Cases

Cases – January 2008

The key to endodontic success is thorough debridement and disinfection of the canal space, effective obturation of the canal systems and an immediate definitive coronal restoration that prevents leakage and loss of tooth structure. Studies have proven over and over that delaying the placement of a definitve coronal restorartion on an endodntically treated tooth results in higher failure.

In my practice, a majority of the endodontically treated teeth receive a definitve coronal restoration immediately after the completion of the obturation of the canals.Some of these restorations involve a post placement in one of the bigger canals.

 

Post placement in my offcie is limited to:

Molars: if more than 2 walls are missing and if remaining dentin is less than what is required to retain the crown.

Premolars: more than one wall is missing, particularly if one of the walls is buccal or lingual and if remaining dentin is less than what is required to retain the crown.

Anteriors: if remaining dentin is less than what is required to retain the crown.

However, keep in mind that the single most important factor that influences positively the retention and the fracture resistance of a crown and the tooth respectively is the remaining dentin after the crown preparation. 2 mm solid dentin circumferentially (ferrule) is a critical necessity. Placing a post will not circumvent this necessity but only will compliment.

As you can see from the attached finished cases in the month of January, all teeth received definiteve restorations whether it is just sealing the access or doing a build up or post and core buildups. If consistency in performing high quality endodontic treatment defines a specialst endodontic practice, placing an immediate coronal buildup is a signature of excellence. Please review the last 40 cases that I finished in my practice defining this fact. Pre ops and at least one post op image is included.