ACHIEVING IDEAL ENDOESTHETIC - RESORATIVE CONTINUUM
Preserving the pulp vitality is the main aim of present
day dentistry. However due to a myriad of conditions,
the use of posts may have to be considered as the last
therapeutic option. Generally, endodontically treated
teeth have already undergone significant coronal
destruction and a pertinent loss of radicular dentine. In
such a condition the non metallic posts help to bring
the concept of an endoesthetic restorative continuum
closer to reality by providing an esthetic post, a
composite core and an automixed resin luting cement ,
thus formulating a monobloc that ensures not only high
quality esthetics but is also safe , durable and easy to
use for the clinician
CLINICAL APPLICATION OF GLASS FIBER
The step by step protocol is easy to follow as givenbelow;
- Evaluate a successfully treated root canal toothby confirming radiographically the intact apicalseal
- Remove the gutta percha such that 3-4 mm ofintact apical seal is retained
- Insert the glass fiber post after adequate canalpreparation
- Lute the post in place using flowable composite
- Build up a composite core
- Take a final impression for crown placementIt is important to note that a post that can be bonded totooth structure improves its ability to retain the entirefoundation.Hence it is imperative to select a post thatprovides maximum retention while at the same timeremoving as little tooth structure as possible
The glass fiber post is a clear resin post that is designedto refract and transmit natural tooth colors .It is placedpassively in prepared canal and is available in differentsizes and diameters. Advantages offered by the resinpost over metallic posts includes increased bondstrength, lesser chairside work for clinician andforming an esthetic tooth composite monobloc. Othersecondary advantages are its ability to distribute stress,capability to maintain intraradicular rehabilitation andease of retreivability.
The root length, shape and amount of tooth structurelost as well as the periodontal status and final root canaltreatment quality are important aspects in deciding thesuccess or failure of post endodontic restoration. Postplacement should be as long as possible for betterstress distribution and increased retention. Placing along post in a short root may cause disruption of rootcanal seal at the apex and eventually may lead to rootfracture also.
Resin fibre glass posts are also easy to retrieve ascompared to metal posts, that may compromise theremaining dentine while being removed from theradicular tooth structure. In case of glass fiber posts,the use of gates glidden drill through the existing postcan safely act as a vertical guide making the postremoval rapid and predictableTrial post placement ,before saeting post in place,is amust, to see the proper placement, position and lengthof post in dentin.After post placement and before curinginitiation, the excess flashes of composite should beremoved by microbrush to aid in better post placement.
Curing of composite at minimum of 40 sec isadvocated, but this variable depends on the type ofcomposite cement used and the manufacturersinstructions. Shade matching should be accomplishedand keeping the variables of hue, chroma and value inmind, so that the core composite material is of the sameshade, as the final crown for an esthetic result
Modern day endodontics demands clinicallyconvenient and esthetic post and core systems to helprestore lost tooth structure. Recent developments in useof esthetically viable non metallic posts have served toprovide an ideal endoesthetic-restorative continiuumcomprising of an esthetic non metallic post, acomposite core and an automixed resin luting cement
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