Explains how a custom cast post and core rebuilds a root-filled tooth that has lost much of its crown, covering the checks needed before starting and the design rules for seal, length, width, ferrule, stops and antirotation. It then sets out direct and indirect techniques for making the cast post and core, and briefly compares prefabricated posts with fibre and ceramic options. A summary table of design rules and a labelled diagram are included.
Topic 44 of 75 in the MU Sofia syllabus for Preclinics of Dental Prosthetics (Dental Medicine, Year 2). The free AceMed note covers it in 6 sections, about 339 words (3 min of reading), with 14 flashcards.
In this note
Introduction
Before you start
Parts
Design rules
Making a custom cast post and core
Prefabricated posts
Introduction
A root-filled tooth has often lost much of its crown to caries, old fillings and the access cavity. Too little is left to hold a crown, and the tooth is more likely to fracture. A post and core rebuilds the missing crown from inside the root, ready for a separate crown on top.
Before you start
The root filling must be sound:
Good apical seal on the radiograph.
No pain to pressure or at the apex; no exudate, fistula or active inflammation.
A poor root filling is redone first. The two deciding factors are the type of tooth and, most important of all, how much coronal tooth is left.
Parts
Post (dowel): sits in the prepared root canal and gives retention.
Core: rebuilds the lost crown and is prepared like a normal tooth to receive the crown.
One-piece post-crowns are now only of historical interest. Today the post and core is made first, and a separate complete crown is placed over it.
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