INTRODUCTION :

The restoration of devital teeth is often one of the greatest challenges a dentist faces.
It has been said that root canal therapy saves root, where as restoration reinstate the
tooth as a function member of the masticatory system. Always the basic restorative
need is restoration of the tooth to fulfill the functional and esthetic demands to which
it will be subjected. To accomplish this objective the restorative procedure should be
primarily concerned with prevention of tooth fracture at some time after the root
canal filling.
EXTENSIVELY DAMAGED TEETH:
Whenever a non vital anterior or posterior tooth that has lost more than half of the
clinical crown the treatment choice is cast coronal restoration with dowel core Hue.
Dowel provides retention for the restorative material and minimi!es potential of root
fracture by transmitting forces parallel to long a"is.
#ore $eplaces lost coronal tooth structures and retains crown.
% If sufficient coronal tooth structure &'()*+ placement of core in coronal pulp
chamber and restoration by full cast crown.
POSTCORE AND COPING:
History:
In ,-th century .ierre /auchard made Wooden post to retain crowns.
0. 1. 2lac3 made .orcelain crown held by a screw inserted into a canal filled with
gold foil.
,--) 4$ichmond crown 45 Threaded tube in the canal with a screw placed through
the crown.
INDICATIONS:
,+ A root canal treated tooth, if any pro"imal surface is involved.
6+ 7oss of 6 incisal angles together with more than half of the pro"imal surfaces of
the tooth.
8+ 7oss of more than ()* of the tooth structure.
9+ 7oss of more than one a"ial angle to a depth more than the anticipated a"ial
reduction for the reinforcing restoration.
(+ A shorted tooth due to nature of destruction or the removal of undermined
undesirable tooth structure.
:+ When a root canal treated tooth is to be used as a bridge abutment.
5+ Discolored tooth.
-+ ;aligned tooth.
<+ =verdenture.
DEFINITIONS:
Dowel Post!: The dowel is a metal post or other rigid restorative material placed in
the radicular portion of a nonvital tooth.
Core: $efers to properly shaped and well restored substructure which replaces
missing coronal structure and retains the final restorations.
Ferr"le: Is defined a metal band that encircles the e"ternal dimension of the residual
tooth.
Dowel functions primarily to aid retention of the restoration and secondarily
to distribute force along the length of the root, thus dowel has a retentive role but
doesn>t strengthen a tooth, instead the tooth is wea3ened if dentin is sacrificed to
facilitate large dowel placement.
ROLE OF THE DO#EL $ POST:
,+ =cclusal forces are transferred through the core to the post and ultimately along
the length of the root. The post must be designed in such a way that it should
serve its retention function without endangering the root or coronal integrity.
6+ The dowel must remain in the root for a successful restoration but must not
damage the root in an attempt to achieve the ma"imum retention.
8+ Dowels must be retained by cementation to the dentin walls of the root, active
engagement of the dowel spaces by screw threads is contraindicated.
CLASSIFICATION:
?ndodontic posts can be classified into 6 broad categories
% #ustom cast posts
% .refabricated posts
% .assive retention post
% Active retention post
CUSTOM CAST POST:
,+ /abricated at the chair or a negative reproduction of the prepared canal.
6+ Wa" or cold cure resins are used to ma3e these patterns.
8+ @ses a casting procedure to ma3e a one piece metal dowel and core.
9+ TechniAue can be direct in patientBs mouth or indirect with impression stones and
dies.
PRE%FA&RICATED POSTS:
This is classified as follows
,+ Tapered smooth sided post systems They are cemented into a channel Cprepared
with endodontic files or reamers of matching si!es ?g. Derr ?ndo .ost
&.refabricated gold alloy dowel+.
6+ .arallel sided serrated or vented post system #emented into a matched channel
prepared by twist drill of matching si!e. ?g. Whaledent 4 .arapost.
8+ Tapered self threading post system Ecrewed into a channel prepared with
matched reamers. ?g. dentatus screw post.
9+ .arallel sided 4 Threaded post system ?ngages dentin by self threading or with
the use of matched tapes. ?g. $adi" Anchor 4 Eelf Thread, Durer Anchor 4 /irst
tapered then threaded into dentin.
(+ .arallel sided threaded split shan3 post ?ngages the dentin wall in a channel
prepared with matched reamers. ?g. fle"i .osts.
:+ .arallel sided, tapered apical end #emented into matched channels.
RETENTIVE FEATURES OF POST: FACTORS AFFECTING RETENTION
OF POSTS:
These areF
,+ Dowel length
6+ Taper
8+ Diameter
9+ Eurface configuration
(+ #ement type
:+ ?mbedment depth
5+ Gumber of posts.
TYPES OF POSTS:
Types of post available can be again classified as
% .assive retention post $etention depends upon dose pro"imity to dentinal walls.
$etention is by adherence of cementing medium ego are
,+ #ast post 6+ Emooth tapered post, 8+ Eerrated parallel post etc.
% Active $etention .ost. $etention is achieved by engaging the dentin directly,
consist of threads that screws into dentin li3e woodscrew or threads that fits into
threaded channels. ?g. ,+ /He"i post, 6+ Durr anchor.
PASSIVE RETENTION POSTS:
% Introduced by Whaldent
% Has 8 designs
% =riginal para post
% .ara post4plus
% @nity systems
% These all are passive, parallel, ventilated post made up of stainless steel or
titanium.
% =riginal para post 4 has hori!ontal serrations.
% .ara post plus4 has spiral flues and grooves.
% @nity post 4 has raised diamond pattern.
% Any cementing medium can be used
% #an be used effectively in areas where high reapplied forces are e"pected.
% 1ent allows for easy escape of cementing medium and reduces stress.
% Go crowding effect, transfer of occlusal forces occurs through the cement layer 4
this buffers the forces uniform distribution of stress.
&OSTON POST SYSTEM:
% Eimilar to para post but no vertical venting.
% It has <<.:* titanium with hori!ontal, non engaging serrations.
% Emear layer removal is recommended
% Gew 2oston .ost ;ade up of titanium with more gnarling and roughened
surface fracture for better retention.
PAR'ELL PARALLEL POST SYSTEM:
% These post are designed for greater retention of parallel post plus good
adaptation to tapered apical portion of canal.
% Available in 6 variations.
% Degussa 4 #ompletely smooth sided, Etraight and tapered portion are eAual in
length.
% 6+ @nite3 2#H 4 Eystem
% 7ess serration on parallel side
% Emooth apical serration with no serration which is 6 mm.
% 7arge coronal portion for core build up.
% 7ess retention than parallel posts.
% .roduces wedging forces in area of apical taper more prone for root fracture than
parallel post.
ACTIVE RETENTION POST:
These are of 6 typesF
,+ Eelf threading screws 4 ?ngages the dentinal wall of prepared post channel, cuts
own thread. ?g. ,+ Dentatus post, 6+ $adi" anchor post, 8+ /le"i post.
6+ 2olts in preformed threads 4 These are tapper in Dentin. ?g. I+ Durer anchor post.
TAPERED DENTATUS:
% ;ore retentive than cemented post.
% Ecrews dentin 45 Epreads dentin as self threads 45. may cause root splitting.
% Acts as a tapered wedge and causes stress con cent, which becomes worse on
occlusal loading.
TAPERED FLEXIPOSTS :
% It is splint shan3, parallel side, threaded post.
% The apical half of post which is split collapses during insertion inwardly and thus
absorbs insertion stresses.
% As apical I6 collapses it becomes a tapered post.
% It threads by cutting in dentin by )., mm 4 ).6 mm.
% #hannel is prepared by drill slightly larger than diameter of shaft of post
% 2lades e"tend 6 mm from the shaft.
% It is first screwed into the prepared canal with a tiny wrench 4 then removed
countercloc3wise and reinserted with cement. Titanium reinforced composite as
cementing medium increases strength.
SELF THREADED PARALLEL POST:
6 designs are available.
% 1 4loc3
% $adi" Anchor system
PARALLEL V%LOC' DRILL AND POST SYSTEM: &r(sseler V Lo)*!
% This is a parallel sided micro threaded post
% ;icrothreads e"tend ).( mm from the shaft and continue its full length.
% Eupplied with precise drills
% ;ore stressful than fle"i post.
PARALLEL RADIX ANCHOR SYSTEM:
% Differs from C1C loc3 post by number of its threads. Threads are sharp low
freAuency helical blades that e"tends partly down the shaft.
% 1ertically vented.
% 7ess retention than other active post because of less threads.
PARALLEL THREADED POSTS #ITH PRE%TAPPED CHANNELS:
?g. Durer Anchor .ost
% ;ost retentive post.
% .arallel in design with no vertical vents.
% They have rounded high freAuency threads that fits into counter threads Ctapped>
in the dentin with manual thread cutter.
% Durer root faces is used to mill a flat foundation in> root preparation for crown
post head.
% Euperior in retention to all other post design.
% ;ore retentive than radi" because of more threads.
% 2ecause of increased retention it is preferred in areas of high load such as partial
denture abutments, over denture abutments, long span bridges etc.
% Also useful in short embedment depth.
% .roduces marc stresses if ape" engages the bevel produced by twist drill at
channel ape". This can be prevented by trimming the post length short of apical
level.
% Ideally it is stress free if end of post short of apical bevel.