Amir Saad Thesis final revision 03x - IUPUI

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The standard of care following endodontic treatment when a tooth lacks
structure and vitality is to place a post and core build-up. The criteria used in restoring
endodontically treated teeth have long been influenced by the feel, experience, and
empiricism of the practitioner. The considerations before initiating endodontic
treatment include an assessment of the ability to restore the tooth to form and
function. If restoration is the decision, then the practitioner has a choice of post and
core designs to retain an overlying crown. Extraction is the alternative.
The use of posts in nonvital teeth dates back more than three centuries. 1 The
concept of posts or dowels was originally designed as a means of retention of the
coronal restoration if inadequate tooth structure remained. 2 Posts were viewed as a
method to reinforce nonvital teeth. 3 Several reports hypothesize that the rigidity of the
post should be as close as possible to that of the root to distribute occlusal forces
evenly along the length of the root. 4, 5 Various post and core designs and materials
have been developed. These include cast post and cores, metal prefabricated posts
with a core build-up of composite resin, and fiber posts with a core build-up of
composite resin. High noble alloys, base metal alloys, zircon and quartz fiber, carbon
fiber, and glass fiber composites have been used as posts.
Post stiffness is important from a mechanical point of view. As the stiffness of
a post increases, so does the risk of tooth fracture. 6 Even so, stiffer than vital or
nonvital natural teeth, cast metals are very useful and long-lasting as the standard of
care in treatment.