, Para5Po"t i" a "errated/ #ented/
re)a%ricated ara&&e& o"t,
IA P)$$38e Retent3#n P#$t$
A" "tated a%o#e/ a""i#e retention o"t" )it the cana& or the channe& in the cana& "ecia&&!
reared )or the.
a; Taered/ S.ooth5Sided Po"t"
The o&de"t and .o"t $ide&! ("ed de"i*n i" the taered/ ".ooth5"ided/ ce.ented o"t,
S!"te." e.&o!in* thi" con)i*(ration are the Be!! En/#'#$t/ and the Moo"er o"t and
)(( c$t#&=c)$t '#$t$7 There i" a&"o a taered 5 7n(r&ed o"t/ the E&&.an N(5Bond, The
$ide ("a*e o) taered o"t" .a!5%e attri%(ted to their ea"e o) (ti&i>ation "ince the taered
)or. i" the nat(ra& "hae o) an endodontic cana&
"ost Retention# The taered/ ".ooth5"ided/ ce.ented o"t 3$ the (e)$t !etent38e o) a&&
o"t de"i*n",
Stress from Installation# Beca("e o) their taer/ the$e '#$t$ )!e $e(0=8ent3n6 and ea"i&!
ce.ented, H!dro"tatic re""(re" do not de#e&o d(rin* ce.entation %eca("e a taer doe"
not act a" a i"ton
Stress from !astication# Taered5".ooth o"t" are $ed*e" and/ a" "(ch/ e<e!t ) 2e/63n6
'!e$$!e (on root" d(rin* )(nction, -ith other )actor" %ein* e0(a&/ the roen"it! )or
root )ract(re )ro. taered o"t" i" ca("e )or concern
%; Para&&e&5"ided Po"t"
Po"t" $ith ara&&e& "ide"/ $hen ce.ented into reared ara&&e& channe&"/ ro#ide .(ch
*reater retention $ith &e"" "tre"" than taered o"t" E+a.&e" are -ha&edent5Po"t"/ the
Bo"ton Po"t and the Par7e&& Para&&e& Po"t, The ara&&e& and "errated Para5Po"t i" the .o"t
$ide&! ("ed,
$i% The "ara&"ost System
-ha&edent ha" introd(ced three o"t de"i*n"B the ori*ina& Para5Po"t/ Para5Po"t P&("/ and
the Unit! S!"te., A&& are a""i#e/ ara&&e&/ #ented o"t" .ade o) e3the! $t)3n(e$$ $tee( #!
t3t)n3&7 Ce.ent retention i" *ained %! hori>onta& "erration" on the Para5Po"t/ "ira&
)&(te" and *roo#e" on Para5 Po"t P&("/ and a rai"ed dia.ond attern on the Unit! Po"t,
An! ce.entin* .edi(. i" acceta%&e,
A, ParaPo"t/ B, ParaPo"t P&("/ C, Unit! Po"t,
"ost Retention# The ara&&e&5"ided/ "errated/ #ented o"t ro#ide" $%$t)nt3)((" 6!e)te!
!etent3#n th)n the $&##th t)'e!e/ /e$36n7 Con"e0(ent&!/ the"e o"t" can %e e))ecti#e&!
e.&o!ed in "it(ation" $here hi*her a&ied )orce" are e+ected,
Stress from Installation# The P)!)=P#$t h)$ ) 8e!t3c)( 6!##8e ct the (en6th #0 3t$
$e!!)t3#n$? )((#23n6 )<3)( 8ent3n67 Thi" de"i*n a&&o$" ce.ent to e"cae and th(" a#oid"
the "tre""e" that .a! %e ind(ced in the dentin %! other ce.ented ara&&e& o"t",
Stress from&!astication# O#era&&/ the ara&&e&5"ided/ "errated Para5Po"t ha" %een "ho$n to
'!#83/e the &#$t e;3t)%(e /3$t!3%t3#n #0 &)$t3c)t#!" 0#!ce$ #0 )(( )8)3()%(e '#$t
/e$36n$, A%o#e a&&/ 3t )8#3/$ the 2e/63n6 e00ect #0 t)'e!e/ '#$t$,
A&& in a&&/ tho(*h the Para5Po"t i" not a" retenti#e a" acti#e o"t" %(t i" a *ood dea& a" &e""
"tre"")(& in &ace.ent, It a&"o $ith"tand" co.re""i#e and )ati*(e )orce" a" $e&& a" the
dentin5en*a*in*
$ii% The 'oston "ost System
In h!"ica& de"i*n/ the Bo"ton Po"t #er! .(ch re"e.%&e" a Para5Po"t $itho(t the #ertica&
#entin* channe&, It i" a a""i#e do$e&? 9971C t3t)n3&/ $ith hori>onta& non5en*a*in*
"erration", It 3$ )(&#$t 2h#((" /e'en/ent #n 3t$ $'ec3)( Dce&ent3n6E &e/3& 0#!
!etent3#n, In 1EE</ the Bo"ton o"t con)i*(ration $a" rede"i*ned $ith deeer *roo#e"
and an etched and ro(*hened "(r)ace to a&&o$ *reater retention,
"ost Retention# Go&d.an and Nathan"on de#e&oed the Bo"ton Po"t at T()t" )o&&o$in*
their "earch )or %etter do$e& retention $itho(t the "tre"" ind(ced %! dentin5en*a*in*
o"t", The! decided the %e"t retention $o(&d %e the dentin it"e&), Freed o) the ".ear &a!er/
the oen dentina& t(%(&e" o))ered a &a%!rinth o) inter&oc7in* "ace into $hich a ce.entin*
.edi(. .i*ht )&o$, The! )ina&&! "ett&ed on a dentina& $a&& %ath o) EDTA and NaOC&5
3,=.& o) each irri*ated into the cana&, The )ir"t $a"h i" $ith 1HC EDTA :H,2 H; to
che&ate a$a! the inor*anic dentin/ )o&&o$ed %! =,3=C NaOC& to re.o#e the or*anic
dentin, Thi" tota&&! re.o#e" the ".ear &a!er %(t &ea#e" the erit(%(&ar dentin in &ace,
Nathan"on one o) the de#e&oer" o) the Bo"ton Po"t "!"te./ )o(nd the ten"i&e "tren*th
re0(ired re.o#in* a Bo"ton Po"t $a" "o.e$hat *reater than a F&e+i5Po"t ce.ented $ith
EDS co.o"ite re"in/ )n/ t23ce )$ !etent38e )$ P)!)=P#$t$ ce&ente/ 23th @3nc
'h#$'h)te ce&ent7 Re.o#in* the ".ear &a!er *reat&! enhance" retention, Stand&ee and
Ca(to "ho$ed *reater retention o) a""i#e o"t"/ no .atter the ce.entin* .edi(./ $hen
the ".ear &a!er $a" re.o#ed,
Stress from Installation# A" $ith the Para5Po"t/ there i" #irt(a&&! no in"ta&&ation "tre""
i.o"ed %! the Bo"ton Po"t,
Stress from !astication# No in)or.ation i" a#ai&a%&e a%o(t co.re""i#e or tor"iona&
)orce" a&ied to cro$n" re"tored $ith the Bo"ton Po"t "!"te., One 0(e"tion" the
ad#i"a%i&it! or nece""it!/ ho$e#er/ #0 '!#/c3n6 the '#$t 0!#& t3t)n3&? 2h3ch h)$
#n(" h)(0 the $t300ne$$ #0 $t)3n(e$$ $tee(7
$iii% "ar(ell "arallel "ost system
Thi" i" "tain&e"" "tee& a""i#e/ #ented/ "errated o"t $ith an anti5rotationa& &oc7 that )it"
into a 6"eat? reared in the root "(r)ace, There are no reort" on the "a)et! and e))icac!
o) thi" "!"te., It" o(&arit! .i*ht %e re&ated to '()$t3c c#!e 0#!&e!$ that co.e $ith the
o"t", The"e a&&o$ the /ent3$t t# %3(/ ' )n 3&&e/3)te c#&'#$3te !e$3n c!#2n c#!e7
Ce.entin* the o"t and core $ith +=META )/he$38e/ %ondin* %oth to the tooth "(r)ace/
.i*ht a&&o$ )or the &ac7 o) a )err(&e, The Par7e&& Po"t a&"o co.e" in a &a"tic %(rn5o(t
attern )or a ca"t #er"ion, Thi" .ode& $o(&d enco(ra*e root rearation to recei#e a
)err(&e in the core ca"tin*,
cAA P)!)((e(=$3/e/ P#$t$ 23th T)'e!e/ A'3c)( En/$:
The"e o"t"/ de"i*ned to ro#ide the *reater retention o) ara&&e& o"t"
!et %etter con)or. to the taered aica& ortion o) the cana&/ co.e in 3
#ariation", One/ the De6$$)? 3$ c#&'(ete(" $&##th=$3/e/7 The
$t!)36ht )n/ t)'e!e/ '#!t3#n$ )!e )%#t e;)( 3n (en6th7 The "econd
#ariation i" the Un3te9 5CH S"$te& 23th (#2e! 0!e;enc" #0
$e!!)t3#n$ )(#n6 the ')!)((e( $3/e$ )n/ ) $&##th )'3c)( t)'e! #0
)%#t .&&7 The BCH o"t a&"o ha" a &ar*er corona& ortion to ro#ide
retention )or core %(i&d5( .ateria&",
"ost Retention# Para&&e& o"t" $ith taered end" ha#e a (#2e! !etent3#n
'#tent3)( th)n !e6()! ')!)((e( '#$t$ o) co.ara%&e &en*th and
dia.eter,
Stress from Installation# Para&&e&5"ided o"t" $ith taered end"/ $hen
ce.ented in &ace rod(ce (3tt(e #! n# 3n$t)(()t3#n $t!e$$7
Stress from !astication# A&& the ce.ented/ ara&&e&5"ided o"t" $ith taered end" rod(ce
a /e03n3te 2e/63n6 e00ect 3n the )!e) #0 the )'3c)( t)'e!, The"e o"t" $i&&/ there)ore/ %e
.ore at to ca("e root )ract(re than ara&&e&5"ided o"t" o) co.ara%&e &en*th and
dia.eter,
IIA Act38e Retent3#n P#$t$:
A" re#io("&! de)ined/ acti#e retention o"t" deend ri.ari&! on e+terna& thread" that
en*a*e the dentin )or retention, Ce.entation i" nece""ar! %(t "econdar!,
There are t$o t!e" o) the"e o"t"B :a;Tho"e $ith "e&)5threadin* "cre$" that en*a*e the
dentin $a&&" o) a reared o"t channe&/ c(ttin* their o$n co(nter5thread"/ are %e"t
eito.i>ed %! the Dentat(" o"t/ the Radi+ Anchor Po"t/ and :%; the F&e+i5Po"t, The
t!e that 6%o&t"? into co(nterthread"/ retaed in the dentin/ i" the @(rer Anchor o"t,
a% "osts with Self&Threading Screws
Tapered Dentatus
One o) the ear&ie"t o) the "e&)5threadin* o"t" i" the Dentat(", A&tho(*h it i" .ore
retenti#e than a""i#eMce.ented o"t"/ it i" a&"o .ore dan*ero(",
"ost Retention# -hi&e it i" tr(e that the taered Dentat(" "cre$ o"t i" .ore retenti#e/ it i"
a&"o tr(e that it *ain" it" retention %! "readin* the dentin a" it "e&)5thread", Lo"" o) the
cro$n i" o)ten the )ir"t indication the root ha" "&it,
Stress from Installation# The "e&)5threadin* taered "cre$ rod(ce" the *reate"t "tre"" %!
)ar $hen in"ta&&ed in the root, Not on&! i" it a $ed*e/ %(t it "et" ( )ract(re &ine" a" it
6c(t"? and "read" it" $a! into the dentin, Stre"" i" hi*he"t and .o"t concentrated at
&en*th" (nder =.. $hen the Dentat(" act" a" a taered $ed*e, E#en $hen it i" 6%ac7ed
o))? one ha&) t(rn/ &itt&e red(ction in "tre"" concentration i" "een,
Stress from !astication# The $ed*e con)i*(ration o) the "cre$ de"i*n i" accent(ated
(nder &oad $hen occ&("a& )orce" are added to the in"ta&&ation )orce" de"cri%ed a%o#e,
Se&)5threadin* taered "cre$" o""e"" the $or"t in"ta&&ation and occ&("a& "tre""5rod(cin*
characteri"tic" o) a&& e+i"tin* de"i*n",
Tapered Fle)i&"ost
A #ariation o) the "e&)5threadin* "cre$ i" the F&e+i5Po"t/ $hich ha" %eco.e one o) the
.o"t o(&ar o"t "!"te.", F(e<3=P#$t 3$ ) '!e0)%!3c)te/? $'(3t=$h)n9? ')!)((e(=$3/e/?
th!e)/e/ '#$t th)t !e'#!te/(" )%$#!%$ the $t!e$$e$ #0 3n$e!t3#n :%" 6!)/)(("
c(#$3n6 /!3n6 '()ce&entA 2h3(e '!#83/3n6 &)<3&& !etent3#n, A" the aica& ha&)
6co&&a"e"?/ it %eco.e" a taered o"t,
"ost Retention# A" a "e&)5threadin* "cre$/ the F&e+i5Po"t *ain" it" "i*ni)icant retention
%! it" thread" ctt3n6 3nt# the /ent3n -71&& t# -7.&&7 The channe& to recei#e the
o"t i" reared %! a dri&& "i>ed "&i*ht&! &ar*er than the dia.eter o) the "ha)t o) the o"t,
The %&ade" :thread"; e+tend %e!ond the "ha)t %! 2,3.. and en*a*e into the dentin
Stress from Installation# Beca("e it i" an acti#e5t!e o"t/ that i"/ "e&)5threadin* into the
dentin/ F&e+i5o"t .("t e+ert "o.e "tre"" $hen it i" in"ta&&ed, It i" )ir"t 6"cre$ed? into
the reared cana& $ith a tin! 6$rench?/ then re.o#ed co(nterc&oc7$i"e/ to %e
rein"erted $ith ce.ent into the "a.e dentin threaded *roo#e",
Stress from !astication# U"in* a )ati*(e5te"tin* aarat(" that "i.(&ate" the )orce" o)
.a"tication and "$a&&o$in*/ the F&e+i5Po"t de#e&oer" co.ared the c!c&ic5)ati*(e
re"(&t" )ro. D endodontic o"t "!"te."
*% Self&Threading "arallel&Threaded "osts
T$o rincia& "e&)5threadin* ara&&e& o"t" are c(rrent&! o(&ar/ the V5Loc7 and the
Radi+ Anchor S!"te., Both ha#e &o$ )re0(enc! "har thread"/ and %#th )!e 8ente/ to
red(ce h!dra(&ic ce.entation "tre"", The" /300e! 3n the (en6th #0 the th!e)/$ /#2n the
$h)0t7
"arallel +&Loc( Drill and "ost System
The $ide&! "earated D&3c!#=th!e)/$E o) the V5Loc7 o"t e+tend 2,=.. )ro. the "ha)t
and contin(e it" )(&& &en*th, V5Loc7 o"t" are "(&ied $ith reci"e dri&&" that reare a
ara&&e&5$a&&ed cana& '("t "&i*ht&! &ar*er than the o"t "ha)t, The! can %e ce.ented $ith
an! ce.ent or adhe"i#e,
"ost retention# An Ore*on "t(d! )o(nd that V5Loc7 o"t" $ere &e"" than ha&) a" retenti#e
:113&%"; a" F&e+i5Po"t" :3H2&%"; and 0(ite co.ara%&e to a""i#e Para5Po"t" :12D&%";
Stress from Installation# At Crei*hton/ $or7er" e#a&(ated the o""i%i&it! o) crac7" or
)ract(re" ari"in* )ro. the in"ertion o) V5Loc7 o"t" and )o(nd none
Stress from !astication# At Te+a"/ San Antonio/ B(r*e"" reorted that V5Loc7 o"t"
$ere the .o"t re"i"tant to co.re""i#e &oadin*/ "o.e$hat .ore than F&e+i5Po"t or Para5
Po"t,
"arallel Radi) Anchor System
Li7e the other acti#e5retenti#e o"t"/ Radi+ Anchor o"t" *ain their ri.ar! retention
%! "e&)5c(ttin* co(nter thread" in the dentin, A" a ara&&e& o"t/ the Radi+ di))er" )ro.
the V5Loc7 o"t %! the n(.%er o) it" thread"/ $hich are "har &o$5)re0(enc! he&ica&
%&ade" that e+tend on&! art&! do$n the "ha)t, It i" #ertica&&! #ented, The Radi+ o"t i"
de"i*ned to )it "n(*&! in a channe& reared )or it in the root, It can %e ce.ented $ith
an! ce.ent/ %(t co.o"ite re"in/ a&"o ("ed to %(i&d( the core/ "ee." re)erred,
"ost Retention# Beca("e o) the &i.ited n(.%er o) thread"/ the Radi+ Anchor ha" &e""
retention than other acti#e&! retained o"t", Moreo#er/ i) the cana& i" o#oid or too
)&arin*/ the %&ade" ne#er contact dentin, In that ca"e/ it ha" hard&! .ore retention in
ce.ent than a ".ooth o"t,
Stress from Installation# I) the o"t i" )(&&! "eated :)(&&! en*a*e" the %e#e& rod(ced %!
the t$i"t dri&& at the channe& ae+;/ "e#ere "tre"" &e#e&" $i&& en"(re, To o%#iate aica&
"tre"" $ith Radi+ o"t"/ the! can %e co(nter5rotated one ha&)5t(rn a)ter re"i"tance i"
detected
Perha" the .o"t critica& a"ect o) ara&&e&5"ided threaded de"i*n i" the initia& threadin*
in"ertion and the &ater ce.entation, Fo&&o$in* channe& rearation/ the o"t i" care)(&&!
threaded into the dentin, It i" then %ac7ed o(t to %e ret(rned )or )ina& ce.entation, In the
initia& threadin* oeration/ Ro""/ Nicho&&"/ and Harrin*ton noted that the R)/3< Anch#!
6ene!)te/ &#!e )'3c)( !##t $t!)3n$ th)n )n" #the! '#$tB <A3F .icro5inche"Minch
o) "train #", HF3 )or the V5Loc7/ and <AA )or the F&e+i5Po"t, Aica& "train" d(rin*
ce.entation $ere near&! a" %adB 1HA< )or the Radi+/ AH< )or the V5Loc7/ and <1D
)or the F&e+i5Po"t, The a(thor" )e&t that the "harne"" o) the thread" and the
di))ic(&t! o) er)ect&! a&i*nin* the (nthreaded aica& end o) the o"t $ith the
reared channe& %oth &a!ed a "i*ni)icant ro&e in "train rod(ction,
Stress from !astication# The Radi+ Anchor o"t *enerate" *reater "tre"" (nder
o%&i0(e co.re""i#e )orce" than the @(rer o"t/ )or e+a.&e,
c% "arallel Threaded "osts with "re&Tapped Channels "ee 5DF .--> )($#
The @(rer Anchor o"t" are the on&! o"t" on the .ar7et that )it into re5taed co(nter5
thread" in the dentin, A" "(ch/ the! are the &#$t !etent38e '#$t$ )8)3()%(e/ no .atter
$hat the ce.entin* .edi(., @(rer anchor o"t" are ara&&e& in de"i*n $ith n# 8e!t3c)(
8ent7 The! ha#e !#n/e/ h36h=0!e;enc" th!e)/$ that )it into co(nterthread" 6taed?
into the dentin $ith a &)n)( th!e)/ ctte!, The! co.e in a n(.%er o) con)i*(ration",
An#the! n3;e 0e)t!e #0 the B!e! Anch#! 3$ the B!e! R##t F)ce! that reare" a
)&at "eat in the root )ace into $hich the corona& ortion i" to )it er)ect&!, Thi" o%#iate" the
ro%&e. o) Radi+ Anchor :)ittin* a*ain"t an (ne#en root "(r)ace;,
@(rer Root5Facer ("ed to 6.i&&? a )&at )o(ndation in root rearation )or cro$n o"t head,
"ost Retention# Para&&e&5"ided/ threaded o"t"/ ce.ented into taed channe&"/ are
$'e!3#! 3n !etent3#n t# )(( #the! '#$t /e$36n$,
Stress from Installation# @(rer o"t" rod(ce $e8e!e )'3c)( $t!e$$ &e#e&" i) the ae+ o) the
o"t )(&&! en*a*e" the %e#e& rod(ced %! the t$i"t dri&& at the channe& ae+,
Stress from !astication# -hen @(rer o"t" are ce.ented into their taed channe&"/ their
%())erin* e))ect i" &e"" rono(nced than it i" )or other de"i*n", The .ain &oad tran")er
ta7e" &ace %et$een the thread" and the dentin
N#n=&et)((3c '#$t$
F3%e! !e3n0#!ce/ '#$t$
C)!%#n=03%e! '#$t$ :G)(t!#6h )n/ M)nn#cc3A
In 1EE2/ D(ret/ Re!na(d and D(ret introd(ced a non5.eta&&ic .ateria& %a"ed on the
car%on5)i%er rein)orced rinci&e o"t" .ade o) thi" .ateria& con"i"ted o) )i%er" o) car%on
"(rro(nded %! a .atri+ o) o&!.er re"in/ ("(a&&! an eo+! re"in, A $ide #ariet! i"
a#ai&a%&e and inc&(de" ara&&e&5"ided/ taered/ ".ooth and "errated )or.",
Their .ain roo"ed ad#anta*e $a" that the! $ere 1; .ore )&e+i%&e than .eta& o"t" and
3; had aro+i.ate&! the "a.e .od(&(" o) e&a"ticit! a" dentin, Thi" roert! a&&o$ed the
o"t to "tre"" (nder &oad? !e$(t3n6 3n the %ette! /3$t!3%t3#n #0 $t!e$$e$ %et2een the
'#$t )n/ the /ent3n? )n/ &3n3&3@3n6 !3$9 #0 0!)ct!e7
The .ain di"ad#anta*e" o) the car%on )i%er o"t are it" /)!9 c#(#! )n/ !)/3#(cent
)''e)!)nce 3n ) !)/3#6!)'h7 More recent #ariation" are >irconi(. coated :Ae"theti
P&("/ Bi"co; and hence/ $hite in co&or, The! are re&ati#e&! ea"! to re.o#e %! %orin*
thro(*h the .idd&e o) the o"t $ith an (&tra"onic or rotar! in"tr(.ent, The orientation o)
the )i%er" he& 7ee the in"tr(.ent roer&! a&i*ned,
Adhe"i#e "!"te." )or. $ea7er %ond" to car%on5)i%er o"t" than to "tain&e"" "tee& and
titani(. %(t "tron*er than to >irconi(. dio+ide, The $ater "ortion and "o&(%i&it! a&"o
#ar! $ith %rand and ho.o*eneit! o) o&!.er .atri+ and .a! a))ect the h!dro&!tic
"ta%i&it! o) the co.o"ite "tr(ct(re, In one "t(d!/ $ater i..er"ion $a" )o(nd to red(ce
the "tren*th and "ti))ne"" to a%o(t H25D2C o) the dr! #a&(e", The"e o"t" a&"o e+hi%ited a
"i*ni)icant decrea"e in "tren*th a)ter ther.oc!c&in*, Thi" ha" %een attri%(ted to
de*radation o) the )i%er" or the .atri+ and to di))erence in ther.a& e+an"ion coe))icient"
%et$een the t$o,
CONTENTS AND MECHANICAL PROPERTIES OF SOME FIBER5REINFORCED
ROOT CANAL POSTS
POST CONTENTS
FLENURAL
MODULUS
:GPa;
FLENURAL
STRENGTH :Ma;
Co.o"io"t :RTD; Car%on )i%er DAC/eo+! 1A= 1/=22
Li*ht5Po"t :RTD; Q(art> )i%er D2C/eo+! AD 1/A22
L("cent :Dentat("; Q(art> )i%er H2C,Po&!e"ter A2 FE2
ParaPo"tFi%er-hite G&a"" )i%er A3C/)i&&er 3EC 3E EE2
:Co&teneM-ha&edent; .ethacr!&ate re"in 3EC
Po"tec
:I#oc&arVi#adent; G&a"" )i%er D1,DC/(rethane A= 1/<E2
di.ethacr!a&ate 1F,<C
trieth!&ene *&!co&di.ethacr!&ate H,DC
Othe! 03%e!=!e3n0#!ce/ '#$t$
Car%on5)i%er o"t" are %&ac7 in co&or and do not &end the."e&#e" to e"thetic re"toration"
$ith a&&5cera.ic (nit", Thi" &ed to the introd(ction o) "i&ica5)i%er o"t" :*&a"" )i%er and
0(art> )i%er5 %oth t!e o) "i&ica; that are tran"&(cent and tooth co&ored, The"e o"t" are
*&a""5)i%er :S *&a""; and 0(art>5)i%er o"t", Another t!e o) )i%er ("ed in o"t" i"
%onda%&e ri%%on $o#en o&!eth!&ene :Ri%%ond;/ $hich can a&"o %e ("ed $ith co.o"ite
to create an entire&! c("to. ca"t do$e& and inte*rated core, Thi" %onda%&e ri%%on o"t
and core $a" "ho$n to ha#e "i*ni)icant&! &o$er )ract(re re"i"tance than CFP"/ .eta& o"t"
and c("to. ca"t o"t",
Advantages
Greater )&e+(re and )ati*(e "tren*th than .eta& or >irconi(. o"t",
Mod(&(" o) e&a"ticit! c&o"e to dentin,
A%i&it! to )or. a "in*&e %onded co.&e+ $ithin the root cana& )or a (ni)ied root5
o"t co.&e+ :.ono%&oc;,
I.ro#ed e"thetic",
Their roertie" ha#e the otentia& to rein)orce a co.ro.i"ed root and to
di"tri%(te "tre"" .ore (ni)or.&! on &oadin* to re#ent root )ract(re,
Ea"! to re.o#e %! c(ttin* thro(*h the o"t, The )i%er" 7ee the %(r centered,
The"e o"t" $i&& !ie&d to "tre""/ %e)ore root )ract(re occ(r"/ %etter than ca"t or
re)a%ricated .eta& o"t",
Recent "t(die" ha#e "ho$n that "and%&a"tin* the"e o"t" rior to ce.entation increa"e"
retention,
COMMON PASSIVE POST SOSTEMS
BRAND NAME TOPE OF POST MANUFACTURER
C5Po"t Car%on )i%er RTDMBi"co
Ae"theti5P&(" Q(art> )i%er RTDMBi"co
D,T,Li*ht5Po"t Q(art> )i%er RTDMBi"co
Fi%er7or G&a"" )i%er GenericMentron
Co".oo"t Jirconi(. Vi#adent
Sno$ Po"t Jirconi(. Dan#i&&e
L(cent Anchor G&a"" )i%er Dentat("
Parao"t -hite G&a"" )i%er Co&teneM-ha&edent
Ce!)&3c )n/ H3!c#n3& '#$t$ :Sch2)!t@ )n/ R#%%3n$) )/8= e$thet3c I
%3#c#&')t3%3(3t"
Another e"thetic a&ternati#e to .eta& and car%on )i%er o"t" are the cera.ic o"t", In
1EEA/ Sandha(" and Pa"che introd(ced the re)a%ricated >irconia endodontic o"t, The"e
o"t" $or7 c&inica&&!/ %(t ha#e "e#era& di"ad#anta*e"B
A" a *ro(/ the! tend to %e $ea7er than .eta& o"t"/ "o a thic7er o"t i" nece""ar!/
$hich re0(ire" re.o#a& o) additiona& radic(&ar tooth "tr(ct(re,
Tho(*h the a&&5>irconi(. o"t i" reorted to ha#e a .od(&(" o) e&a"ticit! hi*her than
that o) "tain&e"" "tee&/ it" )ract(re re"i"tance i" &o$,
Jirconi(. o"t" cannot %e etched $ith h!dro)&(oric acidI there)ore/ it i" not o""i%&e
to %ond a co.o"ite core .ateria& to the o"t/ .a7in* core retention a ro%&e., To
o#erco.e thi"/ a techni0(e ha" %een de"cri%ed $here%! a &e(cite5rein)orced cera.ic
core .ateria& :E.re""; i" re""ed onto the >irconi(. o"t,
Retrie#a& o) >irconi(. and other cera.ic o"t" i" #er! di))ic(&t i) endodontic
retreat.ent i" nece""ar! or i) the o"t )ract(re", So.e cera.ic .ateria&" can %e
re.o#ed %! *rindin* a$a! the re.ainin* o"t .ateria& $ith a %(r/ %(t thi" i" a tedio("
and dan*ero(" roced(re, It i" i.o""i%&e to *rind a$a! a >irconi(. o"t )ro. a
cana& &ace.ent, For the"e rea"on"/ cera.ic and >irconi(. o"t" "ho(&d %e a#oided,
A((=Ce!)&3c P#$t )n/ C#!e :B#t)")$ )n/ Be!nA
A&.o"t "i.(&taneo("&! $ith the introd(ction o) the c(rrent a&&5cera.ic "!"te."/ the ("e
o) a&&5cera.ic o"t" and core" $a" "(**e"ted a" an a&ternati#e to "o&#e the e"thetic
ro%&e." that .eta& o"t" and core" e+hi%it, In 1EFE/ @$iato$"7i and Ge&&er de"cri%ed
the c&inica& a&ication o) 6()$$=ce!)&3c '#$t$ )n/ c#!e$ and in 1EE1/ @ern and @node
introd(ced o"t" and core" .ade o) 6()$$ 3n03(t!)te/ )(&3n3& #<3/e ce!)&3c, In 1EE=/
Pi""i" roo"ed a techni0(e )or the )a%rication o) a o"t and core and a cro$n a" a "in*&e
co.onent .ade o(t o) *&a""5cera.ic .ateria&, In 1EEA and 1EE=/ Sandha(" and Pa"che
and other" introd(ced re)a%ricated >irconia cera.ic endodontic o"t" to re"torati#e
denti"tr!, The! a&"o "(**e"ted ("e o) >irconia cera.ic )or the )a%rication o) core %(i&d(
and o"t in one iece,
The &)J#! )/8)nt)6e #0 )n )((=ce!)&3c '#$t )n/ c#!e 3$ 3t$ /ent3n (39e $h)/e7 The
o"iti#e contri%(tion o) the dentin "hade cera.ic core i" re&ated to the deeer di))("ion
and a%"ortion o) the tran".itted &i*ht in the cera.ic core .a"", An a&&5cera.ic
re"toration tran".it" a certain ercenta*e o) the incident &i*ht to the cera.ic core and
o"t on $hich it had %een &aced, Th("/ $ith a&& cera.ic o"t" and core"/ the co&or o) the
)ina& re"toration $i&& %e deri#ed )ro. an interna& "hade "i.i&ar to the otica& %eha#io(r o)
nat(ra& teeth, In addition/ a cera.ic o"t doe" not re)&ect inten"i#e&! thro(*h thin *in*i#a&
ti""(e"/ and 3t '!#83/e$ )n e$$ent3)( /e'th #0 t!)n$(cenc" 3n the ce!83c)( !##t )!e)$,
The" )!e )($# %3#c#&')t3%(e )n/ /# n#t e<h3%3t 6)(8)n3c c#!!#$3#n7
Re&ati#e&! (#2 0!)ct!e $t!en6th )n/ t#6hne$$ )!e the &)3n #%$t)c(e$ )or an e+tended
("e o) con#entiona& denta& cera.ic" a" o"t and core .ateria&", Hi*h to(*hne"" cera.ic"/
"(ch a" the *&a""5in)i&trated a&(.ina :In5cera.; and the den"e5"intered a&(.ina cera.ic
:Procera;/ "ho$ a <5D ti.e" hi*her )&e+(ra& "tren*th and )ract(re to(*hne"" than do
con#entiona& )e&d"athic and *&a"" cera.ic", Conte.orar! >irconia o$der techno&o*!
contri%(te" to the )a%rication" o) ne$ %ioco.ati%&e cera.ic .ateria&" $ith i.ro#ed
.echanica& roertie"/ i,e, )(rther increa"ed )&e+(ra& "tren*th and )ract(re to(*hne"",
There)ore/ >irconi(. o+ide cera.ic "ee." to %e a #er! ro.i"in* .ateria& )or the
)a%rication o) a&& cera.ic o"t" and core",
Other" 4 root rein)orcin* o"t
5 corona& radic(&ar o"t
THE CORE
The core i" de)ined a" a re"torati#e .ateria& &aced in the corona& area o) a tooth to
re&ace the .i""in* corona& "tr(ct(re, The core i" anchored to the tooth %! e+tendin* into
the corona& a"ect o) the cana&/ or thro(*h the endodontic o"t, Thi" attach.ent %et$een
the core/ tooth and o"t can %e .echanica&/ che.ica& or %oth,
A&tho(*h/ the re.ainin* tooth "tr(ct(re can %e a&tered %! &ace.ent o) in"/ *roo#e" or
channe&" in dentin/ to retain a core and ro#ide re"i"tance to rotation/ the"e .odi)ication"
$ea7en the re.ainin* tooth "tr(ct(re, In .o"t ca"e"/ the irre*(&ar nat(re o) the re"id(a&
corona& tooth "tr(ct(re and the nor.a& .orho&o*! o) the (& cha.%er and cana&
ori)ice" e&i.inate the need )or the"e tooth a&teration", U"in* re"torati#e .ateria&" that
%ond to tooth "tr(ct(re enhance" retention and re"i"tance $itho(t the need )or re.o#a& o)
#a&(a%&e dentin,
deal properties o' the core material:
Hi*h co.re""i#e and ten"i&e "tren*th,
Hi*h .od(&(" o) e&a"ticit! :ri*idit!;,
Hi*h )ract(re to(*hne"",
Di.en"iona& "ta%i&it!,
Ea"e o) .ani(&ation,
Short "ettin* ti.e,
The a%i&it! to %ond to %oth tooth and o"t,
Bioco.ati%i&it!,
Inert :no corro"ion;,
Nat(ra& tooth co&or/ $hen indicated,
Lo$ &a"tic de)or.ation,
Lo$ co"t,
C#!e &)te!3)($:
1, Ca"t core
3, A.a&*a.
<, Co.o"ite
A, G&a"" iono.er ce.ent
=, Re"in .odi)ied *&a"" iono.er ce.ent
C)$t C#!e
A ca"t o"t and core i" the traditiona& $a! to re"tore endodontica&&! treated teeth, The
core i" an inte*ra& e+ten"ion o) the do$e& and "o doe" not deend on .echanica& .ean"
)or retention to the o"t, Thi" con"tr(ction a#oid" di"&od*e.ent o) the core )ro. the o"t
and root $hen .ini.a& tooth "tr(ct(re re.ain", No%&e .eta&" are non5corro"i#e, Cera.ic
core" can a&"o %e inte*rated $ith >irconia do$e&" in "i.i&ar &a%orator! roced(re",
Disadvantages
Ca"t o"t and core are "ho$n to ha#e a hi*her rate o) root )ract(re than
re)a%ricated o"t and core,
E+en"i#e,
La%orator! ha"e i" techni0(e "en"iti#e, Ca"tin* a attern $ith a &ar*e core and a
".a&& dia.eter o"t can re"(&t in oro"it! in the *o&d at the core5o"t inter)ace,
Fract(re .a! occ(r at thi" inter)ace d(rin* )(nction,
Ca"tin* a core to a re)a%ricated "tain&e"" "tee& o"t de*rade" the h!"ica&
roertie" o) the o"t/ re"(&tin* in a o"t and core not "())icient&! "tron* or inert
to $ith"tand c&inica& )orce",
A&)(6)& C#!e
A.a&*a. i" a traditiona& core %(i&d( .ateria& $ith a &on* hi"tor! o) c&inica& "(cce"",
Advantages
Hi*h co.re""i#e "tren*th,
Hi*h .od(&(" o) e&a"ticit!,
Sta%&e (nder ther.a& and )(nctiona& "tre""e" and there)ore/ tran".it" .ini.a&
"tre"" to the tooth and ce.ent and cro$n .ar*in",
Bonded a.a&*a. i.ro#e" the "ea& at the tooth and a&&o! '(nction,
A.a&*a. i" ea"i&! .ani(&ated and ha" a raid "ettin* ti.e,
P&ace.ent o) a )a"t5"ettin* hi*h5coer a&&o! er.it" )ina& cro$n rearation at the initia&
oerati#e aoint.ent/ a&tho(*h ear&! "tren*th i" &o$, A.a&*a. core" are hi*h&!
retenti#e $hen ("ed a" corona&5radic(&ar re"toration" or $ith re)a%ricated "tain&e"" "tee&
do$e&"I the! re0(ire .ore )orce to di"&od*e than ca"t o"t core",
Disadvantages
Potentia& )or corro"ion and "(%"e0(ent di"co&oration o) the *in*i#a or re.ainin*
dentin,
Dar7 co&o(red/ "o cannot %e ("ed in anterior",
It" ("e i" dec&inin* $or&d$ide %eca("e o) &e*i"&ati#e/ "a)et! and en#iron.enta&
i""(e",
Lo$ ear&! "tren*th 4 tooth rearation cannot %e done on "a.e at,
Not %onda%&e to tooth "tr(ct(re5 e+cetion %ein* %onded a.a&*a.
C#&'#$3te Re$3n c#!e
C(rrent&! co.o"ite re"in i" the .o"t o(&ar core %(i&d( .ateria&,
Advantages
It can %e %onded to .an! o) the c(rrent o"t" and to the re.ainin* tooth "tr(ct(re
to increa"e retention,
It ha" hi*h co.re""i#e and ten"i&e "tren*th,
Ea"! to .ani(&ate and raid "et, The tooth can %e reared )or a cro$n
i..ediate&! o)ten o&!.eri>ation,
St(die" ha#e "ho$n that co.o"ite core" ha#e )ract(re re"i"tance co.ara%&e to
a.a&*a. and ca"t o"t and core"/ $ith .ore )a#ora%&e )ract(re" $hen the! )ai&,
Tooth co&ored,
Disadvantages
Co.o"ite "hrin7" d(rin* o&!.eri>ation ca("in* *a )or.ation in the area"
$here adhe"ion i" $ea7e"t,
It a%"or%" $ater a)ter o&!.eri>ation ca("in* it to "$e&&, -ater "ortion a&"o
red(ce" it" "tren*th,
St(die" ha#e "ho$n that ther.oc!c&in* red(ce" "tren*th,
Under*oe" &a"tic de)or.ation (nder reeated &oad",
Adhe"ion to dentin on the (&a& )&oor i" *enera&&! not a" "tron* or re&ia%&e a" to
corona& dentin,
Strict i"o&ation i" an a%"o&(te re0(ire.ent, I) dentin "(r)ace i" conta.inated $ith
%&ood or "a&i#a d(rin* %ondin* roced(re"/ the adhe"ion i" *reat&! red(ced,
Co.o"ite i" not a *ood choice $ith .ini.a& re.ainin* tooth "tr(ct(re
artic(&ar&! i) i"o&ation i" a ro%&e.,
Recent&!/ co.o"ite .ateria&" "eci)ica&&! )or core %(i&d( ha#e %een introd(ced in the
.ar7et, The"e areB
Se&) c(re e,*, C&ear)i& Core/ Core Pa"te/ Re%i&da/ etc,
Li*ht c(re e,*, C&ear)i& Photocore/ LC core/ etc,
D(a& c(re e,*, L(+acore A(to.i+ D(a&/ DC F&o$ Core/ etc,
F&o$a%&e co.o"ite" are a&"o a#ai&a%&e e,*, F&o$ Core, So.e rod(ct" ha#e )&(oride
incororated in the. e,*, Core Pa"te $ith F&(oride, The"e co.o"ite" ha#e hi*h
co.re""i#e "tren*th and .an! rod(ct" are radioa0e,
G()$$ I#n#&e! C#!e
Advantages
Their .a'or %ene)it i" an anticario*enic 0(a&it! d(e to )&(oride re&ea"e,
U"e)(& )or ".a&& %(i&d(" or to )i&& (nderc(t" in reared teeth/ a" the! are
adhe"i#e .ateria&",
Disadvantages
Lo$ "tren*th and )ract(re to(*hne"" re"(&t in %ritt&ene""/ $hich contraindicate"
their ("e in thin anterior teeth or to re&ace (n"(orted c("",
E+hi%it &o$ retention to re)a%ricated .eta& o"t",
So&(%&e and "en"iti#e to .oi"t(re, Adhe"i#e )ai&(re can occ(r )ro. conta.ination
o) the tooth "(r)ace $ith de%ri"/ "a&i#a/ %&ood or rotein,
Not "tron* eno(*h )or a core )or an FPDMRPD a%(t.ent tooth,
Indicated in o"terior teeth in $hichB
1, Li.ited to ".a&& re"toration" in $hich core retention i" not needed,
3, B(&7 o) core .ateria& i" o""i%&e,
<, Si*ni)icant "o(nd dentin re.ain",
A, Additiona& retention i" a#ai&a%&e $ith in"/ *roo#e" or channe&",
=, Moi"t(re contro& i" a""e""ed,
D, Carie" contro& i" indicated,
Re$3n &#/303e/ 6()$$ 3#n#&e! c#!e
The"e .ateria&" ha#e roertie" o) %oth co.o"ite" and *&a""5iono.er ce.ent",
Advantages
F&(oride re&ea"e,
Moderate "tren*th, Greater than GIC/ &e"" than co.o"ite,
Bond "tren*th "i*ni)icant&! hi*her than GIC,
E+hi%it .ini.a& .icro&ea7*e,
So&(%i&it! i" in %et$een that o) GIC and co.o"ite,
Disadvantages
H!*ro"coic e+an"ion o) the"e .ateria&" can ca("e )ract(re o) cera.ic cro$n",
A" a core .ateria&/ it i" ade0(ate )or .oderate "i>e %(i&d(",
5IOMECHANICAL PRINCIPLES OF POST AND CORE PREPARATION
5 C#n$e!8)t3#n #0 t##th $t!ct!e:
o Prearation o) the cana&
o con"er#ation o) corona& ti""(e
5 Retent3#n 0#!&
o Anterior teethB
Prearation *eo.etr!
Po"t &en*th
Po"t dia.eter
Po"t "(r)ace te+t(re
L(tin* a*ent
Po"t .ateria& :cohen;
o Po"terior teethB
5 Re$3$t)nce 0#!&:
o Stre"" di"tri%(tion
o Rotationa& re"i"tance
C#n$e!8)t3#n #0 t##th $t!ct!e
Root cana&B
-hen creatin* o"t "ace/ the ractitioner "ho(&d ("e *reat care to re.o#e on&!
.ini.a& tooth "tr(ct(re )ro. the cana& Th(" it i" reco..ended that the root cana& %e
en&ar*ed on&! the a.o(nt nece""ar! to ena%&e the o"t to )it "n(*&! )or "tren*th and
retention, En&ar*e.ent "e&do. need" to e+ceed one or t$o additiona& )i&e "i>e"
%e!ond the &a"t )i&e ("ed )or endodontic treat.ent,
Po"t $idthB Dia.eter o) the o"t at tiB "ho(&d not %e .ore than one third the dia.eter
o) root
2,D..B &o$er inci"or
1.. B (er inci"or/ canine
2,F .. B .o"t teeth,
Po"t "ho(&d not e+ceed 1.. at it" ti, More %one "ho(&d %e &e)t %(cca& to the o"t,
Corona& ti""(eB
A" .(ch o) the corona& tooth "tr(ct(re "ho(&d %e con"er#ed a" o""i%&e %eca("e
thi" he&" red(ce "tre"" concentration at the *in*i#a& .ar*in It ha" %een "ho$n
e+eri.enta&&! that i) .ore than 3.. o) corona& tooth "tr(ct(re re.ain"/ the o"t de"i*n
&a!" &itt&e ro&e in the )ract(re re"i"tance o) the re"tored tooth, Incororation o) thi" tooth
"tr(ct(re $ithin the )ina& re"toration ro#ide" the )err(&e,
Retent3#n 0#!&
Po"t retention i" de)ined a" the a%i&it! o) a o"t to re"i"t #ertica& di"&od*in* )orce",
Retention o) a o"t i" a))ected %!B
1, Prearation *eo.etr! and o"t de"i*n,
3, Po"t &en*th,
<, Po"t dia.eter,
A, S(r)ace te+t(re,
=, L(tin* a*ent,
D, N(.%er o) o"t",
H, o"t .ateria& :cohen;
1; Po"t de"i*n and rearation *eo.etr!B
Circ(&ar cana&" can %e reared $ith dri&&" or rea.er" to *i#e ara&&e& $a&&" or
.ini.(. taer/ a&&o$in* ("e o) ara&&e&5re)a%ricated o"t, E&&itica& or e+ce""i#e&!
)&ared cana&" cannot %e reared to *i#e ara&&e& $a&&" and re0(ire c("to. ca"t o"t"
or taered re)a%ricated o"t",
3; Po"t &en*thB
Retention increa"e" $ith increa"e in o"t &en*th, One "t(d! "ho$" that retention
increa"e" %! .ore than EHC $hen o"t &en*th e0(a&" or i" *reater than cro$n &en*th
:Soren"en and Martino));, Ho$e#er/ thi" &en*th .("t %e $e&& $ithin con"traint" o)
tooth &en*th/ cana& .orho&o*! and root dia.eter in the aica& area, Vario(" criteria
)or o"t &en*th areB
1, Mini.(. o) =.. o) aica& *(tta5ercha )i&& "ho(&d %e re.ainin*,
3, Po"t &en*th "ho(&d %e e0(a& to 3M<
rd
o) root &en*th or *reater,
<, Po"t &en*th "ho(&d %e at &ea"t e0(a& to the cro$n &en*th,
A, -hen %one "(ort i" &e""/ the o"t "ho(&d e+tend at &ea"t ha&) the &en*th o) root
in the re.ainin* %one,
<; Po"t dia.eterB
-hether o"t" are ce.ented or threaded/ dia.eter .a7e" &itt&e di))erence in retenti#e
a%i&it!, Thi" i" %eca("e o"t" are not &aced in er)ect c!&indrica& cana&", In .an!
ca"e" the cana& i" ri%%on or e&&itica& "haed/ re"(&tin* in #aria%&e ce.ent thic7ne"" or
&ac7 o) tota& en*a*e.ent, Th("/ dia.eter #ariation" are o) &itt&e concern )or ro#idin*
retention,
A; S(r)ace te+t(reB
A "errated or ro(*hened o"t i" .ore retenti#e than a ".ooth one, Ro(*henin* can %e
done $ith "and%&a"tin*,
=; L(tin* a*entB
An! o) the c(rrent &(tin* ce.ent" can %e "(cce"")(&&! ("ed $ith a o"t i) the roer
rinci&e" are )o&&o$ed, The .o"t co..on&! ("ed &(tin* a*ent" areB >inc ho"hate/
re"in/ *&a""5iono.er and re"in5.odi)ied *&a"" iono.er, Ho$e#er/ Re"in5.odi)ied
*&a"" iono.er ce.ent" "ho(&d %e a#oided a" the! e+and on $ater a%"ortion and
.a! ca("e root )ract(re,
Genera&&!/ in the a"t/ >inc ho"hate $a" the ce.ent o) choice/ %(t/ recent trend ha"
%een to$ard re"in ce.ent" %eca("e the!B
Increa"e retention,
Tend to &ea7 &e"" than other ce.ent",
Pro#ide at &ea"t "hort ter. "tren*thenin* o) the root
D; N(.%er o) o"t"B
It i" o""i%&e to &ace .ore than one o"t in teeth $ith .(&ti&e root", Additiona& o"t"
.a! %e ("ed/ $here )ea"i%&e/ to increa"e retention and retain core .ateria&/ e"ecia&&! in
"e#ere&! %ro7en do$n teeth,
C#n$3/e!)t3#n$ 0#! '#$te!3#! teeth:
Re&ati#e&! &on* or circ(&ar o"t" "ho(&d %e a#oided in o"terior teeth $ith c(r#ed ri%%on5
"haed M e&&itica& cana&", For the"e teeth/ ("in* "hort o"t" in di#er*ent cana&" ro#ide"
%etter retention,

I) a ca"t core i" ("ed/ it can %e .ade in "ection" that ha#e di))erent ath" o) $ithdra$a&,
A&ternati#e&!/ the $ide"t cana& i" "e&ected )or the .a'or o"t and then "hort a(+i&iar! o"t
"ace" are reared in the other cana&" $ith the "a.e ath o) $ithdra$a&,

Re$3$t)nce 0#!&
Re"i"tance i" de)ined a" the a%i&it! o) the o"t and tooth to $ith"tand &atera& and
rotationa& )orce",
Stre"" di"tri%(tionB
One o) the )(nction" o) a o"t and core re"toration i" to i.ro#e re"i"tance to &atera&&!
directed )orce" %! di"tri%(tin* the. o#er a" &ar*e an area a" o""i%&e, Ho$e#er/
e+ce""i#e rearation o) the root $ea7en" it and increa"e" the ro%a%i&it! o) )ai&(re,
The o"t de"i*n "ho(&d di"tri%(te "tre""e" a" e#en&! a" o""i%&e,
The in)&(ence o) o"t de"i*n on "tre"" di"tri%(tion ha" %een te"ted ("in* hotoe&a"tic
.ateria&"/ "train *a(*e" and )inite e&e.ent ana&!"i", Fro. the"e &a%orator! "t(die"/ the
)o&&o$in* conc&("ion" ha#e %een dra$n :Ro"en"tie&;B
1, The *reate"t "tre"" concentration" are )o(nd at the "ho(&der/ artic(&ar&! inter5
ro+i.a&&! and at the ae+, Dentin "ho(&d %e con"er#ed in the"e area",
3, Stre"" i" red(ced a" o"t &en*th increa"e", B(t e+ce""i#e &en*th red(ce" the
thic7ne"" o) dentin at the aica& area and hence the )ract(re re"i"tance decrea"e",
<, Para&&e&5"ided o"t" di"tri%(te "tre""e" .ore e#en&! than taered o"t"/ $hich can
ha#e a $ed*in* e))ect, Ho$e#er/ ara&&e& o"t" *enerate hi*h "tre""e" at the ae+,
A, Shar an*&e" "ho(&d %e a#oided a" the! rod(ce hi*h "tre""e" d(rin* &oadin*,
=, Hi*h "tre"" can %e *enerated d(rin* in"ertion" o) ".ooth ara&&e&5"ided o"t" that
ha#e no #ent )or e"cae o) ce.ent", There)ore/ the"e o"t"/ &on*it(dina& *roo#e"
:#ent"; r(nnin* a&on* the &en*th o) the o"t "ho(&d %e ro#ided to a&&o$ e"cae o)
ce.ent th(" red(cin* the h!dro"tatic re""(re and *eneration o) "tre"", Taered
o"t" are "e&)5#entin* and *enera&&! do not re0(ire #ent",
D, Threaded o"t" can rod(ce hi*h "tre""e" d(rin* in"ertion and &oadin*/ %(t the!
ha#e %een "ho$n to di"tri%(te "tre"" e#en&! i) the o"t" are %ac7ed o)) a ha&)5t(rn,
H, The ce.ent &a!er re"(&t" in a .ore e#en "tre"" di"tri%(tion to the root $ith &e""
"tre"" concentration,
In addition/ )i%er :car%on and *&a""; rein)orced o"t" rod(ce .ore e#en "tre""
di"tri%(tion a&on* the &en*th" o) the root than the .eta& o"t",
R#t)t3#n)( Re$3$t)nce:
It i" i.ortant that a o"t $ith a circ(&ar cro"" "ection not rotate d(rin* )(nction, -here
"())icient corona& tooth "tr(ct(re re.ain"/ thi" "ho(&d not re"ent a ro%&e. %eca("e the
a+ia& $a&& then re#ent" rotation, -hen corona& dentin ha" %een co.&ete&! &o"tB
5 A ".a&& *roo#e &aced in the cana& can "er#e a" an anti5rotationa& e&e.ent,
The *roo#e i" nor.a&&! &aced $here the root i" %(&7ie"t/ ("(a&&! on the
&in*(a& a"ect,

5 An a(+i&iar! in on the root )ace can re#ent rotation,
5 Rotation o) a threaded o"t can %e re#ented %! rearin* a ".a&& ca#it!5
ha&) in the o"t/ ha&) in the root and conden"in* a.a&*a. into it a)ter
ce.entation o) the o"t,
5 Additiona& ce.ented o"t" in .(&tirooted teeth,
5 O#a& or e&&itica& cana&",
The Fe!!(e:
Ro"en in 1ED1 de"cri%ed the e+tracorona& %race :)err(&e; and de)ined it a" 6P,a
"(%*in*i#a& co&&ar or aron o) *o&d $hich e+tend" a" )ar a" o""i%&e %e!ond the *in*i#a&
"eat o) the core and co.&ete&! "(rro(nd" the eri.eter o) the cer#ica& art o) the tooth, It
i" an e+ten"ion o) the re"tored cro$n $hich/ %! it" h(**in* action/ re#ent" #ertica&
"hatterin* o) the root?,
More recent&!/ Soren"en and En*e&.an :1EE2; de)ined Ferr(&e E))ect a" 6P,,a <D2Q
.eta& co&&ar o) the cro$n "(rro(ndin* the ara&&e& $a&&" o) the dentin e+tendin* corona& to
the "ho(&der o) the rearation, The re"(&t i" an e&e#ation in re"i"tance )or. o) the cro$n
)ro. the e+ten"ion o) dentina& tooth "tr(ct(re?,
The $a&&" and .ar*in" o) the cro$n or ca"t te&e"coic coin* enca"in* the *in*i#a& 3..
o) the a+ia& $a&&" o) the rearation )or. the )err(&e, A roer&! e+ec(ted )err(&e
"i*ni)icant&! red(ce" the incidence o) )ract(re in the non5#ita& tooth %! rein)orcin* the
root at it" e+terna& "(r)ace and a&"o %! di""iatin* )orce that concentrate" at the narro$e"t
circ(.)erence o) tooth,
A" de"cri%ed %! "e#era& a(thor"/ "tre"" in the radic(&ar dentin d(rin* )(nction i"
concentrated to the circ(.)erence o) the tooth/ $herea" the "tre"" &e#e& i" &o$e"t $ithin
the root cana&, The center o) the root i" a ne(tra& area $ith re*ard to "tre"" concentration/
and th(" no rein)orce.ent i" needed in thi" area, To rein)orce the tooth/ incororatin* a
)err(&e into the de"i*n o) the cro$n/ e.%racin* the circ(.)erence o) the root/ rotect" the
root $here the .a+i.(. )orce" occ(r, The )err(&e e))ect i" a 7e! )actor in the )ai&(re o)
o"t treated teeth,
Fract(re re"i"tance i" "i*ni)icant&! increa"ed $ith increa"in* )err(&e &en*th, The 0e!!(e
)($# !e$3$t$ ()te!)( 0#!ce$ 0!#& '#$t$ )n/ (e8e!)6e 0!#& c!#2n 3n 0nct3#n? )n/ 3t
3nc!e)$e$ the !etent3#n )n/ !e$3$t)nce #0 the !e$t#!)t3#n :C#henA7 A" a&read! "tated/
re"ence o) a )err(&e red(ce" the in)&(ence o) o"t de"i*n on the )ract(re re"i"tance o)
teeth,
To %e "(cce"")(&? the 0e!!(e &$t enc3!c(e ) 8e!t3c)( 2)(( #0 $#n/ t##th $t!ct!e
)%#8e the &)!63n )n/ &$t n#t te!&3n)te #n !e$t#!)t38e &)te!3)(, Both the cro$n
and cro$n rearation .("t .eet )i#e re0(ire.ent"B
1, At &ea"t 3.. o) dentin a+ia& $a&& hei*ht,
Stress in radicular dentin during function is
concentrated to circumference of tooth, stress
is lowest within root canal#
3, Para&&e& a+ia& $a&&",
<, Meta& .("t tota&&! encirc&e the tooth,
A, Mar*in" .("t %e on "o(nd tooth "tr(ct(re,
=, Cro$n and cro$n rearation .("t not in#ade the attach.ent aarat(",
Thi" .ean" that a +=> && he36ht )n/ 1&& th3c9ne$$ #0 $#n/ $'!)%#n" t##th
$t!ct!e $h#(/ %e )8)3()%(e t# )cc#&&#/)te the 'e!3#/#nt)( %3#(#63c 23/th )n/
the !e$t#!)t38e 0e!!(e7 A tooth $ith re.ainin* tooth "tr(ct(re that i" in"())icient to
con"tr(ct a )err(&e "ho(&d %e e#a&(ated )orB
5 eriodonta& cro$n &en*thenin* "(r*er!/ or/
5 orthodontic e+tr("ion,
to *ain acce"" to additiona& root "(r)ace, The &ac7 o) "())icient )err(&e in the )ina&
re"toration )orce" the core/ the o"t and the root to accet hi*h )(nctiona& "tre""e"/ o)ten
re"(&tin* in )ract(re,
CLINICAL TECHNIGUES
5 Po"t "e&ection
5 Re.o#a& o) endodontic )i&&in*
5 Po"t "ace rearation
5 Prearation o) corona& "tr(ct(re
5 Po"t )a%rication
5 Core )a%rication
5 Te.ori>aion
5 Tr! in and ce.enation
P#$t $e(ect3#n:
The o"t "!"te. to %e ("ed deend" onB
1; Root .orho&o*!,
3; Re.ainin* corona& tooth "tr(ct(re,
<; Occ&("a& )orce",
5 I) the root narro$" con"idera%&! in the aica& one5third :e,*, .a+i&&ar! )ir"t
re.o&ar" and .andi%(&ar centra& and &atera& inci"or";/ the ("e o) a ara&&e& o"t
.a! co.e dan*ero("&! c&o"e to er)oratin* the &atera& "(r)ace o) the root,
5 O#a& or ri%%on5"haed cana&" cannot %e reared ea"i&! to recei#e circ(&ar/
ara&&e& o"t, In the"e "it(ation" a c("to. o"t )or.ed to the "hae o) the cana&
con"er#e" tooth "tr(ct(re and in#o&#e" &e"" rearation in the aica& re*ion o) the
root,
5 I) it i" o""i%&e to reare a c!&indrica& channe& e0(a& to or &on*er than the c&inica&
cro$n o) the tooth/ a ara&&e& ce.ented o"t in co.%ination" $ith corona& core
$i&& %e"t )(&)i&& re0(ire.ent",
5 -here e"thetic" i" a concern/ tooth co&ored *&a"" )i%er or cera.ic o"t" "ho(&d %e
("ed,
Re&)3n3n6 C#!#n)( T##th St!ct!e:
A" a&read! di"c(""ed/ the a.o(nt o) re.ainin* tooth "tr(ct(re $i&& deter.ine the
need )or o"t and core re"toration,
Occ($)( 0#!ce$:
Occ&("a& )orce" on indi#id(a& teeth are in)&(enced %!B
Tooth t!e and o"ition 4 Mo&ar" ha#e hi*h )orce" actin* on the. than )or inci"or"
and re.o&ar",
Pre"ence or a%"ence o) ad'acent teeth 4 occ&("a& )orce" di""iated to ad'acent teeth #ia
ro+i.a& contact", A%"ence o) ad'acent teeth increa"e" the a.o(nt o) )orce" actin* on
the indi#id(a& teeth,
The )(nction" the tooth .("t "er#e )or e,*, RPD or FPD a.o(nt, Here the a.o(nt o)
)orce" actin* on the indi#id(a& tooth i" increa"ed,
Patient9" occ&("a& ha%it" e,*, %r(+i".,
The hi*her the occ&("a& )orce"/ the *reater the retention needed, Thi" can %e achie#ed %!
("in* ara&&e&5"ided o"t", In .(&tirooted teeth/ additiona& o"t" can %e ("ed to increa"e
retention,
Re&#8)( #0 the En/#/#nt3c F3((3n6 M)te!3)(
It i" reco..ended that the root cana& "!"te. "ho(&d )ir"t %e co.&ete&! o%t(rated and
then "ace .ade )or a o"t, Thi" $i&& en"(re that the &atera& cana&" are "ea&ed, A o"t
cannot %e &aced i) the cana& i" )i&&ed $ith a )(&& &en*th "i&#er oint/ "o the"e .("t %e
re.o#ed and the tooth re5treated $ith *(tta5ercha,
)ow? the t$o co..on&! ("ed .ethod" )or *(tta5ercha re.o#a& areB
1, -ith a heated endodontic &(**er,
3, -ith a rotar! in"tr(.ent,
Tho(*h re#io("&! it $a" tho(*ht that rotar! in"tr(.ent" $o(&d di"t(r% the aica&
"ea&/ recent re"earch ha" "ho$n that %oth .ethod" can %e "a)e&! ("ed to re.o#e *(tta5
ercha $itho(t di"t(r%in* the aica& "ea& $hen =.. o) *(tta5ercha i" retained aica&&!
:In*&e;,
When? Contro#er"! a&"o e+i"ted re*ardin* the ti.in* o) re.o#a& o) *(tta5ercha
a)ter endodontic treat.ent, It $a" %e&ie#ed that re.o#a& "ho(&d %e de&a!ed %! 1 $ee7/ a"
inter.ediate re.o#a& "ho(&d di"t(r% the aica& "ea&, Ho$e#er no$ it ha" %een "ho$n that
3&&e/3)te '!e')!)t3#n #0 the '#$t $')ce : Fan et a&/ So&ano et a&; )o&&o$in* o%t(ration
i" the %e"t techni0(e, It .ini.i>e" the .icro&ea7a*e, A&"o rearation "ho(&d %e done %!
the "a.e c&inician a" he i" )a.i&iar $ith the root cana& anato.!,
Re&#8)( 23th !#t)!" 3n$t!&ent$:
G(tta5ercha can %e re.o#ed $ith GG dri&&"/ Pe""o rea.er"/ Parao"t5dri&&" and
other co..ercia&&! a#ai&a%&e %(r", -hen rotar! in"tr(.ent" &i7e %(r" or dri&&" :B R C;
are ("ed/ it "ho(&d %e en"(red that the in"tr(.ent )o&&o$" the *(tta5ercha and doe" not
en*a*e the dentin other$i"e er)oration $i&& occ(r, For thi" rea"on GG dri&&" and Pee"o
rea.er" :A; are re)erred a" their non5c(ttin* ti" 7ee the. centered on the *(tta5ercha
:the ath o) &ea"t re"i"tance;,
#echni*ue:
1, Choo"e a Pe""o rea.er "&i*ht&! narro$er than the cana&,
3, The deth o) in"ertion i" deter.ined %! "(eri.o"in* the Pee"o rea.er o#er the
radio*rah o) the tooth %ein* re"tored, Set the "toer at the &e#e& o) inci"a& ed*e
o) ad'acent teeth,
<, Care)(&&! re.o#e the *(tta5ercha and a#oid c(ttin* the root dentin, O)ten on&! a
art o) the root cana& )i&& need %e re.o#ed $ith a rotar! in"tr(.ent/ and the
re.ainder can %e re.o#ed $ith the heated conden"er,
A, Once re.o#a& reache" the aroriate deth "hae the cana& a" needed,
Re&#8)( 23th ) he)te/ en/#/#nt3c c#n/en$e!:
In thi" .ethod a heated endodontic &(**er or an e&ectronic de#ice i" ("ed to
re.o#e the *(tta5ercha, Thi" .ethod i" co..on&! ("ed $hen *(tta5ercha i" to %e
re.o#ed ri*ht a)ter o%t(ration a" there are .ini.a& chance" o) di"t(r%in* the aica& "ea&,
#echni*ue:
1, Be)ore re.o#in* *(tta5ercha ca&c(&ate the aroriate &en*th o) the o"t, A" a
*(ide/ the o"t &en*th "ho(&d %e e0(a& to the hei*ht o) the anato.ic cro$n or t$o5
third" the &en*th o) the root/ $hiche#er i" *reater/ %(t =.. o) aica& *(tta5ercha
"ho(&d %e &e)t, In "hort teeth/ co.ro.i"e" .("t %e .ade, An a%"o&(te .ini.(.
o) <.. o) aica& )i&& i" needed, I) thi" cannot %e achie#ed $itho(t ha#in* a #er!
"hort o"t/ then ro*no"i" o) the tooth i" i.aired,
3, A#oid the aica& =.. i) o""i%&e a" c(r#at(re" and &atera& cana&" are )o(nd in thi"
"e*.ent, The in"tr(.ent i" *a(*ed )or &en*th a*ain"t a reoerati#e radio*rah
and the "toer i" "et at the &e#e& o) inci"a& ed*e o) ad'acent teeth,
<, A&! r(%%er da. to re#ent a"iration o) in"tr(.ent,
A, Se&ect an endodontic conden"er &ar*e eno(*h to ho&d heat $e&& %(t not "o &ar*e
that it %ind" a*ain"t the cana& $a&&",
=, The in"tr(.ent i" heated ti&& it i" red hot/ in"erted into the *(tta5ercha and i"
0(ic7&! $ithdra$n, Thi" "ear" o)) the *(tta5ercha, I) conden"er it 7et )or a
&on*er ti.e or i" not heated $e&& the *(tta5ercha $i&& "tic7 to the in"tr(.ent
re"(&tin* in it" %ein* (&&ed o(t $hen the conden"er i" $ithdra$n/ th(" di"t(r%in*
the endodontic "ea&,
D, I) the *(tta5ercha i" o&d and ha" &o"t it" ther.o&a"ticit!/ ("e a rotar! in"tr(.ent,
En()!6e&ent #0 the C)n)(
Thi" i" acco.&i"hed $ith in"tr(.ent"/ Pe""o rea.er" or a &o$ "eed dri&&, The
(ro"e i" to re.o#e (nderc(t" and reare the cana& to recei#e an aroriate&! "i>ed
o"t $itho(t e+ce""i#e&! en&ar*in* the cana&, It ha" %een reco..ended that the o"t %e
no .ore than one5third the dia.eter o) the root $ith the root and $a&&" at &ea"t 1..
thic7, Th("/ 7no$&ed*e o) a#era*e root di.en"ion" i" i.ortant in addition to root cana&
"hae",
Be)ore "tartin* cana& rearation/ re.o#e an! e+i"tin* re"toration"/ carie"/ %a"e"
and thin or (n"(orted $a&&" o) tooth "tr(ct(re, Pre"er#in* a" .(ch tooth "tr(ct(re a"
o""i%&e,
F#! P!e=0)%!3c)te/ P#$t$:
1, Set the "toer on the in"tr(.ent to the redeter.ined &en*th, En&ar*e the cana&
one or t$o "i>e" $ith a dri&&/ endodontic )i&e or rea.er that .atche" the
con)i*(ration o) the o"t, -hen Pee"o rea.er" are ("ed :A;/ the cana& i" en&ar*ed
to a dia.eter "&i*ht&! ".a&&er than that o) the "eci)ic in"tr(.ent :e,*, ParaPo"t
Dri&&; re0(ired )or the "!"te. %ein* ("ed, Fina& rearation i" then done $ith that
in"tr(.ent :B;, In ca"e o) a threaded o"t/ a ta :to .a7e thread" in the dentin;
)o&&o$" the aroriate dri&&/ (n&e"" "e&)5threadin* "cre$" are %ein* ("ed,

A B
3, En&ar*in* the cana& in 2,3.. incre.ent" di.ini"he" the o""i%i&it! o) the
in"tr(.ent "tra!in* )ro. the cana&, Con#entiona& dri&&" ("ed $itho(t an! rior
en&ar*e.ent o) the cana& are .ore rone to "tra! )ro. the ori*ina& cana& ath$a!
than Pee"o rea.er",
<, Be care)(& not to re.o#e .ore dentin at the aica& e+tent o) the o"t "ace,
Radio*rah" are not nor.a&&! re0(ired/ ro#ided care)(& .ea"(re.ent techni0(e"
ha#e %een )o&&o$ed,
A, To ro#ide anti5rotationa& re"i"tance/ a in .a! %e ("ed, Dri&& one or t$o 2,D..
in ho&e" to a deth o) 3../ in the area o) the *reate"t %(&7 %et$een the cana& and
the eriher! o) the tooth :("(a&&! on &in*(a& "ide;,
F#! C$t#&=&)/e P#$t$:
O)ten #er! &itt&e rearation $i&& %e needed )or a c("to.5.ade o"t, Ho$e#er/
(nderc(t" $ithin the cana& "ho(&d %e re.o#ed and "o.e additiona& "acin* i" ("(a&&!
nece""ar!,
1, Set the "toer on the in"tr(.ent to the redeter.ined &en*th,
3, Grad(a&&! en&ar*e the cana& :in 2,3.. incre.ent"; to the "i>e that ha" %een
deter.ined )or that tooth, A" a&read! .entioned/ it "ho(&d not %e *reater than one5
The outlines of the roots and the posts are shown
superimposed on the occlusal surfaces of the teeth
on the left# The recommended post diameters are
shown on the right# $From Shilling*urg- .
rd
ed#%
third the dia.eter o) the root at the CEG :A; and there "ho(&d %e a .ini.(.
thic7ne"" o) 1,2.. o) tooth "tr(ct(re aro(nd the o"t at .id5root and %e!ond :B;,
<, I) anti5rotationa& re"i"tance i" re0(ired ("e a no, 1H2 %(r to .a7e a 7e! $a! or
*roo#e in the ori)ice o) the cana&, P&ace it in the area o) *reate"t %(&7, It "ho(&d %e
c(t to the deth o) the %(r :aro+, 2,D..; and ( the cana& to the &en*th o) the
c(ttin* %&ade" o) the %(r :aro+, A..;, On a re.o&ar and .o&ar/ the "econd
cana& "er#e" the anti5rotationa& )(nction,
P!e')!)t3#n #0 C#!#n)( T##th St!ct!e
A)ter the o"t "ace ha" %een reared/ the corona& tooth "tr(ct(re i" red(ced )or
the e+tracorona& re"toration, Anterior teeth are re"tored $ith .eta&5cera.ic cro$n or
$hen e"thetic o"t" and core" ("ed/ $ith an a&&5cera.ic re"toration, A&&5.eta& cro$n" are
*enera&&! *i#en )or o"terior",
1, I*nore an! .i""in* tooth "tr(ct(re and reare the re.ainin* tooth a" tho(*h it
$a" (nda.a*ed,
3, The )acia& "(r)ace :in anterior"; "ho(&d %e ade0(ate&! red(ced )or *ood e"thetic",
<, Re.o#e a&& (nderc(t" that $i&& re#ent re.o#a& o) attern, Thi" i" not needed $ith
direct core %(i&d(",
A, Pre"er#e a" .(ch tooth "tr(ct(re a" o""i%&e,
=, Preare the )ini"h &ine at &ea"t 3.. *in*i#a& to the core, Thi" e"ta%&i"he" the
)err(&e, For c("to.5.ade o"t and core re"toration"/ &ace a contra %e#e& :Fi*,;
$ith a )&a.e5"haed dia.ond at the '(nction o) the core and tooth "tr(ct(re, The
%e#e& ro#ide" a .eta& co&&ar aro(nd the occ&("a& circ(.)erence o) the rearation
:in addition to the )err(&e; in %racin* the tooth a*ain"t )ract(re, It a&"o ro#ide" a
#ertica& "to to re#ent o#er5"eatin* and $ed*in* e))ect o) the o"t,
D, Co.&ete the rearation" %! e&i.inatin* "har an*&e" and e"ta%&i"hin* a ".ooth
)ini"h &ine,
P#$t F)%!3c)t3#n
P!e0)%!3c)te/ '#$t$:
The"e ha#e to %e "e&ected to .atch the di.en"ion" o) the cana&, The! .("t %e
"eated ti&& )(&& deth, An! di"creanc! %et$een the corona& art o) o"t and cana& $a&& can
%e )i&&ed $ith core .ateria& d(rin* the %(i&d ( o) core,
To "horten the &en*th o) the o"tB
5 Do it at the aica& end i) the o"t ha" a "ecia& "hae to the head :)or retention o)
core;,
5 I) the o"t ha" a "ecia&&! "haed aica& ti :e,*, taered end in a ara&&e& o"t &i7e
BCH o"t;/ do an! needed "hortenin* at the corona& end, At &ea"t 35<.. o) the
o"t "ho(&d %e re"ent "(ra*in*i#a&&! )or retention and "(ort o) core .ateria&,
C$t#&=&)/e '#$t$:
5 A c("to.5.ade o"t can %e ca"t )ro. a direct attern or an indirect one, A direct
attern (ti&i>in* a(too&!.eri>in* re"in i" reco..ended )or "in*&e cana&"
$herea" an indirect roced(re i" .ore aroriate )or .(&ti&e cana&",
+irect procedure:
1, Tri. a 1A5*a(*e "o&id &a"tic "r(e "o that it "&ide" ea"i&! into the cana& to the
aica& end o) the o"t rearation $itho(t %indin*, C(t a ".a&& notch on the )acia&
ortion to aid in orientation d(rin* "(%"e0(ent "te",
3, Mi+ acr!&ic re"in .ono.er and o&!.er to a r(nn! con"i"tenc!,
<, L(%ricate cana& $ith etro&e(. or an! other &(%ricatin* a*ent/ on cotton $raed
on a Pee"o rea.er,
A, Fi&& the ori)ice o) the cana& a" )(&& a" o""i%&e $ith acr!&ic re"in a&ied $ith a
&a"tic )i&&in* in"tr(.ent, A&ternati#e&!B
5 U"e the %ead5%r("h techni0(e to add re"in to the ori)ice/ and to the "r(e,
5 In the do(*h! "ta*e/ ro&& the re"in into a thin c!&inder/ introd(ce it in the cana& and
("h it to &ace $ith the .ono.er5"o)tened "r(e,
=, Seat the .ono.er coated "r(e co.&ete&! into the cana&, Ma7e "(re the e+terna&
%e#e& i" co.&ete&! co#ered $ith re"in at thi" ti.e, Tr!in* to co#er it &ater .a!
di"t(r% the )it o) the o"t,
D, -hen acr!&ic re"in %eco.e" to(*h and do(*h!/ (. the attern in and o(t to
in"(re that it $i&& not &oc7 into (nderc(t",
H, A" the re"in o&!.eri>e"/ re.o#e o"t )ro. cana& and .a7e "(re it e+tend" ti&& the
aica& end, I) re0(ired/ additiona& re"in can %e &aced at the aica& end and the
o"t i" re"eated and re.o#ed, An! #oid" can %e )i&&ed $ith "o)t dead $a+ e,*,
(ti&i>in* $a+ Rein"ert and re.o#e to en"(re ".ooth $ithdra$a&,
F, A direct attern can a&"o %e .ade ("in* in&a! $a+ in a "i.i&ar .anner,
E, Add .ore re"in or $a+ to )or. the core, Shae it in the )or. o) the )ina&
rearation,
ndirect Procedure:
An! e&a"to.eric .ateria& $i&& .a7e an acc(rate i.re""ion o) the root cana& i)
$ire rein)orce.ent i" &aced to re#ent di"tortion,
1, C(t iece" o) orthodontic $ire to &en*th and "hae the. &i7e the &etter G,
3, Veri)! the )it in each cana&, It "ho(&d )it &oo"e&! and e+tend to the )(&& deth o) the
o"t "ace,
<, Coat the $ire and tra! $ith adhe"i#eI *in*i#a& retraction $o(&d %e needed )or
"(%*in*i#a& .ar*in", U"e a die &(%ricant to &(%ricate cana&" and )aci&itate re.o#a&,
A, U"in* a &ent(&o"ira&/ )i&& the cana&" $ith e&a"tic i.re""ion .ateria&,
=, Seat the $ire to )(&& deth/ "!rin*e in .ore i.re""ion .ateria& aro(nd the
reared teeth and in"ert the i.re""ion tra!,
D, Re.o#e the i.re""ion/ e#a&(ate it/ and o(r the )ina& ca"t,
H, In the ca"t/ tri. a &oo"e )ittin* &a"tic o"t or "r(e to )it the rearation ti&& the
aica& end $itho(t %indin*/ .a7e a notch )or orientation, U"e the i.re""ion a" a
*(ide to aid in orientation,
F, A&! a thin coat o) "tic7! $a+ to the &a"tic o"t and add "o)t in&a! $a+ in
incre.ent", It i" %e"t to "tart at the .o"t aica& end and .a7e "(re that the o"t i"
correct&! oriented a" it i" "eated to adat the $a+,
E, -hen o"t attern i" .ade/ add $a+ to )or. the core,
12, U"e the i.re""ion" a" a *(ide to e#a&(ate $hether the $a+ attern i" co.&ete&!
adated to the o"t "ace,
C#!e F)%!3c)t3#n
C)$t=&et)( c#!e:
The"e are "haed in re"in or $a+ and added to the o"t attern %e)ore the
a""e.%&! i" ca"t in .eta&, Thi" re#ent" o""i%&e )ai&(re at the o"t5core inter)ace, In
addition to ca"t o"t"/ the! can a&"o %e ca"t direct&! onto .o"t re)a%ricated o"t "!"te.",
Advantages
1, No )ai&(re at o"t5core inter)ace,
3, Can %e ("ed $ith re)a%ricated o"t",
<, Con#entiona& hi*h no%&e a&&o!" can %e ("ed,
A, An indirect roced(re can %e e.&o!ed/ .a7in* re"toration o) o"terior teeth
ea"ier,
Disadvantages
1, An additiona& aoint.ent i" re0(ired,
3, More e+en"i#e than a.a&*a. or co.o"ite core",
<, Ca"tin* direct&! onto re)a%ricated o"t" .a! a&ter their h!"ica& roertie"/ th("
$ea7enin* the.,
+irect procedure 'or single,rooted teeth:
1, U"e a re)a%ricated .eta& or c("to. acr!&ic re"in o"t,
3, Add re"in %! 6%ead? techni0(e/ diin* a ".a&& %r("h into .ono.er and then into
o&!.er and a&!in* it to the o"t, Li*ht c(red re"in .a! %e ("ed,
<, S&i*ht&! o#er%(i&d the core and a&&o$ it to )(&&! o&!.eri>e,
A, Shae the core $ith car%ide )ini"hin* %(r", U"e $ater "ra! to a#oid o#erheatin*
o) acr!&ic re"in correct an! ".a&& de)ect" $ith $a+,
=, Re.o#e the attern/ "r(e and in#e"t i..ediate&!,
D, It can %e "i.i&ar&! %(i&t $ith in&a! $a+ and "haed $ith car#er" $hen the direct
attern i" .ade $ith $a+,
+irect pattern 'or multi,rooted teeth:
A direct attern .a! %e ("ed )or o"terior teeth, A "in*&e iece core $ith a(+i&iar!
o"t" i" ("ed, The core i" ca"t direct&! onto the o"t o) one cana&, The other cana&" a&read!
ha#e re)a%ricated o"t" that a"" thro(*h ho&e" in the core, S.ooth "ided ara&&e& or
taered o"t" are ("ed a" a(+i&iar! o"t",
1, Fit re)a%ricated o"t" into the reared cana&", One o"t i" ro(*hened :to $hich
the core i" ca"t onto;I other" are &e)t ".ooth and &(%ricated, A&& o"t" "ho(&d
e+tend %e!ond the e#ent(a& rearation, A&ternati#e&!/ the .ain o"t cana& a&"o %e
.ade %! direct re"in attern and i" then ca"t a&on* $ith the core,
3, B(i&d ( the core $ith co&d c(re re"in %! the %ead techni0(e,
<, Shae the core to the )ina& )or. $ith car%ide %(r",
A, Gri the ".ooth &(%ricated o"t" $ith )orce and re.o#e the.,
=, Re.o#e/ in#e"t and ca"t/ the core $ith the ro(*hened o"t or re"in attern, -hen
thi" i" done/ the ho&e" )or a(+i&iar! o"t" can %e re)ined $ith the aroriate t$i"t
dri&&,
D, A)ter #eri)!in* the )it/ ce.ent the core and a(+i&iar! o"t" to &ace,
ndirect pattern 'or multi,rooted teeth:
-hen there i" &i.ited acce""/ indirect aroach i" ea"ier to ("e, A .(&ti5iece o"t
and core i" .ade %! thi" .ethod :S&it ca"tin*;,
In the )ina& ca"tB
1, -a+ the c("to.5.ade o"t" a" de"cri%ed re#io("&!,
3, B(i&d art o) the core aro(nd the )ir"t o"t,
<, Re.o#e an! (nderc(t" ad'acent to other o"t ho&e" and ca"t the )ir"t "ection,
A, -a+ the additiona& "ection" and ca"t the., Each "ection "ho(&d %e $a+ed to
en"(re that no (nderc(t" are created,
=, Ca"t each "ection "earate&!,
A&ternati#e&!/ inter&oc7in* "ection" can %e .ade %! ("in* do#etai&" to inter&oc7
the "ection", B(t thi" .a7e" the roced(re .ore co.&icated and i" o) &i.ited %ene)it/
e"ecia&&! %eca("e the )ina& %(i&d( i" he&d to*ether %! the )i+ed ca"t re"toration,
P()$t3c F3((3n6 M)te!3)($:
A.a&*a./ co.o"ite re"in or GIC are ("ed a" core %(i&d( .ateria&" $ith
re)a%ricated o"t", D(e to it" &o$ "tren*th GIC i" *enera&&! not reco..ended (n&e""
.ini.a& %(i&d( i" re0(ired,
Advantages
1, Ma+i.(. tooth "tr(ct(re can %e re"er#ed/ a" (nderc(t" need not %e re.o#ed,
3, Treat.ent re0(ire" one &e"" aoint.ent,
<, Fe$er &a%orator! "te"/ hence cheaer,
A, Good "tren*th,
Disadvantages
1, Lon* ter. "(cce"" .a! %e &i.ited %!B
5 Corro"ion o) a.a&*a.,
5 Lo$ ten"i&e "tren*th o) GIC,
5 Hi*h ther.a& e+an"ion coe))icient" o) co.o"ite re"in core",
3, Micro&ea7a*e $ith ther.oc!&in* i" )o(nd in co.o"ite and a.a&*a. core",
<, Certain roced(re" &i7e r(%%er da. and .atri+ a&ication .a! %e di))ic(&t/
e"ecia&&! $ith %ad&! %ro7en do$n teeth,
A&)(6)& c#!e$:
The! are "(ita%&e )or o"terior teeth/ artic(&ar&! $hen "o.e corona& "tr(ct(re
re.ain", Their .erit" and de.erit" ha#e a&read! %een di"c(""ed,
1, A .atri+ %and i" a&ied to the tooth and a.a&*a. i" conden"ed aro(nd the o"t"/
and %(i&t ( corona&&!,
3, Once it "et"/ the %and i" re.o#ed and core "haed $ith %(r" a" needed, A )a"t
"ettin* hi*h coer a.a&*a. i" ("ed,
&malgam Coronal,radicular -estoration #echni*ue:
U"ed )or re"torin* o"terior teeth that are &ar*e&! intact, The roced(re de"cri%ed %!
Na!!ar et a& :1EF2;/ $ith a.a&*a. ("ed )or the o"t" a" $e&& i" con"er#ati#e o) tooth
"tr(ct(re, The re"toration i" &aced at the "a.e aoint.ent a" the root cana& o%t(ration
)or then the cana&" are "ti&& i"o&ated/ the cana& anato.! i" )re"h in the ractitioner" .ind
and the core can "er#e a" a "(ort )or the ro#i"iona& re"toration,
1, Re.o#e the *(tta5ercha )ro. the (& cha.%er a" $e&& a" 35A.. into each root
cana& i) &e"" than A.. o) corona& hei*ht re.ain", U"e a heated &(**er,
3, Re.o#e an! e+i"tin* re"toration/ (nder.ined ena.e&/ or cario(" or $ea7ened
dentin/ e"ta%&i"h ca#it! )or., E#en i) c("" are .i""in*/ in" are not nor.a&&!
re0(ired %eca("e o) e+ten"ion into root cana&",
<, I) it i" "("ected that the )&oor o) the (& cha.%er i" thin/ then rotect it )ro.
conden"in* re""(re" $ith a ce.ent %a"e,
A, Fit a .atri+ %and )or %ad&! %ro7en do$n teeth or an orthodontic %and .a! %e
("ed,
=, Conden"e the )ir"t incre.ent" o) a.a&*a. into the root cana&" $ith a &(**er,
D, Fi&& the (& cha.%er and corona& ca#it! in the con#entiona& .anner,
H, Car#e the a&&o! to "haeB the i.re""ion can %e .ade i..ediate&!, A&ternati#e&!/
the a.a&*a. can %e %(i&t to anato.ic conto(r" and then "haed $ith %(r",
C#&'#$3te !e$3n c#!e$:
The"e are %(i&t ( ("in* cro$n )or.", A c&ear cro$n )or. er.it" ("e o) a &i*ht
acti#ated co.o"ite/ $hi&e a o&!car%onate )or. can %e ("ed $ith che.ica&&! acti#ated
co.o"ite,
1, I) a o&!car%onate cro$n )or. i" ("ed/ &ace a "earatin* .edi(.,
3, Fi&& the cro$n )or. $ith re"in and ho&d it in o"ition o#er the rotr(din* do$e&
(nti& it o&!.eri>e",
<, Re.o#e the .atri+ and "hae the core $ith %(r" to the )or. o) a cro$n
rearation,
A, The *in*i#a& )ini"h &ine "ho(&d %e in tooth "tr(ct(re,
A&ternati#e&!/ the core can %e %(i&t $ith &i*ht acti#ated co.o"ite in incre.ent"
$itho(t ("in* a cro$n )or.,
In8e$t3n6 )n/ c)$t3n6:
The o"t5core attern i" "r(ed on the inci"a& or occ&("a& end, 1,2 to 3,2cc o) e+tra
$ater i" added to the in#e"t.ent and a &iner i" o.itted to increa"e the ca"tin* "hrin7a*e
:Shi&&in*%(r*;, Thi" re"(&t" in a "&i*ht&! ".a&&er o"t that doe" not %ind in the cana&/ and it
a&"o ro#ide" "ace )or the ce.ent, A ti*ht )it .a! ca("e root )ract(re, -hen re"in i"
("ed/ the attern "ho(&d re.ain )or <2 .in(te" &on*er in the %(rno(t o#en to en"(re
co.&ete e&i.ination o) the re"in,
P!#83$3#n)( Re$t#!)t3#n$
A)ter endodontic treat.ent/ i) a ca"t o"t and core i" &anned/ ) '!#83$3#n)(
c!#2n $ith attached te.orar! o"t can %e )a%ricated )or the teeth $ith &i.ited
"(ra*in*i#a& "tr(ct(re, A ro#i"iona& re"toration i" a&"o needed $hi&e the o"t and core i"
%ein* )a%ricated to re#ent dri)t o) ad'acent and oo"in* teeth, Fittin* a $ire aer c&i
:e,*, or orthodontic $ire; into the reared cana& or ("in* a te.orar! o"t a#ai&a%&e $ith
rorietar! o"t "!"te." can do thi", Re"toration i" then con#enient&! )a%ricated $ith
a(too&!.eri>in* re"in $ith the direct techni0(e,
5)!!3e! techn3;eB GIC ce.ent 35< .. .a! %e &aced in the reared o"t "ace o#er
the re.ainin* o%t(ration,
The )ina& o"t/ core and cro$n "ho(&d %e )a%ricated a" "oon a" o""i%&e/ %eca("e
.icro&ea7a*e can conta.inate the o"t "ace and endodontic )i&&, Pro#i"iona& re"toration"
"ho(&d %e ("ed $ith e+tre.e ca(tion %eca("e artia& &o"" o) the ce.ent "ea& .a! *o
(ndetected )or "o.e ti.e, Thi" &ea7a*e can &ead "e#ere cario(" in#a"ion and &o"" o) tooth,
In addition to carie"/ &ea7a*e can 'eoardi>e the "(cce"" o) endodontic",
T!"=In )n/ Ce&ent)t3#n
An! ce.ent .a! %e ("ed i) retention and re"i"tance o) the o"t are ade0(ate, The choice
o) ce.ent .a! %eco.e .ore i.ortant i) the o"t ha" a oor )it in the cana&, -hen re"in
ce.ent" are ("ed/ the o"t "ho(&d %e ce.ented $ith a(to5c(re or d(a&5c(re re"in ce.ent
%eca("e o) &i.ited &i*ht enetration into the root, Irri*ation $ith 3,=cc o) 1HC EDTA to
che&ate ca&ci(. )o&&o$ed %! 3,=cc o) =,3=C NaOC& to )&("h a$a! de%ri"/ ha" %een
reco..ended to re.o#e ".ear &a!er and i.ro#e retention, A&"o/ .icro%r("he" can %e
("ed to de&i#er etchant" and %ondin* a*ent" dee into the cana&,
P!e0)%!3c)te/ '#$t$:
1, Once the o"t ha" %een "e&ected/ .a7e a thin .i+ o) ce.ent and coat the o"t $ith
it,
3, Introd(ce ce.ent into the o"t "ace $ith a &a"tic in"tr(.ent, U"e a &ent(&o"ira&
to en"(re that the $a&&" are coated $ith ce.ent, Accordin* to Shi&&in*%(r*/
retention can %e increa"ed %! a" .(ch a" E2C i) a &ent(&o"ira& i" ("ed,
<, P("h the o"t "&o$&! to &ace a&&o$in* e+ce"" ce.ent to e"cae, Para&&e&5"ided
o"t" "ho(&d ha#e an e"cae #ent to a&&o$ e"cae o) e+ce"" ce.ent,
A, Ho&d the o"t $ith )in*er re""(re (nti& initia& "et occ(r", Then re.o#e e+ce""
ce.ent )ro. aro(nd o"t head and in",
=, Fa%ricate core/ reare it "i.i&ar to a tooth rearation, Ta7e i.re""ion )or )ina&
re"toration,
C$t#&=&)/e '#$t$:
1, Chec7 the )it o) the o"t5core in the tooth %! "eatin* it $ith &i*ht re""(re,
3, I) it %ind" in cana& or $i&& not "eat co.&ete&!/ air a%rade the o"t and rein"ert it in
the cana&, Re&ie#e an! "hin! "ot",
<, The core ortion o) the ca"tin* "ho(&d %e o&i"hed, I) re0(ired/ a #ertica& *roo#e/
)ro. aica& end to contra%e#e&/ can %e c(t in the o"t to ro#ide an e"cae #ent
)or the ce.ent,
A, The cana& "ho(&d %e c&eaned $ith a ca#it! c&eaner to re.o#e &(%ricant M te.orar!
ce.ent $hich .a! inhi%it "et o) re"in ce.ent" and decrea"e retention,
=, Ce.ent the o"t a" )or re)a%ricated o"t",
D, Modi)! the core i) nece""ar!, Ma7e an i.re""ion )or the )ina& re"toration,
ESTHETIC POSTS TECHNIGUE:
-ith increa"in* "e&)5a$arene"" the de.and )or "(erior e"thetic" ha" increa"ed,
Th("/ ("e o) e"thetic/ tooth5co&ored o"t" are no$ .o"t co..on&! ("ed in the anterior
re*ion, Three .ain techni0(e" are (ti&i>edB
1, Fi%er o"t" $ith co.o"ite core",
3, Cera.ic :>irconia; o"t" $ith co.o"iteMcera.ic core",
<, A&&5cera.ic o"t" and core",
Techn3;e$ 0#! 03%e! '#$t$
T$o cate*orie" o) )i%er rein)orced o"t" are a#ai&a%&eB
1, Pre)a%ricated o"t",
3, Chair"ide5)a%ricated o"t",
PREFA5RICATED SYSTEMS
(.reedman)
Se#era& re)a%ricated o"t "!"te." are a#ai&a%&e to the ractitioner )or the re"toration o)
the endodontica&&! treated tooth,
Int!)!)/3c()! Reh)%3(3t)t3#n
Occa"iona&&!/ the o"t5endodontic re"entation o) the cana& .a! %e too $ide )or ro(tine
direct re"toration, Thi" .a! ha#e occ(rred a" a re"(&t o) e+ten"i#e deca! or a**re""i#e
in"tr(.entation o) the cana& or the atient .a! %e !o(n* $ith &ar*e cana&", Si.&!
&acin* a o"t in thi" cana& $o(&d &ea#e a #er! thic7 &a!er o) ce.ent, It i" a&"o di))ic(&t to
o"ition the o"t in an idea& &ocation )or the "(%"e0(ent re"toration, The L(.ine+ Li*ht
Tran".ittin* S!"te. :Dentat("/ Ne$ Oor7/ NO; i" ("ed to reha%i&itate thi" cana& to an
idea& "i>e and "hae,
1, The cana& i" rea.ed to the de"ired deth $ith a "i>e5.atched rea.er, The rea.er i"
corre&ated in "i>e and "hae to a corre"ondin* &i*ht tran".ittin* o"t and a L("cent
Anchor,
3, The L(.ine+ Li*ht Tran".ittin* Po"t :LTP; i" tried in and ad'("ted )or &en*th, The
cana& i" then dried/ etched and rin"ed,
<, A d(a&5c(red )i)th5*eneration %ondin* a*ent/ Pri.e R Bond NT D(a& C(re :Ca(&75
Dent"&!/ Mi&)ord/ DE; i" then a&ied to the interna& "(r)ace o) the cana&/ air %&o$n
to e&i.inate oo&in*/ and &i*ht c(red,
A, A .icroh!%rid/ E"thetN :Ca(&75Dent"&!; i" in'ected into the %onded cana& and the
Li*ht Tran".ittin* Po"t i" ("hed into the (nc(red co.o"ite re"in to it" )(&& deth,
=, The LTP and the co.o"ite re"in are &i*ht c(red to*ether )or D2 "econd", The Li*ht
Tran".ittin* o"t a&&o$" the a""a*e o) &i*ht thro(*h it" %od! %(t doe" not %ond to
the co.o"ite .ateria&,
D, A he.o"tat i" ("ed to rotate and re.o#e the LTP/ &ea#in* an idea&&! "haed and "i>ed
o"t "ace )or the "i>e5.atched L("cent anchor :Dentat(";/ $hich can %e &aced
i..ediate&!,
At thi" "ta*e the o"t "ace can %e treated ro(tine&!, The o"t5and5core roced(re $i&& %e
redicta%&e/ and the ro*no"i" )or the tooth .(ch i.ro#ed,
A&ternati#e&!/ a" the L("cent Anchor a&"o tran".it" &i*ht/ intraradic(&ar reha%i&itation can
%e done direct&! $ith thi" o"t $itho(t ("in* the L(.ine+ Po"t,
L$cent Anch#! P#$t Techn3;e
The L("cent anchor o"t :Dentat("; i" a )i%er5*&a""/ c&ear re"in o"t that i"
de"i*ned to re)ract and tran".it nat(ra& tooth co&or" )or e"thetic o"t5and5core
)o(ndation", The L("cent anchor i" radio&(cent and identi)ied on radio*rah" %! the
"(rro(ndin* re"in ce.ent, De"i*ned to %e &aced a""i#e&! in reared cana&"/ it i"
a#ai&a%&e in three dia.eter"/ and i" "i>e inte*rated $ith the Li*ht Tran".ittin* Po"t", The
L("cent anchor i" ea"i&! re.o#ed/ i) re0(ired/ )or endodontic re5treat.ent,
1, U"in* the o"t "ace created %! the LTP/ L("cent anchor i" tried into the cana&, I)
there ha" %een no .oi"t(re conta.ination/ the o+!*en5inhi%ited &a!er i" "ti&& a#ai&a%&e
)or the ne+t re"torati#e &a!er,
3, L(+acore :Jenith/ En*&e$ood C&i))"/ NG;/ an a(to.i+ed/ "e&)5c(red re"in i" in'ected
direct&! into the cana&, The L("cent o"t i" in"erted into the (nc(red co.o"ite re"in
and the core %(i&d5( i" co..enced i..ediate&!, The L(+acore $i&& "et $ithin A
.in(te"/ at $hich oint it can %e "haed,
<, A)ter rearation )or a )(&& cro$n/ the L("cent anchor o"t5and5core i" read! )or the
i.re""ion and ro#i"iona&i>ation "te",
P)!)P#$t F3%e! Kh3te Techn3;e
The ParaPo"t Fi%er -hite Po"t :Co&teneM-ha&edent/ Mah$ah/ NG; i" a )i&&ed re"in/
.ono5directiona& )i%er .atri+ $ith a )&e+(ra& .od(&(" that #er! c&o"e&! aro+i.ate" that
o) the nat(ra& dentin, The co&or o) the o"t i" $hite tran"&(cent/ de"i*ned to .ini.i>e
"hado$in* (nder a&&5cera.ic re"toration", The ara&&e&5"ided o"t" are intended )or
a""i#e "eatin* in the cana&/ and the antirotationa& o"t head "ta%i&i>e" the core .ateria&",
The ParaPo"t )i%er $hite i" a#ai&a%&e in )o(r dia.eter"/ co&or5coded to .atchin* dri&&",
The"e o"t" are readi&! re.o#ed "ho(&d endodontic re5treat.ent %e nece""ar!,
1, The o"t5endodontic cana& i" re)ined $ith a )a.i&iar/ co&or5coded ParaPo"t dri&&,
3, The ParaPo"t Fi%er -hite o"t i" tried into the cana& and the cana& i" then dried/
etched/ rin"ed/ and &e)t "&i*ht&! .oi"t,
<, One Coat Bond :Co&teneM-ha&edent; i" a&ied into the cana&/ air thinned and then
&i*ht c(red,
A, L(+acore i" in'ected into the %onded cana& and the Fi%er -hite o"t i" "eated into the
(nc(red co.o"ite to it" )(&& deth, The core can %e %(i&t ( i..ediate&! and it "et"
$ithin A .in(te",
=, -ith the '(dicio(" a&ication o) %(i&d5( .ateria&"/ the idea& cro$n )o(ndation i"
c&o"e&! aro+i.ated, It i" no$ read! )or the )ina& cro$n rearation,
Ch)3! $3/e 0)%!3c)te/ '#$t
(.reilich et al)
Thi" techni0(e (ti&i>e" o&!eth!&ene $o#en ri%%on :Ri%%ond; )i%re" a&on* $ith a
co.o"ite re"in,
Techni0(eB
1, The tooth i" i"o&ated and ("in* heat or Pee"o rea.er"/ *(tta5ercha i" re.o#ed
)ro. the cana& to the de"ired &en*th,
3, The e+i"tin* cana& i" not en&ar*ed or "haed an! )(rther,
<, Stri" o) Ri%%ond i" c(t in e+ce"" o) t$ice the o"t "ace,
A, The cana& "ace i" etched/ rin"ed and a )orth *eneration dentin %ondin* "!"te. i"
a&ied to the cana&/ (& cha.%er and re.ainin* tooth "tr(ct(re,
=, A d(a&5c(re or che.ica&5c(re co.o"ite re"in &(tin* ce.ent i" a&ied into the
cana&,
D, The Ri%%ond )i%er i" "at(rated $ith re"in/ )or.in* it into a V5"hae and i" &aced
into the cana& &ea#in* the e+ce"" a" an 6ear? o(t into the cha.%er M re.ainin*
tooth "tr(ct(re, A" .an! iece" o) Ri%%ond are &aced a" $i&& )it into the cana&,
H, Co.o"ite re"in core .ateria& i" a&ied to the corona& e+ten"ion :ear; o) Ri%%ond
to create a core, The core i" "haed a" the cro$n rearation,
Ce!)&3c '#$t$ = The"e o"t"/ .ain&! >irconia o"t"/ can %e ("ed $ith either co.o"ite
core" or cera.ic core" can %e )a%ricated o#er the., The cera.ic core ro#ide" the
ad#anta*e o) *reater "tren*th at the o"t5core inter)ace,
A((=ce!)&3c '#$t$ )n/ c#!e$
((outayas and (ern)
The"e are )a%ricated/ ("in* hi*h5to(*hne"" cera.ic .ateria&" "(ch a" a&(.ina and
>irconia cera.ic"/ thro(*h )o(r di))erent techni0(e"B
1, The S&i5ca"tin* Techni0(e
3, The Co!5.i&&in* Techni0(e
<, The T$o5iece Techni0(e/ $hich in#o&#e" a re)a%ricated >irconia o"t and a co!5
.i&&ed a&(.ina or >irconia cera.ic core,
A, The Heat5re""ed Techni0(e/ $hich in#o&#e" a re)a%ricated >irconia cera.ic o"t
and a heat5re""ed *&a""5cera.ic core,
La%orator! "t(die" ha#e "ho$n cera.ic o"t" to ha#e &o$er )ract(re "tren*th than
)i%er o"t", Ho$e#er/ the! ro#ide "(erior e"thetic"/ a" their otica& roertie" are
"i.i&ar to nat(ra& teeth,
FAILURE AND REMOVAL OF POST AND CORES:
/ire c&a""i)ied )ai&(re o) endodontica&&! treated teeth areB
1, Pro"thetic )ai&(re",
3, Periodontic )ai&(re",
<, Endodontic )ai&(re",
O) the"e/ ro"thetic )ai&(re" occ(rred =E,AC o) the ti.e"/ th(" e.ha"i>in* the need
to roer&! re"tore endodontica&&! treated teeth to increa"e their &on*e#it!,
For o"t and core re"toration"/ )ai&(re rate" %et$een HC and 1=C ha#e %een reorted
in the &iterat(re :Tor%'orner;, The .ain )actor" that .a7e endodontica&&! treated teeth
.ore di"o"ed to technica& )ai&(re areB
1, Thin5$a&&ed/ $ea7ened root" (na%&e to $ith"tand hi*h "tre"",
3, Red(ced retenti#e "(r)ace" re"(&tin* in hi*h "tre"" &e#e&" in the ce.ent,
The .ain ca("e" o) o"t and core re"toration )ai&(re areB
1, Di"&od*e.ent o) o"t :&o"" o) retention;,
3, Root )ract(re,
<, Fract(re o) o"t,
A, Carie",
=, Periodonta& di"ea"e,
Care)(&/ ca"e "e&ection/ adherence to %io.echanica& rinci&e" o) o"t and core
re"toration/ aroriate o"t "e&ection and .etic(&o(" .aintenance o) ora& h!*iene on the
art o) the atient can re#ent thi",
F)3(!e &#/e
An i.ortant )actor re&ated to re"i"tance i" )ai&(re .ode, A&& o"t "!"te." ha#e
"o.e ercenta*e o) c&inica& )ai&(re, Ho$e#er/ "o.e o"t" ca("e a hi*her ercenta*e o)
)ai&(re" that re"(&t in teeth that are non5re"tora%&e :(n)a#ora%&e )ract(re";, For e+a.&e/
teeth re"tored $ith &e"" ri*id o"t"/ e,*, )i%er o"t"/ tend to ha#e )ai&(re" that are .ore
&i7e&! to %e re"tora%&e, The"e o"t" tend to )ract(re rather than ca("in* root )ract(re",
E#en i) root )ract(re" occ(r/ the! are *enera&&! )a#ora%&e/ i,e, can %e re"tored,
E#en >irconia o"t" )ract(re .ore co..on&! than .eta& o"t",
On the other hand/ "ti))er .eta& and >irconia o"t" )ai& (n)a#ora%&!/ ca("in* non5
re"tora%&e root )ract(re" :o%&i0(e or #ertica&;, In )act/ ara&&e&5"ided .eta& o"t"
c&a""ica&&! ca("e o%&i0(e root )ract(re" $ith aica& art o) the )ract(re corre"ondin* to
the aica& art o) the o"t,
The taered o"t de"i*n tend" to ca("e #ertica& root )ract(re d(e to it" $ed*in* e))ect, A
o"iti#e corona& "eat &e""en" thi" to "o.e e+tent,
Fai&(re %et$een o"t and core i" a&"o "een, Thi" i" .o"t co..on in ca"e o) >irconia o"t"
and co.o"ite core" a" >irconia o"t" are not ea"i&! etched,
Teeth reared $ith a )err(&e a&"o tend" to )ai& in a .ore )a#ora%&e .ode, Recent re"earch
ha" "ho$n that ("e o) %onded o"t" and core" $itho(t )err(&e/ re"(&t" in co.ara%&e
)ract(re re"i"tance to rearation" $ith a )err(&e,
The t!e o) core .ateria& a&"o can a))ect )ai&(re .ode, It ha" %een "ho$n that co.o"ite
core" tended to )ai& .ore )a#ora%&! than a.a&*a. or *o&d,
Re&#8)( #0 e<3$t3n6 '#$t$
Occa""iona&&! an e+i"tin* o"t5and5core .("t %e re.o#ed :e,*, )or retreat.ent o)
a )ai&ed root cana& )i&&in*;, I) "())icient &en*th o) o"t i" e+o"ed corona&&!/ the o"t can
%e retrie#ed $ith thin5%ea7ed )orce", Vi%ratin* the o"t )ir"t $ith an (&tra"onic "ca&er
$i&& $ea7en the ce.ent and )aci&itate re.o#a&, A thin "ca&er ti i" reco..ended7
Po"t re.o#a& %! (&tra"onic de#ice, A/ Preoerati#e radio*rah o) the &e)t .a+i&&ar! )ir"t
re.o&ar $ith a ara&&e&5"ided threaded o"t that had to %e re.o#ed )or endodontic
retreat.ent, B/ A)ter the corona& ortion o) the o"t ha" %een $e&& i"o&ated/ the ti o) the
(&tra"onic de#ice i" &aced a*ain"t it and ener*! i" a&ied to di"r(t the ce.ent inter)ace,
Note the "(ction ti/ $hich re.o#e" $ater )ro. the $ater "ra! ("ed $ith the (&tra"onic
handiece, C/ A)ter a ti.e/ the o"t %eco.e" &oo"e $ithin the cana& and can %e retrie#ed
%! )orce", D/ Radio*rah o) the re.o&ar a)ter o"t re.o#a&,
A&ternati#e&!/ a o"t (&&er can %e ("ed, Thi" de#ice con"i"t" o) a #i"e to *ri the
o"t and &e*" that %ear on the root )ace, A "cre$ acti#ate" the #i"e and e+tract" the o"t,
Po"t re.o#a& %! e+tractor, A/ The Tho.a" :Gonon; o"t5re.o#in* "!"te., It inc&(de"
&ier"/ trehine %(r"/ .andre&"/ and $a"her", B/ Preoerati#e radio*rah o) the &e)t
.a+i&&ar! &atera& inci"or $ith a o"t, C/ Note the )&ared "hae o) the o"t in thi"
reoerati#e #ie$ and the hei*ht o) the "(rro(ndin* tooth "tr(ct(re, D/ A hi*h5"eed %(r
i" ("ed to )ree the o"t )ro. corona& tooth "tr(ct(re and ara&&e& it" "ide", :NOTEB An
(&tra"onic de#ice .a! %e ("ed at thi" oint to di"t(r% the ce.ent inter)ace,; E/ A trehine
%(r .achine" the o"t to the correct dia.eter and &ace" thread" )or the .andre&, F/ The
.andre& i" threaded onto the o"t $ith "ecia& $a"her"/ $hich di"tri%(te the )orce" )ro.
the e+tractor e#en&! o#er the tooth, G/ The %ea7" o) the &ier" are )itted onto the .andre&I
the 7no% o) the &ier" i" then rotated/ $hich "earate" the %ea7"/ and the o"t i" e+tr(ded
)ro. the tooth, H/ The re.o#ed o"t "ti&& attached to the .andre& and &ier", 1/
Radio*rah o) the &atera& inci"or a)ter o"t re.o#a&,
A o"t that ha" )ract(red $ithin the root cana& can not %e re.o#ed $ith a o"t
(&&er or )orce", The o"t can %e dri&&ed o(t/ %(t *reat care i" needed to a#oid de#iation,
The techni0(e i" %e"t &i.ited to re&ati#e&! "hort )ract(red o"t",
Po"t re.o#a& %! hi*h5"eed %(r, A/ Preoerati#e radio*rah o) the ri*ht .a+i&&ar! &atera&
inci"or/ in $hich %oth the cro$n and art o) a o"t ha#e %een )ract(red o)), A ortion o)
the @(rer5t!e/ ara&&e&5"ided/ threaded o"t re.ain" $ithin the cana&, B/ Beca("e o) the
&ar*e dia.eter o) the o"t and it" o"ition $ithin the cana&/ a hi*h5"eed handiece $a"
cho"en to dri&& it o(t, C/ Radio*rah to #eri)! the correct orientation o) the %(rS" ro*re""
in"ide the cana&, -ith thi" .ethod o) o"t re.o#a&/ the oerator .("t %e e+tre.e&!
care)(& not to &et the hi*h5"eed %(r contact the cana& $a&&/ $hich $o(&d *ra#e&!
co.ro.i"e tooth "tr(ct(re, D/ Radio*rah o) the inci"or a)ter o"t re.o#a& and
retreat.ent,
Another .ean" o) hand&in* an e.%edded )ract(red o"t :de"cri%ed %! Ma""erann in
1EDD; ("e" "ecia& ho&&o$ end5c(ttin* t(%e" :or trehine"; to reare a thin trench
aro(nd the o"t, The techni0(e ha" ro#ed to %e 0(ite "(cce"")(&, Retrie#a& can %e
)aci&itated %! ("in* an adhe"i#e to attach a ho&&o$ t(%e e+tractor,
Ma""erann techni0(e )or the re.o#a& o) )ract(red o"t", A and F/ Ma+i&&ar! inci"or $ith a
o"t that ha" )ract(red in"ide the cana&, C/ The dia.eter o) the o"t i" *a(*ed $ith a
"i>in* too&/ and D/ the "e&ected trehine i" care)(&&! rotated co(nterc&oc7$i"e to create a
narro$ channe& aro(nd the o"t, E/ -hen the in"tr(.ent ha" re.o#ed "())icient .ateria&/
the o"t i" reco#ered, F/The )ract(red cro$n and o"t a)ter re.o#a&,
Bio&o*ica& $idth5 it i" the di.en"ion o) "ace that hea&th! *in*i#a& ti""(e" occ(! corona&
to a&#eo&ar %one, It i" a co.%ination o) 1,2H.. a&#eo&ar %one to GE and 2,EH.. GE to
%a"e o) "(&c(" i,e, 3.. :a#*;, Re"toration "ho(&d not %e &aced 3.. )ro. GE e&"e
in)&a..ation re"(&t", :*&i7.an E
th
edi 5 E=2;

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