Article: Volume 47 Number 8 Page 670 - September 2020

  Dent Update 2020; 47: 670-676  Read article

Restorative dentistry:  The Restoration of Structurally Compromised Endodontically Treated Teeth: Principles and Indications of Post and Core Restorations

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Abstract: The use of posts to retain indirect restorations in structurally compromised teeth is a technique that has been used for many years. There are many factors that need to be considered prior to the provision of post- and core-retained crowns to reduce the risk of failure. This includes case selection and an understanding of the cumulative prognostic endodontic, periodontal and prosthodontic factors. Many clinicians are hesitant to use post- and core-retained restorations, due to an uncertainty of whether the treatment modality would work, and with some seeing it as an out-dated clinical technique. The evolution and widespread use of dental implants has also provided an additional fixed tooth replacement option, which may result in a reduced drive to retain structurally compromised teeth. As a result, fewer post-retained restorations are being placed, with the majority of these being old restorations present in the older age demographic. It is important for this treatment modality to remain within a clinician’s armamentarium, not only for application when clinically appropriate but, with an ageing population with a heavily restored dentition, clinicians must be able to repair and replace these restorations when necessary.

Clinical relevance: A sound understanding of the biological and technical considerations in the provision of post and core restorations will allow clinicians to offer this treatment modality to appropriate patients with greater predictability and reduced failure rates.

Author notes: Reem Ahmed, BDS, MFDS RCS, Dental Core Trainee, Department of Restorative Dentistry, St George’s Hospital and Raj Dubal, BDS, MFDS, MClin Dent(Pros), MRD(Rest), PGCertDentEd, FDS, ISFE (Rest Dent), Consultant in Restorative Dentistry, Department of Restorative Dentistry, St George’s Hospital, Blackshaw Road, London, SW17 0QT, UK.

Objective: To provide an overview of the different post classifications as well as to discuss the principles underlying effective assessment and the clinical technique through a step-by-step guide using a clinical case.