Restoration of endodontically treated posterior teeth using two-piece cast posts and cores.

Abstract

When restoring severely damaged endodontically treated teeth, a post and core restoration is a common procedure. The post and core fabrication is usually performed chair side using acrylic resin for the direct core build–up. Because of multiple roots and root divergence, second maxillary premolars and molars need a different approach. In this clinical situation a multiple piece dowel-core with separate dowels should be employed. Several methods have been proposed for accomplishing this: – The core can be made in two pieces held together by interlocking lugs. – The core can be made with a channel into which an accessory dowel is cemented. This secondary post can be prefabricated or it can be cast (custom made). Both techniques can either be performed in the clinic (direct technique) or in the lab (indirect technique). It is obvious that the indirect technique saves clinical time, but increases costs due to lab fees. Post space preparation is a common procedure performed using a combination of Gates-Gliden drills and Peeso reamers. The aim of this article is to discuss all the different techniques , analyse the clinical and lab procedures and show several examples covering the majority of cases.