Tooth crown reconstruction
Postendo
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Endodontically treated tooth
Risk of reinfection
Decreased resistrance
Limited area for retention
Consider endo treatment –
Consider tooth restorability
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Aim of postendodontic
treatment
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Prevent reinfection
Longevity of crown reconstruction
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Contemporary trends
Less indication of root canal posts
Adhesive materials
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2 mm
1 -1,5 mm
Indication – loss of the crown – minimal
requirements
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cca 2 mm
Biological width
Within the biological width
can be the crown elongated
using gingivectomy.
If it is necessary
to achieve more
– the ostectomy can
be performed. But the ratio
clinical crown /the root
after this procedure must
remain at least 1:1
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Ferrule effect
2 mm
Retention
Transfer of
masticatory forces
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When post
Depends
- How much hard dental
tissues is lost
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In frontal area:
- when two marginal ridges are lost plus
access cavity
- When only one marginal ridge is lost plus
access cavity plus heavy loading (e.g deep
bite)
In posterior area – when both proximal
ridges are completely lost
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Frontal area
➢Bigger loading with transversal forces
➢Smaller area for retention
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Removal of old fillings, dental caries
Are 3-4 walls are present with sufficient
thickness and heigth
1 -2 walls with sufficient amount of hard dental tissues
are present
Only 1 wall or no walls are present
The thickness of the root canal wall is suficient
Extraction
Direct adhesive restoration
No (less then 2 mm supragingivalla and
less than 1 mm circulary
Is there a sufficient amount of hard dental tissues?
Post and core
FRC post
Root canal inlay plus crown
Elongation of clinical crown
(ratio crown/root 1:1 )
surgically or extrusion
No. Elongation is not
possible (ratio
crown/root is bigger
than 1:1)
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Posterior area
➢Loading more in axial direction (less
amount of transversal loading)
➢Overlay is considered without any post in
most cases
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Techniques without posts
Amalgam overaly
Metal overlay
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Composit or ceramic overaly
- Endodontic crown
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Metal versus FRC post
lenka.roubalikova@tiscali.cz
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Available posts
Kov Vláknový uhlík FRC Zirkon
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Benefits of FRC posts
Elastic modulus similar to dentin
Good seal – adhesive technology
Aesthetics
One visit less (dental lab no need)
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40–48GPa
10 – 12 GPa
Elastic Modulus [GPa]
0 50 100 150 200 250
Dentin
Glass-fibre
Carbon-fibre
Steel
Titanium
Zirconia
Source: Materials Science and Engineering. An introduction. 6th ed. Wiley
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Supragingival tissues
Ferrule
Good adhesion
Risks – only when technology
is not properly followed
Decementation
Fracture of the post
Fraktura of the root
Gap
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Core made of composite material
Step by step procedure
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Check root canal filling
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Preparation
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Try the post
4 mm of root canal filling is left
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Adhesive procedure
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Cementation using a dual
or chemically
curing composite cement
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Cements
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Core
Special materiál
Filling composite materiál
Post and core materiál – one materiál
- for post cementation and core
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