01 Post and Core Flashcards
When is RCT officially complete
When the tooth is properly restored
5 Keys to Successful endo therapy
- Sufficient apical seal
- Coronal seal
- Asymptomatic
- Absence of periapical pathology
- Absence of initial fistula
Ray and Trope Determined that which was more important to long term endo treatment quality, the RCT or the permanent restoration
Restoration
Is there any evidence that supports the notion that RCT dentin is weaker than vital dentin
no
What can improve the prognosis of endodontically treated teeth
Restorations that enhance structural integrity
As a general rule, what can anterior teeth be restored with following RCT
Composite, as long as there are no interproximal lesions or restorations
What are the functional requirements of a structurally compromised incisor and cuspid
Post and Core
Crown
What will premolars require after RCT than anterior teeth do not
Cuspal coverage
What was the only significant variable to predict long term success of posterior RCT teeth?
Cuspal coverage
In reality, how many posterior teeth were restored with cuspal coverage after RCT?
50%
How deep does the pulp chamber need to be to provide adequate retention
4 mm
What if the pulp chamber is less than 4 mm
remove 2-3mm of gutta percha from the canals
Are posts commonly needed
no
What are sources of retention for posterior RCT teeth
Pulp Chamber
Canals
Amalgapins
Bonding
What is the purpose of a post
To retain the core
What is the decision to place a post predicated on?
The amount of remaining coronal tooth structure after the crown placement
What is the indication for posts
If there is any question whether or not a post is needed, it is recommended to place one!
What is the general rule regarding post indications
All anterior and premolar teeth requiring a crown having an endo access and an interproximal lesion or restoration shold be considered to be restored with post and core and crown
What are the two Prefabricated post materials highlighted by dr. Imbery
Stainless steel
Carbon fiber
What is the advantage of fiber-reinforced resin based composite posts
The modulus of elasticity is closest to dentin
What are the possible core materials
Amalgam
Composite
Light Cured
Z250
Dual Cured
CompCore
TiCoreWhat are the prefabricated post systems at VCU
ParaPost XP
Fiber Lux
What are the Cusom Post options at VCU
Cast Type III Gold or Option Alloy
Direct or Indirect
What is ParaPost XP
Stainless Steel, Parallel
What is Fiber Lux
Carbon Fiber, Parallel
Where is ParaPost XP not recommended
In non-circular canals
What type of cement is used with ParaPost Xp
FujiCem II
What do you place of the post of ParaPost Fiber Lux
Silane
What cement is used with Fiber Lux
Nexus 3
What are the advantages of a custom post
Custom fit
Core attached to the post
What are the disadvantages of a custom post
2 appointments
What instruments are recommended for Gutta Percha Removal
Gates Glidden
What determines whether to use a pre-fab or custom post?
Canal shape
Do teeth with thicker, or thinner posts fracture more easily?
Thicker
Which posts lead to more root fractures, tapered or parallel?
Tapered
Does an increased post diameter equal increased retention?
No
What should you always be on the lookout for
Unusual root morphology and dilacerations
What should you not exceed
1/3 cross-section diameter of the root
How long should the post be?
Equal to the height of the clinical crown
At least 8mm if possible
Extend apically beyond the crest of bone
Leave 4-5 mm of gutta percha
Limited by anatomical variations
By how much should you enlarge the canal?
Only enough to allow a post to fit accurately and passsively
Does the type of cement used have a big impact on retention
No
What should the stopper be set at when removing gutta percha from a tooth 19 mm long?
19-5 = 14 mm
What is a prime factor in the fracture resistance of the root
Thickness of remaning dentin
Why is the gates glidden drill recommended over the parapost drill?
It conformed to the original canal more consistently that the PP drill
When are PP drills useful
For shaping the canal after the GP is removed
Which canal should the post be placed in?
The straightest
Which canal is used for mandibular molars?
Distal
Which canal is used for Mx Molars
Palatal
Which way does the palatal canal curve usually
facially
What should you always use when placing post and cores
Rubber dam
Which canal is preferred in premolars for the Fiber Lux
Palatal
What is duralay?
Chemically cured methacrylate resin
What size post should you use when waxing up your custom cast post
Plastic post corresponding to the size of the last parapost drill
For an indirect custom core, what must be placed in the pulp chamber is the chamber is oval or circular
An anti-rotational groove
What size ferrule is needed for an indirect custom post and core
2 mm circumferential
What should be remembered about the posts
Used to retain a core
Preserve periradicular dentin
Use postos of adequate length and diameter
Use posts that are retrievable
