Factors for Successful Endodontic Post Placement: A Step-By-Step Guide

Clinician’s Corner – Educational Content for Clinical Directors,
Chief Dental Officers, Clinical Boards and the Entire Clinical Team.

Case Study sponsored by Essential Dental Systems

Read the Case and Receive your Free Translucent Post Clinical Evaluation Kit.

Our goal as clinicians and business owners is to offer the highest quality services possible while maintaining profitable services for the practice. Several factors for successful endodontic post placement include long-term retention, stability and esthetics (if required). These factors are accomplished by choosing the best possible armamentarium and non-complicated, reproducible clinical techniques. The below technique guide utilizes a system which is amongst the most economical available and highly rated by The Dental Advisor clinicians.

Clinician’s comments include:

• “The undercuts secure core material tenaciously.”
• “Easy to use and consistent results.”
• “The second tier makes it more secure.”
• “Great physical characteristics.”

Post Selection:
As the purpose of a dental post is to replace missing tooth structure and retain a core restoration and crown it is important to choose a post that redistribute stresses as to thereby reduce the risk of coronal fracture. Post designs have greatly evolved since the first development of cast posts. Unlike tapered posts that have a “wedge design” (like wedges that split logs) or straight posts that can “bottom out” causing high apical stress, some post provide a multiple-tiered design. This design adapts to the anatomical flare of the canal and it provides a “seat” for the post so it rests on coronal tooth structure for stability and strength. The following with demonstrate the clinical placement of a post with just such a multiple-tiered design.

The Procedure:
Upon instrumentation and obturation of the root canal procedure, post selection is best done by assuring that there is a minimum of approximately 0.5mm of lateral root structure at the most apical placement of the post, there is sufficient root structure for placement.

Step By Step:

  1. Use a Peeso Reamer or Gates Glidden drill to remove gutta percha, and for preliminary sizing of the canal. In this case we will be placing a red, size one, EZ-Fit Translucent post (Essential Dental Systems). Therefore, we are using a red EDS’ Gates Glidden Drills for the removal of gutta percha (Fig 1).

Fig 1. Removal of gutta percha using a gates glidden drill. (User tip: Cut wet will all drills)

2. Use the primary reamer (Fig 2) to prepare the full length of the post hole.

Fig 2. Primary reamer used for preliminary sizing of the canal. (User tips: Do not use the primary reamer to remove gutta percha. Do so may cause it to break)

3. Use the secondary drill to prepare the seat for the second tier (Fig 3).

Fig 3. The secondary drill (left) creates the multiple tiered preparation (right).

4. Trial seat before cementation. (Fig 4)

Fig 4. Note: The post must always seat fully in the second tier. If the post does not sit within second tier preparation, remove the post and cut apical end to ensure a full seat.

5. Insert the post slowly to relieve any hydrostatic pressure of cement and ensure the post is fully seated with the preparation. Remove any access cement and light cure (Fig 5).

Fig 5. Light cure the post within the preparation

6. Due to the highly translucent post material and reinforced unidirectional fibers the light is transmitted down the root canal for optimal curing. The core material is now placed around the post head. Here we are using Ti-Core Flow Plus. This rock-hard core material cuts like dentin so there is no ditching or grooving during preparation. Light cure the Ti-Core Flow Plus core material, remove the core form and shape the core.

Fig 6. Core formation.

To request a complimentary EZ-Fit
Translucent Post Clinical Evaluation Kit.

Please visit: https://edsdental.com/ezfit_eval

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