Resto of Endo Tooth + Endo Interface

Question 1

Clinical assessment of endo tx tooth

Answer 1

Coronal seal
Swelling
Sinus/abscess
TTP
Buccal sulcus
Mobility
Pocketing
BOP
Remaining tooth structure - ferrule
Occlusion - 2mm inter occlusal space

Question 2

Radiographic assessment of endo tx tooth

Answer 2

Obturation - adequate length/quality/voids
Any unfilled/missed RC’s
No PAP
Bone loss
Caries
Root anatomy - crown to root ratio 1:1.5

Question 3

Function of a post/core

Answer 3

Gain inter-radicular support

Question 4

Function of core

Answer 4

Retention

Question 5

Function of post

Answer 5

Retains core

Question 6

Post risks to consent patient requiring this

Answer 6

Secondary caries
Root fracture
Post fracture
Core fracture
Perforation
Depends on amount of ferrule
Infection requiring reRCT
Bruxism/deep OB/edge to edge inc fracture risk

Question 7

Function of cuspal coverage

Answer 7

Prevents microleakage
Prevents fracture through buccal wall

Question 8

What teeth are posts recommended for?

Answer 8

Anteriors
- Avoid in mandibular due to thin tapering narrow m+d roots

Premolars
- Avoid in curved canals as perforation risk

Molars
- avoid, can insert for short distance in straightest canal

Question 9

List the ideal post characteristics (3)

Answer 9

Parallel sided
- More retentive
- Avoids wedging

Non threaded
- Smooth so less stress on root

Cement retained
- Acts as buffer between masticatory forces + tooth

Question 10

List the ideal post dimensions

Answer 10

1:1 crown length: post length
At least half post length into root
4-5mm apical GP
Post width no more than 3rd of root width at narrowest point
1.5mm ferrule

Question 11

Classification of posts (4)

Answer 11

Manufacture - direct/indirect
Materials - metal/ceramic/fibre
Post shape - parallel/tapered
Post texture - smooth/serated

Question 12

What is a Nayyar core?

Answer 12

AM packed into RC’s for retention
Can’t be prepped for 24hrs

Question 13

Tx for post perforation

Answer 13

Periradicular surgery
XLa

Question 14

Methods for post removal

Answer 14

Moskito forceps
Anthogyr
Sliding hammer
Eggler forceps
Masseran kit
Ultrasonic

Question 15

Steps for indirect post

Answer 15

Putty for provisional
Crown prep
GP removal 4-5mm remains apical plug
Use the parapost kit to same length
Try in impression post (make notches + trim to incisal length)
Indirect impressions + opposing + jaw reg
Temp post + temp

Question 16

Lab card for post

Answer 16

Please construct cast post + core MCC for tooth
Parapost colour
Core 6 degree taper
Please leave 2mm space in occlusion for crown
Cast U+L imps + articulate to jaw refi provided

Question 17

List adv + disadvantage of direct + indirect posts

Answer 17

DIRECT ADV
- Same day placement, low cost + no lab
DIRECT DISADV
- Not accurate, need ferrule, not for wider canals

INDIRECT ADV
- Accurate fit, ok if less ferrule, used for wider canals
DIRECT DISADV
- imps, high cost + lab

Question 18

List some adv + disadvantages of metal, ceramic + fibre posts

Answer 18

METAL ADV
-Radiopaque, easily retrievable, better fit to crown
METAL DISADV
- Aesthetics, corrosion, root fracture, nickel sensitivity

CERAMIC ADV
- High flexural strength, high fracture toughness, aesthetics
CERAMIC DISADV
- Difficult retrievability, root fracture, technique sensitive (silane equally spread)

FIBRE ADV
- Flexible, similar properties to dentine, replicates elastic root modulus, aesthetic, allows light cure through post
FIBRE DISADV
- Radiopaque, difficulty retrievability

Question 19

List some adv and disadvantages of post shape

Answer 19

PARALLEL ADV
- More retentive, avoids wedging, decreased stress on root
PARALLEL DISADV
- Less conservative

TAPERED ADV
- More conservative, increased strength
TAPERED DISADV
- Increased stress on root, less retentive

Question 20

List some adv and disadvantages of post texture

Answer 20

SMOOTH ADV
- Passive fit, less stress on root
SMOOTH DISADV
- Less retentive

SERRATED ADV
- Increased retention
SERRATED DISADV
- Increased stress on root