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Cast post cores in an adhesion world?
Sent: Wednesday, March 29, 2006 2:37 PM
Subject: Re: [roots] Cast post cores in an adhesion world?
Personally I like using cast posts when indicated.
I had better success with castposts than adhesive posts. The clinical exam
at the end of our postgrad course in India requires we make the intracanal
impression for a castpost and fabricate, cement it the next day. I guess my
technique is better with castposts than adhesive posts. I feel they do have
a role in certain cases especially in teeth with minimal coronal tooth
structure. This is one such case I did 4 months ago. Pt was on a holiday,
fractured the crown and reported for a quick fix before she could get back
to her dentist in UK.
Right upper canine with a 3 year old all ceramic crown fractured at the
cervical region. Ceramic Crown was intact with carious tooth structure firmly
cemented inside. I suggested XLA and implant as a long term solution and
offered to do a partial denture over the fractured tooth till she gets back
home. Implant was ruled out due to financial issues. Hence I decided to restore
it with cast post and utilise the old crown ( to bring down cost). one visit endo
and canal prep , canal impression with a metal post and elatomeric material.
temp crown using used endo file and strip crown. second visit cleansed the canal
with ultrasonics and cemented the cast post and crown with resin cement.
(pics are arranged in a clockwise circle starting from left top corner and
ending in the center) As you said the crown ferrule only works when the crown fits.
In this case I could not achieve it because I was using the old crown. Ideally I
would have prefered crown lenghtening and new crown. What in your opinion is the
prognosis for this case? I instructed my lab technician to clear occlusion
(especially lateral and forward movements)
I told the patient to save up money for implants in 3 years. (I'm optimistic)
thanks - Venkat