When to Use Y Post with Teeth？

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Post and core is a dental restoration treatment that's sometimes performed after a root canal.

When a significant portion of a tooth's structure is removed, a post and core can help keep a dental crown in place. Dental crowns are put on top of teeth, to protect them from further damage or infection.

In this article we'll go over the post and core procedure from start to finish, as well as discuss what recovery looks like.

What is post and core?

During a root canal procedure, a portion of your tooth and your pulp-filled cavity in the root of your tooth is removed. The pulp contains:

• blood vessels
• nerves
• connective tissue

In some instances, there may not be enough tooth left intact to return it to typical function.

When this occurs, a post and core can be performed to keep a dental crown in place, and to reconstruct, or build the missing portions of your tooth.

'In laymen's terms, you cannot build a new house on a missing foundation,' says Dr. Cindy Roark, DMD MS, of Sage Dental. 'A post in dentistry is used much like a post in a fence.'

Roark explains that posts are placed into the canal where the root of your tooth used to be. This helps retain your tooth's core.

'The root canal houses the post, and the post retains the core buildup,' Roark says. The core replaces the missing tooth structure and foundation and supports the crown.

When is post and core used?

During a post and core procedure, the root canal must be devoid of its original pulp-filled cavity or chamber (the root is still present).

The post goes inside the canal, which is sealed during the root canal procedure. For that reason, this post and core is performed after a root canal.

Roark only recommends a post and core procedure when more than 50 percent of your tooth's original structure is removed. In these instances, the post helps mechanically retain the dental crown and core.

The post and core procedure should not be performed if there is enough remaining tooth structure available to hold a crown in place.

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How is a post and core done?

According to Patrick Campbell, DDS, LT, DC, USN, of Walter Reed National Military Medical Center, there are two types of post and core procedures:

• Prefabricated post and core. This is a pre-made unit.
• Cast post and core. This is a one-piece unit that is custom-made at a dental laboratory. It may be constructed with multiple posts.

Your dentist will decide which type is best for you, based upon the extent of your tooth's damage or decay.

'The important takeaway for patients is that prefabricated post and cores usually take one appointment, while cast post and cores usually take two,' says Campbell.

Pros and cons of post and core

Here are pros and cons of a post and core procedure.

Pros

• A post and core procedure allows you to retain your tooth, eliminating the need for an extraction and dental replacement, which may be costly.

Cons

• Post and core procedures don't reinforce or strengthen teeth.
• In some instances, a post may stress or weaken your teeth over time.

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Takeaway

Post and core is a dental restoration procedure which is sometimes performed after a root canal. The purpose of a post and core is to salvage an existing tooth that has lost a significant amount of its internal structure.

A post and core helps anchor a dental crown on top of a tooth to shield it from infection and further damage.

Restoring a root-canal treated tooth can be challenging. Preventing contamination or fracture is always a concern ' especially when a large part of the coronal tooth structure is missing, making it difficult to find sufficient retention for the restoration. With so much at stake, how do you achieve restorative success? It starts by taking a closer look at the treatment options available and addressing significant case factors before making a decision.

While insufficient tooth structure is a common issue, advancements in adhesive dentistry allow dentists to bond the restoration to the remaining tooth substance, even if proper retention is missing. Keep in mind that at least one intact wall should be present to provide a decent bonding surface for the new overlay restoration. In the posterior region, additional retention can be found in the pulp-chamber of the molar, enabling an 'endocrown', or monolithic restoration ' without the need to place a post-and-core. One study demonstrated a 98% survival after seven years in place.1

Case #1 images 1-3: After fracture of the palatal wall and filling, only the buccal wall remained. This was sufficient to bond the restoration, without having to place a post. Some gingivectomy was done on the palatal side to expose the margin, and the buccal wall was lowered to allow cuspal coverage. The final restoration was luted to the tooth using an adhesive resin cement (3M' RelyX' Ultimate Adhesive Resin Cement).

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