restorationoftheendodonticallytreatedtooth

Dentistry
Post and core

1. Restoration of the
endodontically
treated tooth

2. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

3. The tooth as a house

4. INTRODUCTION
Endodontictreatmentislargelyperformed
onteethsignificantlyaffectedbycaries,multiple
repeatrestorationsand/orfracture.Already
structurallyweakened, suchteethareoften
furtherweakenedbytheendodonticprocedures
designedtoprovideoptimalaccessandbythe
restorativeproceduresnecessarytorebuildthe
tooth.
Itisthereforeacceptedthatendodontically
treatedteethareweakerandtendtohavealower
lifetimeprognosis.

5. INTRODUCTION
Hencerequirespecialconsiderationsfor
thefinalrestoration,particularlywherethere
hasbeenextensivelossoftoothstructure.The
specialneedsinvolveensuringbothadequate
retentionforthefinalrestorationand
maximumresistancetotoothfracture.
Endodonticsuccessdependsnotonly
onthequalityoftherootcanaltreatment,but
alsoontimelycoronalrestorationofthe
compromisedtooth.

6. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

7. HISTORY
Various methods of restoring
pulpless teeth have been
reported for past 200 years.
In 1747 Pierre Fauchard
fabricated gold and silver
posts to be placed in root
canal space.
Replacement crowns were
made from bone, ivory,
animal tooth.

8. Is final restoration
after endodontic
treatment important?

9. LITERATUREREVIEW
1
In this study using radiographs they assessed the
following
Good restorations + good endodontic treatments
resulted in absence of periapical inflammation in
91.4%.
Poor restorations + poor endodontic treatments
resulted in the absence of periradicular inflammation
in only 18.1%.
Poor endodontic treatment + good restorations
yielded a success rate of 67.6%.
1
Periapical status of endodontically treated teeth in relation to the technical
quality of the root filling and the coronal restoration.H. A. Ray and M. Trope
International Endodontic Journal, vol. 28, no. 1, pp. 12– 18, 1995.
This shows the importance of final restoration
in endodontically treated teeth

10. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

11. What are the
objectives of Final
restoration?

12. GOALS

2
Maintained coronal and apical seal of the root
canal treatment
Protect and preserve the remaining tooth structure
Provided a supportive and retention foundation for
the placement of definitive restoration
Restore the function and esthetics
2
Colour atlas of endodontics 2 edition
William T.Johnson DDS MS
Page no 130

13. What are the factors
to be considered while
planning the final
restoration?

14. FACTORS

3
Amount of remaining sound tooth structure
Occlusal function
Opposing dentition
Position of the tooth in the arch
Length, width and curvature of the roots
3
Endodontics : Restoring of Endodontically Treated Teeth
American Association of Endodontics.1995 Dec Publication

15. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

16. 4
Based on the remaining tooth
structure
ClassificationDescription
Class I 4 walls
Class II 3 walls
ClassIII 2 walls
Class IV 1 wall
Class V No wall
4
Restoring endodontically treated teeth with posts and cores—a review
Ingrid peroz et al.Quintessence International no.9 volume 36 oct 2005.

17. 6
Restoration of Endodontically Treated
Teeth:
An Evidence-Based Literature Review
University of Toronto, Faculty of Dentistry. Int
J Prosthodont 2008;18 (1):40-1.

18. FERRARI AND
OTHERS
FOKKINGA &
OTHERS
SAMPLES
240 endodontically-treated
premolars in 210
patients
307 endodontically-treated teeth
in 257
patients
TEST
TREATMENT
Fiber posts Cast post and core
Pre-fab metal post and
composite core
CONTROL
TREATMENT
No post Post-free composite core
DURATION
(YRS)
2 Up to 17
CONCLUSIONS
4 coronal wall remaining: no
difference in
complication rates
≤ 3 coronal walls remaining:
post placement
increases survival rates
Where “substantial remaining
dentin” is available, a post and
core does not perform better
than a post-free core

19. 8
Ferrari M. Post placement affects survival of endodontically treated
premolars. JDentRes 2007;86(8):729-734.
8
Fokkinga W. Up to 17- year controlled clinical study on post-and-cores and
covering crowns. J Dent 2007;35(10):778-786.

20. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

21. ANTERIOR TEETH

9
Anterior teeth with
minimal loss of tooth
structure can be
restored
conservatively with a
bonded restoration in
the access opening
9
Intracoronal reinforcement & coronal coverage:a study of endodontically
treated teeth. Sorensen JA, Martinoff JT. J Prosthet Dent 1984;51:780–4.

22. ANTERIOR TEETH

10
A post is of little or no benefit in a
structurally sound anterior tooth
Increases the chances of a failure
10
Fracture strength and survival rate of endodontically treated maxillary incisors
with approximal cavities after restoration with different post and core systems: an
in-vitro study. Heydecke G, Butz F, Strub JR. J Dent 2001; 29:427–33.

23. ANTERIOR TEETH

11
In cases of extensive loss of external tooth
structure, a post is usually required for anterior
teeth, due to the predominantly shearing forces
present and the narrow tooth dimensions.
Extra-coronal crown preparation combined with
endodontic access preparation significantly
weakens the cervical area of anterior teeth.
11
PostPlacementandRestorationofEndodonticallyTreatedTeeth:A
LiteratureReview.RichardS.Schwartz,etal.Journalof
Endodontics:VOL.30,NO.5,MAY2004

24. Anterior Teeth
13
Biomechanical considerations for the restoration of endodontically
treated teeth: A systematic review of the literature. Didier Dietschi,, Ivo
Krejci, Quintessence international Volume 39 number 2 february 2008

25. Anterior Teeth
14
Biomechanical considerations for the restoration of endodontically
treated teeth: A systematic review of the literature. Didier Dietschi,, Ivo
Krejci, Quintessence international Volume 39 number 2 february 2008

26. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

27. Considerations for posterior teeth
Endodontically treated posterior teeth are
subject to greater loading than anterior
teeth, because of their position closer to the
insertion of the masticatory muscles.

This, combined with their morphologic
characteristics, makes them more
susceptible to fracture.

28. Posterior teeth
15
The results showed that the clinical
success rates of endodontically treated
premolars restored with fiber posts and direct
composite restorations or full coverage with
metal-ceramic crowns were highly successful
without any failures, even after 3 years of
service .
15
J Prosthet Dent 2002 Sep;88(3):297-301.Three- year clinical survival of
endodontically treated premolars restored with either full cast coverage
or with direct composite restoration.Mannocci F, Bertelli E, Sherriff M,
Watson TF, Ford TR

29. CASE REPORT
Post-endodontic restoration of a
deeply decayed tooth -options and
limitation Michael Bruder, DDS.
Jounal of oral science,11: 2;2007.

32. Posterior teeth
16
Molar teeth rarely require a post unless
there has been significant loss of tooth
structure. A coronal-radicular core buildup
with silver amalgam utilizing the pulp
chamber, and possible 2 mm canal extensions,
has proved very effective in vitro and in vivo.
16
Nayyar, A., An amalgam coronal-radicular dowel and core technique
for endodontically treated posterior teeth. J Prosthet Dent, 1980. 43: p.
511.

33. CASE REPORT
Reconstruction of Endodontically Treated
Posterior Teeth—with or without Post?
Maciej Zarow, Walter Devoto. The European
Journal Of Esthetic Dentistry. Volume
4,number 4,december 2009.

38. Tooth fracture of an endodontically treated
maxillary molar restored with a bonded composite
restoration.

39. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

40. COMPONENTS OF FINAL
RESTORATION
A.Posts
B.Cores
C.Crowns

41. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

42. Role of posts
Indications
Post selection:Factors to be considered
Ferrule effect
Types
Procedure
POSTS

43. The Role of Posts in the Restoration
of Endodontically Treated Teeth

18
The primary purpose for a post is to retain a
core that can be used to support the final
restoration.

Posts do not reinforce endodontically treated teeth, and a post is not necessary when substantial tooth structure is present after a
tooth has been prepared.
18
W. Cheung, “A review of the management of endodontically treated teeth:
post, core and the final restoration,” Journal of the American Dental
Association, vol. 136, no. 5, pp. 611– 619, 2005.

44. INDICATIONS
19
Post placement is indicated if both of the
following clinical conditions exist:
The remaining coronal tooth structure is
inadequate for the retention of a restoration.
When there is sufficient root length to
accommodate the post while maintaining an
adequate apical seal.
19
StocktonLW.Factorsaffectingretentionofpostsystems:
Aliteraturereview.JProsthetDent1999;81:380–385.

45. FACTORSTOCONSIDER
Post length
Post diameter
Post design
20
StocktonLW.Factorsaffectingretentionofpostsystems:
Aliteraturereview.JProsthetDent1999;81:380–385.

46. Post length
21
Guidelines:
1. The post should more than the incisocervical
or occlusocervical dimension of the crown.
2. The post should be longer than the crown.
3. The post should be 1 1/3 the length of the
crown.
4. The post should end halfway between the
crestal bone and the root apex.
21
StocktonLW.Factorsaffectingretentionofpostsystems:
Aliteraturereview.JProsthetDent1999;81:380–385.

47. Ideal tooth
preparation
for post
placement

49. Post Size and Length
22
Post length is unique and individualized for each
case. The clinician should have a thorough
knowledge of root morphology before placing a post.
The longer the post, the greater the retention. A
guideline of one half to three quarters of the root
length is often followed but may not be reasonable
for extremely long, short, narrow, or curved roots
22
Retention of endodontic dowels: effects of cement, dowel length, diameter, and
design. Standlee JP, Caputo AA, Hanson EC:J Prosthet Dent 39:401, 1998.
The effect of the embedded depth of posts on
retentive capacity has been shown to be
significant

50. Post diameter

23
The diameter of the post is dictated by
the root canal anatomy.
A minimal dentin thickness of 1 mm around
the post should be provided.
23
LloydPM,PalikJF.Thephilosophiesofdoweldiameterpreparation:A
literaturereview.JProsthetDent1993;69:32–36.

51. The diameter of the post is dictated by the remaining root
substance and root canal space: (A) too narrow; (B) optimum
size post; (C) too large.

52. Post design

24
Posts can be serrated,
smooth, roughened or
threaded.
Parallel, serrated posts
are cemented into the
canal passively. They are
retentive and produce less
stress in the root dentine
than threaded systems
24
PostPlacementandRestorationofEndodonticallyTreatedTeeth:A
LiteratureReview.RichardS.Schwartz,etal.Journalof
Endodontics:VOL.30,NO.5,MAY2004

53. Ferrule Effect

25
The ferrule is the circumferential ring of
sound tooth structure that is enveloped by
the cervical portion of the crown
restoration. A minimum sound dentine
height of 1.5-2 mm is required between the
core and crown margins.
25
Sorensen JA and Engelman MJ. Ferrule design and fracture resistance of
endodontically treated teeth. J Prosthet Dent 1999;63:529- 536.

54. Importance of ferrule
The ferrule provides bracing or casing action
to protect the integrity of the root.

55. 26
Effect of a crown ferrule on the fracture
resistance of endodontically treated teeth
restored with prefabricated posts
STATEMENT OF PROBLEM: Root fracture is
one of the most serious complications following
restoration of endodontically treated teeth

Fifty freshly extracted canines were
endodontically treated. The teeth were randomly
divided into groups of 10 and prepared according
to 5 experimental protocols
The results of this study showed that an increased
amount of coronal dentin (ferrule) significantly increases
the fracture resistance of endodontically treated teeth.
26
Effect of a crown ferrule on the fracture resistance of endodontically treated
teeth restored with prefabricated posts.
Pereira JR, de Ornelas F, Conti PC, do Valle AL
J Prosthet Dent. 2006 Jan;95(1):50-4.

56. 27
An incomplete crown ferrule is
associated with greater variation in load capacity
and, despite high fracture values, inclines to
fracture.
27
Effect of incomplete crown ferrules on load capacity of endodontically
treated maxillary incisors restored with fiber posts, composite build-ups, and
all-ceramic crowns: an in vitro evaluation after chewing simulation.
Naumann M, Preuss A, Rosentritt M.
Acta Odontol Scand. 2006 Feb;64(1):31- 6.

57. 27
CHARACTERISTICS OF AN
IDEAL POST:
Minimum preparation.
Resistance to fatigue.
Elastic modulus similar to dentin.
Non corrosive.
Retentive (post & Head).
Easy to adjust and fit.
Radiopaque.
Adequate material
Easy Removal
27
Factorsdeterminingpost selection: A literatureReview.
FernandesA., ShettySh., CoutinhoI.-
J Prosth. Dent. Dec. 2003.

58. 28
TYPESOFPOSTS
METALLIC NON-METALLIC
Stainless Steel
Titanium
Titanium Alloy
Gold-Plated
brass
Carbon Fibre
Ceramic
Glass-fibre
reinforced
Composite
28
Fundamental of fixed prosthodontics 3 editions
Herbert T. shillingburg
Page no 345

59. Types of Posts

60. Prefabricated posts

61. Custom made posts
Direct Technique
Indirect Technique
Wax pattern before casting.

62. Custom cast post and core
Advantages:
Preservation of maximum
tooth structure
Provision of anti-rotational
properties
Core retention
Less chances of vertical
fractures during preparation
High strength
Disadvantages:
Less stiff than
wrought
Time consuming,
complex procedure
Recommended Use:
Elliptical canals
Flared canals

63. 29
Prefabricated Tapered Post
Advantages:
Conserves tooth
structure
High strength and
stiffness
Disadvantages:
Low retention
Longitudinal
splitting of
remaining root
RecommendedUse:
Small circular canals or
Very tapered canals
29
Post placement and restoration of endodontically treated teeth: A
literature review.
Schwartz. R, Robbins. J.
J Endodon 2004, 30: 289- 301.

64. 30
Prefabricated Parallel -Sided
Smooth Post
Advantages:
Excellent clinical
retention
Minimal stress
production within
root
Ease of placement
Superior rating
Disadvantages:
Precious material
post expensive
Corrosion of
stainless-steel
Less conservative of
tooth structure
30
Color Atlas of Endodontics. , 2
nd
edition
William T.Johnson, page no 133- 134.

65. 31
Prefabricated Threaded Posts
Advantages:
High retention
Disadvantages:
Stresses generated in
canal may lead to
fracture
Does not conserve
coronal and radicular
tooth structure
RecommendedUse:
Onlywhenmaximum
retentionisessential
31
Color Atlas of Endodontics. , 2
nd
edition
William T.Johnson, page no, 133-134.

66. 32
Carbon Fiber Post
Advantages:
Dentin bonding
Easy removal
Disadvantages:
Low strength
(compared to metal)
Lack of radiopacity
Carbon color
presents an esthetic
problemRecommendedUse:
Can be used in posteriors
with moderate loss of
coronal structure
32
PostPlacementandRestorationofEndodonticallyTreatedTeeth:A
LiteratureReview.RichardS.Schwartz,etal.
JournalofEndodontics:VOL.30,NO.5,MAY2004

67. 33
Fiber Reinforced Post
Advantages:
Esthetic
Disadvantages:
Low strength
High failure rate
RecommendedUse:
Should not be used where remaining
tooth structure is less than ideal or where
high occlusal forces are present.
33
Aesthetic posts and cores for metal free restoration of
endodontically treated teeth. Adriana Quintas, Jose Dinato. Pract
Periodont Aesthet Dent; 12(9): 875- 884

68. 34
Zirconia Ceramic Post
Advantages:
Esthetics
High stiffness
High modulus of
elasticity
Disadvantages:
Expensive
Uncertain clinical
performances
RecommendedUse:
Highestheticdemands

69. Procedure
Textbook of Endodontology 2 editions
Preben Hørsted-Bindslev
Page no 326

70. A review of the studies done
on the various post systems
suggests that the fiber
posts are the most reliable!!!

71. Background: Post design and material has very
important effects on dentinal stress distribution since
the post placement can create stresses that lead to
root fracture.
Materials:
4 metallic posts (ParaPost XH, ParaPost XT,
ParaPost XP, and Flexi-Flange) and 1 fiberglass post
(ParaPost Fiber Lux) were used.
35
Fiberposts show more
homogeneous stress distribution
than metallic posts.
35
Influence of different post design and composition on stress distribution in
maxillary posterior teeth. Finite element analysis.
Natercia R Silva, Carolina G Castro, Paulo CF Santos-Filho.
Indian journal of dental research 2009 vol 20

72. Purpose.This in vitro study compared the effect of
titanium, quartz fiber, glass fiber, and zirconia posts
systems on the fracture resistance and fracture patterns
of crowned, endodontically treated teeth
Results.Teeth restored with quartz fiber posts
exhibited significantly higher resistance to fracture than
the other 3 groups. Teeth restored with glass fiber and
zirconia posts were statistically similar.
Fractures that would allow repair of the tooth were
observed in quartz fiber and glass fiber , whereas
unrestorable, catastropic fractures were observed in
titanium and zirconia post groups.
36
Resistance to fracture of endodontically treated teeth restored with different
post systems.
Akkayan B, Gulmez T.
J Prosthet Dent. 2002;87:431–437.
Fractures allow repairGood strength

73. Conclusion: The fiber posts evaluated
provided an advantage over a conventional
post that showed a higher number of
irretrievable post and unrestorable root
fractures. The fiber posts were readily
retrievable after failure, whereas the
remaining post systems tested were non
retrievable.
37
In vitro comparison of the fracture resistance and failure mode of fiber,
ceramic, and conventional post systems at various stages of restoration.
Cormier CJ, Burns DR, Moon P.
J Prosthodont. 2001;10:26–36.
Readily retrievable

74. PURPOSE: This retrospective study evaluated
treatment outcome of cast post and core and
Composipost systems after 4 yrs of clinical
service.
The results of this retrospective study indicated
that the Composipost(95% success) system(fiber-
reinforced epoxy resin posts) was superior to the
conventional cast post and core system(84%
success) after 4 yrs of clinical service.
38
Clinical evaluation of fiber-reinforced epoxy resin posts & cast post & cores.
Ferrari M, Vichi A, Garcia-Godoy F.
Am J Dent. 2000;13:15B–18B.
Better than cast post
system in the long term

75. PURPOSE: This study aggregated literature data on in
vitro failure loads and failure modes of prefabricated
fiber-reinforced composite (FRC) post systems and to
compare them to those of prefabricated metal, custom-
cast, and ceramic post systems.
RESULTS: Custom-cast post systems showed higher
failure loads than prefabricated FRC post systems,
whereas ceramic showed lower failure loads.
Significantly more favourable failures occurred with
prefabricated FRC post systems than with prefabricated
and custom-cast metal post systems.
39
A structured analysis of in vitro failure loads and failure modes of fiber, metal,
and ceramic post-and-core systems.
Fokkinga WA, Kreulen CM, Vallittu PK, Creugers NH.
Int J Prosthodont. 2004;17(4):476–482.
More favourable

76. MECHANICAL PROPERTIES
Material Flexural
strength
Gpa
Tensile
Strength
MPa
Elastic
Modulous
GPa
Stainless
Steel
800 n/a 200
Titanium
Alloy
1000 n/a 110
Zirconium
Oxide
820 n/a 200
C-Post
(64% Carbon)
1100 2900 17.8
40
Evolving Technologyin EndodonticPosts.
PitelM., HicksN
Comp. Of Cont. Educ. in Dent. January2003.

77. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

78. Indications
Principles
Types of core build up
Procedure
CORES

79. INDICATIONS
Core restorations are indicated if any of the
following clinical conditions exist:
The replacement of missing coronal tooth
structure is necessary.
When the enhanced retention and resistance
to displacement of the final restoration is
necessary.
41
Fundamental of fixed prosthodontics 3 editions
Herbert T. shillingburg
Page no 367

80. MATERIALSUSEDFORCORE
BUILDUP
DIRECT PLACEMENT:
1.Composite resin
2.Amalgam
3.Glass ionomer resin
INDIRECT PLACEMENT:
Casting
42
Fundamental of fixed prosthodontics 3 editions
Herbert T. shillingburg
Page no 369

81. Composite resin core
Advantages:
Good compressive
strength
Easy to manipulate
Rapid
polymerization
Dentin bonding
Disadvantages:
Polymerization shrinkage
Poor dimensional stability
RecommendedUse:
Excellent build-up material
for posterior and anterior
teeth if isolation assured

82. Amalgam core
Advantages:
Reduced marginal
leakage
Better dimensional
stability
Better compressive
strength
Better modulus of
elasticity
Disadvantages:
Mercury sensitivity
Low tensile strength
Corrosion with base
metal
RecommendedUse:
Molars with adequate
coronal tooth
structure

83. Glass Ionomer resin core
Advantages:
Anticariogenic
Adhesive
Easy to manipulate
Disadvantages:
Low resistance to
fracture
Low retention to
preformed post
Sensitive to moisture
RecommendedUse:
Teethwithminimum
toothstructuremissing

84. So which is the best
material for core
buildup???

85. The modulus of elasticity of amalgam is
significantly higher than all other material
tested and is closer to that of dentin
Prepared core build-ups in a hybrid
composite material provided the highest
fracture resistance
46
Fracture resistance of five pinretained core buildup materials on teeth
with and without extracoronal preparation.
Burke, FJT, Shaglouf, AG, Combe, EC, Wilson, NHF.
Operative Dentistry 2000; 25: 388- 394.

86. This study showed that the tensile and
flexural strengths of composite are
significantly higher than that of amalgam
and glass ionomer.
47
Kovarik, Robert E., Breeding, Larry C., Caughman, W. Franklin. Fatigue
life of three core materials under simulated chewing conditions.
The Journal of Prosthetic Dentistry Oct 1992; 68(4): 584- 589.

87. Tensile strength and modulus of elasticity
of glass ionomer cements are significantly
lower than dentin and amalgam
Glass ionomers are relatively slow-setting
and their early resistance to moisture is poor
48
Mechanical properties of direct core buildup materials.
Combe, E.C., Shaglouf, A., Watts, D.C., Wilson, N.H.F.
Dental Materials 1999; 15: 158-165.
Based on the above stated
evidence, composite seems to be
the best choice as a core build up
material.

88. CONTENTS
Introduction
History
Need for final
restoration
Objectives

Classification
Anterior teeth
Posterior teeth
Components of final restoration:
I.Posts
II.Cores
III.Crowns

89. CROWNS
Indications
Advantages
Disadvantages
Types

90. CROWNPLACEMENT
INDICATIONS
Better esthetics
Situations in which the structural integrity
of natural crown is compromised
CONTRAINDICATIONS
Anterior teeth have only have conservative
access opening
49
Textbook of Endodontology
Gunnar BergenholtzPage no 317

91. CROWNS
Advantages:
Durable
Good esthetics
Restoring dental
function
Good Form
Protection of tooth
Disadvantages:
Loss of tooth structure
Expensive
50
Textbook of Endodontology
Gunnar BergenholtzPage no 317

92. METAL-CERAMICCROWNS
It consists of a ceramic layer bonded to a
thin cast metal coping that fits over the
tooth preparation.
It combines the strength and accurate fit of
a cast restoration with the esthetic effect of
a ceramin crown.
Less tooth preparation required compared to
all ceramic crowns.

93. 51
PORCELAINJACKETCROWN
It consists of a crown entirely made up of ceramic.
Superior esthetics and excellent translucency.
Good tissue response even with subgingival
margins.
But is has reduced strength and is the least
conservative of all tooth preparation.
51
Endontics Problem-Solving in Clinical Prctice
TR Pitt Ford, BDS, PhD
Page No.161

94. 52
FULLCASTMETALCROWNS
Cast metal crown is a full crown restoration which
is cast with dental alloy.
It had high strength, is long lasting and requires
the least amount of tooth preparation.
Cannot be used in areas where esthetics is of
prime concern.
52
Endodontics Problem-Solving in Clinical Practice
First published in the United Kingdom in 2002
ISBN 1-85317-695-8
TR Pitt Ford, BDS, PhD Page no 161,

95. 53
PARTIALCASTMETAL
CROWNS
Partial cast metal crowns may be used when the
buccal surface of the tooth is intact. They are more
conservative of tooth tissue than complete crowns,
but they are more demanding technically both for
clinician and in the laboratory
53
Color Atlas of Endodontics.
William T.Johnson, 2nd edition, 133- 134.

96. 54
TEMPORARY CROWNS
Temporary crowns are used to protect a tooth that
has been prepared for a permanent crown while
the patient waits for the permanent crown to be
fabricated by the dental lab.
Types:
i.Polycarbonate
ii.acrylic temporary
iii.Custom-cast temporaries
iv.Composite resin
54
Color Atlas of Endodontics.
William T.Johnson, 2nd edition, 133- 134.

97. Conclusion

98. Anterior Tooth
Class IV
Class I -III
Complete Coverage
is required
Prefabricated fiber post with
composite core
full ceramic crown
Complete
Coverage is
not required
Conservative Trt
Resin composite
Class V
Complete Coverage
is required

99. Posterior Tooth
Class IV
Class I-III
Conservative Trt
Onlay
Class V
Composite Core
Fiber post
Metal Ceramic
Crown
Pre-fabricated fiber
post
Composite Core
Metal Ceramic
crown

100. Thank You