Esthetic post systems/ dental crown & bridge courses

Esthetic postEsthetic post
systemssystems
INDIAN DENTAL ACADEMYINDIAN DENTAL ACADEMY
Leader in continuing Dental EducationLeader in continuing Dental Education
www.indiandentalacademy.comwww.indiandentalacademy.com

contentscontents
 IntroductionIntroduction
 Effects of endodontic treatment on teethEffects of endodontic treatment on teeth
 Considerations for anteriro and posteriorConsiderations for anteriro and posterior
teethteeth
 Requirements of postsRequirements of posts
 Key features of post and core designKey features of post and core design
 Factors affecting selection of postsFactors affecting selection of posts

 Factors affecting retention of postsFactors affecting retention of posts
 Classification of esthetic post systemsClassification of esthetic post systems
 Properties of fiber post systemsProperties of fiber post systems
 Clinical techniquesClinical techniques
 CementationCementation
 SummarySummary
 ConclusionConclusion
 referencesreferences

IntroductionIntroduction

Effect of endodonticEffect of endodontic
treatment on teethtreatment on teeth
 Tooth structure after endodonticTooth structure after endodontic
treatment weakened by previoustreatment weakened by previous
episodes ofepisodes of
 FractureFracture
 Tooth preparationTooth preparation
 RestorationRestoration
 Endodontic manipulationEndodontic manipulation

 Loss of tooth structureLoss of tooth structure
 Altered physical characteristicsAltered physical characteristics
 Altered esthetic characteristicsAltered esthetic characteristics

considerationsconsiderations
 Anterior teethAnterior teeth
 Intact , non-vital , has not lost toothIntact , non-vital , has not lost tooth
structurebeyond access cavity preperationstructurebeyond access cavity preperation
Less risk of fractureLess risk of fracture
Sealing the access cavitySealing the access cavity

considerationsconsiderations
 Anterior teethAnterior teeth
 Intact , non-vital , has lost significantIntact , non-vital , has lost significant
tooth structuretooth structure
More risk of fractureMore risk of fracture
crown retained by dowel and corecrown retained by dowel and core

 Posterior teethPosterior teeth
 Depends on remaining tooth structureDepends on remaining tooth structure
 If adeqaute tooth structure present , coreIf adeqaute tooth structure present , core
and crown is sufficientand crown is sufficient
 If inadeqaute, post and core with crownIf inadeqaute, post and core with crown
necessarynecessary

Requirements of postRequirements of post
and coreand core
 Physical properties similar to dentine
 Maximum
 Retention with little removal of dentin
 Distribution of functional stresses evenly along
the root surface,
 Esthetic compatibility with the definitive
restoration and surrounding tissue,
 Minimal stress during placement and
cementation,

 Resistance to displacement,
 Good core retention,
 Easy retrievability,
 Material compatibility with core,
 Ease of use, safety and reliability,
 Reasonable cost.

Key features for aKey features for a
succesful post and coresuccesful post and core
designdesign

Factors determiningFactors determining
selection of postsselection of posts
 Root lengthRoot length
 Greater the post
length, the better the
retention and stress
distribution
 Reserve 3 to 5mm of
apical gutta-percha
to maintain the apical
seal

 Tooth anatomyTooth anatomy
 A consideration of the root size and length is
important, because improper post space
preparation and use of large-diameter posts
present the risk of apical or lateral
perforation.
 An active post can initiate cracks in the thin
dentinal wall

 Post widthPost width
 Preserving tooth structure, reducing the
chances of perforation, and permitting the
restored tooth to resist fractures are criteria
in selection of the post width

Lloyd PM, Palik JF. The philosophies of
dowel diameter preparation: a literature
review. J Prosthet Dent 1993;69:32-6.
 Selection of post width sumarised bySelection of post width sumarised by
Lloyd and palik into 3 categoriesLloyd and palik into 3 categories
 Conservationist
 Preservationist
 Proportionist

 Canal configuration and post adaptabilityCanal configuration and post adaptability
 Canal configuration aids in making a choice
between a custom-designed post and a
prefabricated post
 If post confirms to the shape of the canal
closly  more conservative procedure 
more resistance to fracture

 Coronal structureCoronal structure
 The bulk of the tooth above the restorative margin
should be at least 1.5 to 2 mm to achieve resistance
form.
 Teeth restored with carbon fiber posts had inferior
strength compared with those restored with metal
posts when subjected to forces simulating those in a
clinical setting
 (Sidoli GE, King PA, Setchell DJ. An in vitro evaluation of a carbon
fiber based post and core system. J Prosthet Dent 1997;78:5-9.)

 Carbon fiber post system, can be used
when ample coronal dentin remains and
the crown is well supported by remaining
tooth structure; otherwise, cast post and
core may be used when there is
moderate to severe tooth loss.

 SStresstress
 Post and core–restored endodontically
treated teeth are subjected to various types
of stresses:
 compression,
 tensile, and shear
 An increase in the post length with diameter kept
to a minimum will help to reduce shear stresses
and preserve tooth structure

 Torsional forcesTorsional forces
 Intraorally, post and core–restored teeth are
subjected to various types of forces.
Torsional forces on the post-core-crown unit
may lead to loosening and displacement of
the post from the canal, causing failure of
the system

 Role of hydrostatic pressureRole of hydrostatic pressure
 Cementation plays a significant role in
enhancing retention, stress distribution, and
sealing irregularities between the tooth and
the post

 Post designPost design
 Classified according to shape design and surfaceClassified according to shape design and surface
characteristics.characteristics.
 According to shape designAccording to shape design
 Parallel sidedParallel sided
 TaperedTapered
 Parallel tapered combinationParallel tapered combination
According to surface characteristicsAccording to surface characteristics
Active and passiveActive and passive

 Post materialPost material
 Metal post systemsMetal post systems
 Carbon fiber postsCarbon fiber posts
 Zirconia postsZirconia posts

(Mannocci E, Ferrari M, Watson TF. Intermittent loading
of teeth restored using quartz fiber, carbon-quartz fiber
and zirconium dioxide ceramic root canal posts. J
Adhes Dent 1999;1:153-8.)
 Bonding abilityBonding ability
 Resin luting agents showed good adhesion
to carbon
 Fiber posts and glass fiber posts.69 The
adhesion to zirconia posts was found to be
unsatisfactory.69 It was also observed that
to improve retention, the carbon fiber post
did not require any surface treatment as
compared with the zirconia post.

 Core materialCore material
 RetrievebilityRetrievebility
 EstheticsEsthetics

Factors affecting theFactors affecting the
retention of postsretention of posts
 Post lengthPost length
 The post should equal the incisocervical
or occlusocervical dimension of the
crown.
 The post should be as long as possible
without disturbing the apical seal
 Short posts are especially dangerous
and have a much higher failure rate

 Post diameterPost diameter
 Increasing the diameter of the post does not provide
a significant increase in the retention of the post;
however, it can increase the stiffness of the post at
the expense of the remaining dentin and the fracture
resistance of the root.
 post diameter must be controlled to preserve
radicular dentin, reduce the potential for
perforations, and permit the tooth to resist fracture

 Luting cementsLuting cements
 Resistance formResistance form
 Stress distributionStress distribution
 Rotational resistanceRotational resistance

Ferrule effectFerrule effect

Classification ofClassification of
esthetic postsesthetic posts
 Polyethylene fiber postsPolyethylene fiber posts
 RibondRibond
 Glass fiber postsGlass fiber posts
 Fibrekor posts (Generic Pentron)Fibrekor posts (Generic Pentron)
 Carbon fiber postsCarbon fiber posts
 ComposipostComposipost
 C – Post systemsC – Post systems

 Quartz fibers bound in an epoxy matrixQuartz fibers bound in an epoxy matrix
 D T Light post (Bisco Usa)D T Light post (Bisco Usa)
 Astheti Plus postsAstheti Plus posts
 Light postsLight posts
 Ceramic postsCeramic posts
 Direct methodDirect method
 Cerapost (Lemgo, Germany)Cerapost (Lemgo, Germany)

 Indirect methodIndirect method
 Split casting technique (Inceram posts)Split casting technique (Inceram posts)
 Copy milling technique (In ceram Celay posts)Copy milling technique (In ceram Celay posts)
 Two Piece technique (ER – Post systems,Two Piece technique (ER – Post systems,
Brassler Germany)Brassler Germany)
 Heat preassure techniqueHeat preassure technique
 Cosmopost (Ivoclar)Cosmopost (Ivoclar)

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