Abstract
Abstract Introduction Endodontically treated teeth with extensive coronary destruction require posts and cores to enable prosthetic restoration. Despite the increasing use of prefabricated posts, cast metal posts and cores are still widely used. The quality of the latter is important for the longevity of restorative treatment, and failure can occur if the fundamental principles are not followed. Objective To radiographically evaluate the prosthetic principles of 1000 cast metal post-and-core restorations performed in single-rooted teeth and their coherence with the principles used for their confection. Material and method Digital periapical radiographs of 1000 endodontically treated, single-rooted teeth with cast metal posts and cores were selected from the collection of a radiology clinic (Centro de Imagem, Aracaju/SE, Brazil). The images were analyzed using a measurement software (ImageJ, USA) in accordance with the fundamental prosthetic principles: length and diameter of the post, ratio between post and bone crest, contiguity of post to the root canal, gap between post and the remaining root canal filling, amount of remaining root canal filling, and absence of periapical lesion. The data were qualitatively analyzed, classified into ideal and not ideal, and submitted to the chi-square test (α=0.05). Result Only 6.7% of the cast metal posts analyzed were satisfactorily fabricated. Conclusion Many prosthetic criteria are neglected during the manufacturing of cast metal post and cores, resulting in inadequate work that may compromise the longevity of restorative treatments.
Highlights
Treated teeth with extensive coronary destruction require posts and cores to enable prosthetic restoration
The study was conducted through the selection of digital periapical radiographs of 1000 endodontically treated, single-rooted teeth with cast metal posts and cores
The following levels of adequacy were verified for the assessed prosthetic criteria: post length (13.5%), post diameter (80.1%), post:bone crest ratio (19.4%), post contiguity to root canal (92.9%), absence of gap between post and the remaining root canal filling (51.9%), amount of remaining root canal filling not associated with short post (8.3%), and absence of periapical lesion (85.8%)
Summary
Treated teeth with extensive coronary destruction require posts and cores to enable prosthetic restoration. Treated teeth require special care when they are prosthetically restored because of the substantial tooth structure loss caused by removal of carious lesion, crown fracture, and access for endodontic treatment. Restoration of this lost dental structure, so that the tooth can again develop its functions in the oral cavity, depends on the amount of dental remnant. They can be fabricated using both indirect and direct techniques: in the first case, a plaster impression is sent to a dental laboratory for post construction; in the latter case, an acrylic resin post is built up in the patient’s mouth, providing better retention[2]
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