Dr. Conn 1 Flashcards

1
Q

Endo treated tooth: majority of failures due to

A
  • inadequate restoration followed by tooth loss due to perio
  • few teeth are lost due to endo
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2
Q

Success rate of treatment for general dentists vs endo?

A
  • General=65-75%
  • Endo=70-95%
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3
Q

Orthograde contamination

A
  • Failure mechanism
  • contamination via leakage of oral fluids apically within root
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4
Q

Coronal Sealing

A
  • done as soon as possible after root canal is finished
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5
Q

Factors to place a post in a tooth

A
  • position of the tooth in the arch
  • occlusion
  • function of the restored tooth
  • amount of remaining tooth structure
  • canal configuration
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6
Q

reasons for placing a post

A
  • old Assumption:
    • strengthen the root of a endo treated tooth
  • Todays assumption:
    • retain the core buildup material
    • reinforce remaining coronal tooth
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7
Q

Post types

A
  • Custom cast posts
  • Pre-fabricated posts
    • metallic posts
    • non-metallic posts (tooth colored)
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8
Q

What does increased post length result in?

A
  • Results in:
    • increased retention
    • restistance to fracture
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9
Q

Posts: most Retention to least

A
  • Most to least retention
    • active posts
    • parallel posts
    • tapered post=least
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10
Q

Posts: Most conservative to least

(of tooth structure)

A
  • Most
    • tapered
    • parallel
    • active
  • least
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11
Q

How to choose the right post

A
  • most conservative post
  • adequate rentention
  • without compromising fracture resistance of the root
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12
Q

Does a post strengthen a tooth?

A

it Depends

  • Fracture resistance
    • of the root descreases with post placement
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13
Q

Indications for custom cast post and core

A
  • multiple posts and cores
  • cores for smaller teeth
  • changing the orientation of the core to post
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14
Q

Parallel Posts characteristics

A
  • Passive parallel posts
    • intermediate
      • retention
      • conservation
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15
Q

indications for Parallel posts

A
  • parallel canal prep
  • large diameter root at the tip of the post
  • need increased retention
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16
Q

Examples of parallel posts

A
  • Parapost Plus
  • BCH
  • Unity
  • Boston Post
17
Q

Tapered posts characteristics

A
  • Least retentive
  • most conservative
18
Q

Indications for Tapered Posts

A
  • Tapered root/canal obturation in roots with thin tapered canals
    • maxillary
    • premolar
    • lateral incisors
    • mandibular incisors
  • Adequate length is present (7-8mm)
  • Canal is not over enlarged
19
Q

Examples of tapered posts

A
  • Endowel
  • Filpost
20
Q

Star Endowel Post

A
  • Tapered post
  • plastic patterns used in custom cast post and core
  • cast by removable lab in chromium-cobalt alloy
    • inexpensive prefabricated tapered post
  • Gates Gliddents fit the endowel sizes
  • Mechnical retention must be cut into the endowel before cementation
21
Q

Active Posts characteristics

A
  • Greatest retention
  • Least conservative
  • increase stresses to the tooth
22
Q

Indications for Active Posts

A
  • post space length minimal
    • short clinical roots
    • Canal space obstructed
  • Funnel shaped canal
23
Q

Examples of Active Posts

A
  • Flexipost
  • V-Lock
  • Radix
  • Cytco
24
Q

Advantages of Non-Metallic posts

A
  • MOE similar to dentin
    • good for tooth
    • bad for core materials
  • Esthetic=tooth colored
25
Q

Examples of Non-metallic posts

A
  • Carbon fiber posts=OUT
    • radiolucent
    • can’t remove
  • Zirconium
    • not recommended
    • rigid and brittle
    • can’t bond effectively
    • very difficult to remove
  • Composite fiber posts-YES
26
Q

How do I choose a post?

A
  • Retention Triad
27
Q

Resistance

A
  • Prevent dislodgement or fracture by compressive forces
    • Resistance features of restoration not met=high fail probablity
    • Crown Bevil
      • most important resistance feature of restoration
      • part of crown margin
      • extends past the post and core margin onto natural tooth
    • Vertical Remaining tooth affects resistance
      • no longer flatten face of tooth for post buildup
    • Antirotation
      • important component of resistance
28
Q

Resistance Triad

A
  • Resistance Form
    • Antirotation
      • oblong canal orifice
      • keyways
      • pins
    • Crown Bevel
      • effective if it:
        • encirlces the tooth
        • extend onto tooth structure at least 2 mm below post and core margin
    • Vertical Remaining tooth structure
      • leaving as much vertical tooth structure increases the resistance
29
Q

Retention form is affected by:

A
  • Post Length
  • Luting Agent (Cement)
  • Post style
30
Q

Luting Agents (Cements)

A
  • Cement=least important part of retention triad
  • Increased usage of resin cements
31
Q

Resin Cement: Advantages vs disadvantages

A
  • Advantages:
    • low solubility
    • high modulus of elasticity
    • quick setting
    • bonds to post and dentin
  • Disadvantage
    • technique sensitive
    • Doesn’t bond to post or root dentin
32
Q

Indications for Post placement in Anterior Teeth

A
  • experience mostly shear forces
    • different than posterior teeth
  • Maxillary Centrals & Canines
    • fxn of tooth
    • amount of coronal tooth structure
  • Intact anterior tooth w/conservative endo access
    • DOES NOT require a POST or coronal coverage
33
Q

Indications for Post placement in Posterior Teeth

A
  • Require cuspal coverage (except mandibular 1st molar)
    • Molars not crowned
      • lost at 6x greater rate
    • Premolars not crowned
      • lost at 5.8x greater rate
  • Premolars-requires judgement
    • Consider:
      • tooth morphology
      • tooth fxn
    • post indicated when:
      • serves as abutment
      • lateral stress
      • Clinical crown height is taller than the diameter at the CEJ
34
Q

Chamber Retention Buildup

A
  • Aka Amalcore
  • Very effective
  • Post in molar teeth only required for retention of buildup material
  • Post not indicated when other less invasive procedures can be used
    • chamber retention
    • pins
    • amalgam pins
    • adhesives
  • If less than 4mm
    • helps to go into canal space
35
Q

Complex Post Buildups

A
  • Molars
    • Only 1 post in the large canal