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The opinions within this web page are not ours. Authors have been credited
for the individual posts and photographs where they are. -

Cast post cores in an adhesion world?

From: Venkat
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

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