Post & Core
A post and core is a dental restoration used to sufficiently build-up tooth structure for future restoration with a crown when there is not enough tooth structure to properly retain the crown, due to loss of tooth structure to either decay or fracture. Post and cores are therefore referred to as foundation restorations.
The post itself is a reinforced fibre structure that is placed within the root of a tooth that has had a root canal (endodontic procedure). When a root canal is performed, the nerve is removed and the space it occupied is filled with a special filling material.
In placing a post, we remove some of this root canal filling material creating a space. The space that is created is used to anchor the post within the root of the tooth.
The type of post that is chosen will depend upon a number of factors. Most posts used today are prefabricated. The appropriate size is selected depending on the tooth.
A core is built from filling material around the part of the post that sticks out of the root after the post is cemented into the root. The core is shaped so that it will anchor and retain a crown.
Although posts are usually recommended when there is minimal support for a crown, they are not always necessary. The use of a post is determined on an individual basis based upon support and structural strength required.
Structure
A post and core consists of two parts :Procedure For Post And Core
Deciding Post in the Root or Not - The decision to place a post in the root canal is based depending on the amount of tooth structure remaining above the gum line. If sufficient amount of tooth structure is present above the gum line and a small access cavity is present, then there is no need for placement of post. The tooth is just filled with a filling material and crown is placed over it if it is required.
But if large amount of tooth structure is missing above the gum line, a post has to be placed inside the root canal so that crown can be retained properly over it.
Procedure For Post And Core Placement
- First of all, Root Canal Treatment (RCT) of the tooth is done to remove the infection and shape the root to receive a post. Use of local anesthesia is required while doing RCT. In root canal treatment; after cleaning and shaping the root, the root canal is filled with an inert material called gutta-percha to seal the root canal completely.
- After the RCT is complete, in the subsequent appointment some of the gutta-percha from the root canal is removed leaving at least 5mm of gutta-percha inside the root canal. Then using a series of graduated instrument called reamer, root canal is enlarged sufficiently to receive a post.
- Posts are usually pre-fabricated and available in many shapes. Post most suitable for the prepared root is chosen and cemented in the root canal such that it gets firmly embedded inside the root canal.
- The tooth structure is then built up using a suitable core material such as amalgam or composite. When core material gets hardened it is shaped properly and prepared to receive a crown.
- Then impression of the tooth is taken and sent to the dental laboratory for the fabrication of crown.
- Until permanent crown gets prepared in the lab, the tooth is covered by a temporary crown for its protection.
- Permanent crown is prepared in the lab in 10-15 days, so next appointment is scheduled accordingly and in next appointment permanent crown is cemented over core.