Does an endodontist place a post? An expert's perspective

Endodontists are often asked if they place posts when performing root canal treatment. Learn more about when posts are necessary from an expert's perspective.

Does an endodontist place a post? An expert's perspective

Endodontists are often asked to place a permanent filling (build-up) and post if necessary. In the case of maxillary premolars with two roots, the buccal canal should be posted if possible. This is because, in the event of treatment failure, it is possible to conservatively remove the palatine canal. However, care should be taken in the first premolars due to the mesial concavity.

A high percentage of these teeth are endodontically affected due to mesial marginal ridge cracks extending along the mesial side toward the bifurcation. Non-passive post placement can exacerbate cracks in this area. Posting the palatal root often means resecting a perfectly good buccal root to gain access to the defective palatal root, in case the placed buccal canal needs surgical access. The buccal root is always easier to locate and prepare. In that case, the length of the healthy palatal root is preserved.

A similar rule can be used for mandibular teeth with buccal and lingual canals. Sometimes, teeth lack a large part of their structure due to decay, fracture, loss of a filling, or as a result of creating the access cavity necessary for their root canal work. This reduction in size and shape may not provide an adequate basis for the planned final restoration of the tooth (crown abutment or dental bridge). A core buildup is placed for the specific purpose of allowing the dentist the opportunity to create the ideal foundation for a new dental crown. As such, a core will not meet many of the criteria that a filling must meet, such as how it comes into contact with neighboring teeth or the teeth that bite it. The crown that is placed over the core will meet these criteria, not the core itself.

There was enough part of the crown of this tooth left after his endodontic procedure that no post was required. The above findings are not intended to suggest that placing posts is a “bad” thing. However, a dental post should be recognized only as an aid to help anchor a dental core and plays no role in strengthening a tooth. A dental post is cemented into the prepared space of the root canal of a tooth that has undergone endodontic treatment (endodontics). Its sole purpose is to help anchor the buildup of core attached to the tooth. Compared to a post and a core, the placement of the dental core alone is a comparatively less complicated procedure.

And, as such, combinations of core (alone) with corona would generally be expected to have a high survival rate. Unfortunately, we couldn't find a contemporary (recent) source to cite that would have researched this topic. It should be noted that crown failure generally does not involve tooth loss, whereas posterior and central failure most often does so (often due to complications associated with root fracture). The above findings suggest that when determining the prudence of saving a tooth (by performing root canal treatment and then reconstructing it with a post, core, and crown), what is technically possible (“dental heroism”) may not amount to making the best decision. A comparison of composite post accumulations and molten gold post and core accumulations for non-vital tooth restoration after 5 to 10 years can provide insight into this matter. About thirty years ago I damaged the nerve of one of my front teeth, at that time I had a root canal.

In June, when I was visiting my dentist, he commented on how black my front tooth had become. He said I should consider putting on a crown, made an appointment for this to be done, after a week I came back and created a post from the damaged front tooth. He fixed a temporary crown and told me it would take me about two weeks to get a new crown, when the crown arrived it was the wrong color, so it had to be redone. After another week or so, the temporary crown was removed, so I went back to the dentist to have it replaced. A dentist replaced it with what I can only say is a substance that was ejected from a gun and molded into shape. A few days later I went back to the male dentist to have my new crown put on.

The dentist had a difficult job removing my temporary crown, so much so that I felt a sound and a crackling sensation. I asked him that my tooth was OK and they told me it was OK, after placing the new crown, I stopped. About two weeks later, as I got into my car, my crown, including the mail maid, fell out of my tooth. I went back to the dentist, the dentist replaced the crown with what she called a flexible post, however, this was very flexible. I complained but they told me that if it came off I would put a new crown on it with a steel pole. By December I returned and she agreed that a new crown with steel pole would fit her; The new pole was installed three days ago and despite telling her that it was still very loose she said it was fine.

However this Saturday morning he retired. I contacted helpline but they couldn't help; It seemed to me that there was no adhesive on post but only around tooth. It could be failure with materials used (cement union) something like you explain but pole should not be held only by grip of its “cement” its shape resistance (resistance detachment due its shape fit inside tooth) more important factor. That said for future attempts your dentist will likely choose cement known adhere both tooth structure metal which can certainly help; A crown splint has do how edges crown...

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