Esthetic post systems /certified fixed orthodontic courses by Indian dental academy

ESTHETICS POST SYSTEMS

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com

contents
 Introduction
 Effects of endodontic treatment on teeth
 Considerations for anteriro and posterior
teeth
 Requirements of posts
 Key features of post and core design
 Factors affecting selection of posts

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Factors affecting retention of posts
Classification of esthetic post systems
Properties of fiber post systems
Clinical techniques
Cementation
Summary
Conclusion
references

Intr oduction


Effect of endodontic
treatment on teeth
 Tooth structure after endodontic
treatment weakened by previous
episodes of
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Fracture
Tooth preparation
Restoration
Endodontic manipulation

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


considerations
 Anterior teeth
 Intact , non-vital , has not lost tooth
structurebeyond access cavity preperation
Less risk of fracture
Sealing the access cavity

considerations
 Anterior teeth
 Intact , non-vital , has lost significant
tooth structure
More risk of fracture
crown retained by dowel and core

 Posterior teeth
 Depends on remaining tooth structure
 If adeqaute tooth structure present , core
and crown is sufficient
 If inadeqaute, post and core with crown
necessary


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

Key features for a
succesful post and core
design


Factors determining
selection of posts
 Root 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 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 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 by
Lloyd and palik into 3 categories
 Conservationist
 Preservationist
 Proportionist


 Canal 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 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.


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


 Post design
 Classified according to shape design and surface
characteristics.
 According to shape design
Parallel sided
Tapered
Parallel tapered combination
According to surface characteristics
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Active and passive

 Post material
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Metal post systems
Carbon fiber posts
Zirconia 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 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 material
 Retrievebility
 Esthetics


Factors affecting the
retention of posts
 Post 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 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 cements
 Resistance form
 Stress distribution
 Rotational resistance


Ferrule effect


Classification of
esthetic posts
 Polyethylene fiber posts
 Ribond

 Glass fiber posts
 Fibrekor posts (Generic Pentron)

 Carbon fiber posts
 Composipost
 C – Post systems

 Quartz fibers bound in an epoxy matrix
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D T Light post (Bisco Usa)
Astheti Plus posts
Light posts

 Ceramic posts
 Direct method
 Cerapost (Lemgo, Germany)

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


Thank you
Leader in continuing dental education


Esthetic post systems /certified fixed orthodontic courses by Indian dental academy

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