Reconstruction of
endodontically treated teth
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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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Restorability of the endodontically
treated tooth
It is necessary to judge
the amount of remaining
hard dental tissues
Bandlish DB, Mc Donald
AV,
Setchel DJ
Assesment of the amount
of remaining coronal
dentine
in root treated teeth
Journal of Dentistry
2006;9:699 - 708
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2 mm
1 -1,5 mm
Indication – loss of the crown – minimal
requirements
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Ferrule effect
2 mm
Retention
Transfer of
masticatory forces
on the alveolary
bone
10
cca 2 mm
Biological width
Gingival sulcus depth
+
Epithelial atachement
+
Connective tissue
attachement
Ferrule efect plus keeping of biological
width (the distance between the
restoration and alveolar crest) are crucial
factors for the longevity of the
postendodontic restoration
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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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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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Metal versus FRC post
lenka.roubalikova@tiscali.cz
Techniques without posts
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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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Indication of FRC posts in
Premolars: on proximal ridge is lost
Molars: both proximal ridges are lost
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Available posts
prefabricated, custom made
Kov Vláknový uhlík FRC Zirkon
lenka.roubalikova@tiscali.cz
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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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30
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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