Restoration of the

endodontically
treated tooth

Amith Babu
Amrita Dora
Ganesh O.R
Praveen J
Ourvind Singh
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
The tooth as a house
 INTRODUCTION
Endodontic treatment is largely performed
on teeth significantly affected by caries, multiple
repeat restorations and/or fracture. Already
structurally weakened, such teeth are often
further weakened by the endodontic procedures
designed to provide optimal access and by the
restorative procedures necessary to rebuild the
tooth.
It is therefore accepted that endodontically
treated teeth are weaker and tend to have a lower
lifetime prognosis.
 INTRODUCTION
Hence require special considerations for
the final restoration, particularly where there
has been extensive loss of tooth structure. The
special needs involve ensuring both adequate
retention for the final restoration and
maximum resistance to tooth fracture.
Endodontic success depends not only
on the quality of the root canal treatment, but
also on timely coronal restoration of the
compromised tooth.
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 HISTORY
 Various methods of restoring
pulpless teeth have been
reported for past 200 years.
 In 1747 Pierre Fauchard
fabricated gold and silver
posts to be placed in root
canal space.
 Replacement crowns were
made from bone, ivory,
animal tooth.
Is final restoration
after endodontic
treatment
important?
 LITERATURE REVIEW
1
In this study using radiographs they assessed the
following
Good restorations + good endodontic treatments
resulted in absence of periapical inflammation in 91.4%.
PoorThis
restorations + poor
shows the endodontic
importance treatments
of final restoration
resulted in thein
absence of periradicular
endodontically treated inflammation
teeth in
only 18.1%.
Poor endodontic treatment + good restorations yielded
a success rate of 67.6%.

1
Periapical status of endodontically treated teeth in relation to the technical
quality of the root filling and the coronal restoration.H. A. Ray and M. Trope
International Endodontic Journal, vol. 28, no. 1, pp. 12–18, 1995.
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 What are the
objectives of Final
restoration?
 GOALS
 2Maintained coronal and apical seal of the root
canal treatment
 Protect and preserve the remaining tooth structure
 Provided a supportive and retention foundation for
the placement of definitive restoration
 Restore the function and esthetics

Colour atlas of endodontics 2 edition

2

William T.Johnson DDS MS

Page no 130
What are the factors
to be considered
while planning the
final restoration?
 FACTORS

 3Amount of remaining sound tooth structure

 Occlusal function
 Opposing dentition
 Position of the tooth in the arch
 Length, width and curvature of the roots

Endodontics : Restoring of Endodontically Treated Teeth

3

American Association of Endodontics.1995 Dec Publication

 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 4
Based on the remaining tooth
structure
Classification Description
Class I 4 walls
Class II 3 walls
Class III 2 walls
Class IV 1 wall
Class V No wall

4
Restoring endodontically treated teeth with posts and cores—a review
Ingrid peroz et al.Quintessence International no.9 volume 36 oct 2005.
Restoration of Endodontically Treated
6

Teeth:
An Evidence-Based Literature Review
University of Toronto, Faculty of Dentistry. Int
J Prosthodont 2008;18(1):40-1.
 FERRARI AND FOKKINGA &
OTHERS OTHERS
240 endodontically-treated 307 endodontically-treated teeth
SAMPLES premolars in 210 in 257
patients patients
TEST Fiber posts Cast post and core
TREATMENT Pre-fab metal post and
composite core
CONTROL No post Post-free composite core

TREATMENT
DURATION 2 Up to 17
(YRS)
4 coronal wall remaining: no Where “substantial remaining
difference in dentin” is available, a post and
complication rates core does not perform better
CONCLUSIONS ≤ 3 coronal walls remaining: than a post-free core
post placement
increases survival rates
8
Ferrari M. Post placement affects survival of endodontically treated
premolars. JDentRes 2007;86(8):729-734.

8
Fokkinga W. Up to 17-year controlled clinical study on post-and-cores
and covering crowns. J Dent 2007;35(10):778-786.
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 ANTERIOR TEETH
 9Anterior teeth with
minimal loss of tooth
structure can be
restored
conservatively with a
bonded restoration in
the access opening

9
Intracoronal reinforcement & coronal coverage:a study of endodontically
treated teeth. Sorensen JA, Martinoff JT. J Prosthet Dent 1984;51:780–4.
 ANTERIOR TEETH
 10A post is of little or no benefit in a
structurally sound anterior tooth
 Increases the chances of a failure

Fracture strength and survival rate of endodontically treated maxillary incisors

10

with approximal cavities after restoration with different post and core systems:
an in-vitro study. Heydecke G, Butz F, Strub JR. J Dent 2001; 29:427–33.
 ANTERIOR TEETH
 11In cases of extensive loss of external tooth
structure, a post is usually required for anterior
teeth, due to the predominantly shearing forces
present and the narrow tooth dimensions.
 Extra-coronal crown preparation combined with
endodontic access preparation significantly
weakens the cervical area of anterior teeth.

Post Placement and Restoration of Endodontically Treated Teeth: A

11

Literature Review. Richard S. Schwartz, et al. Journal of

Endodontics:VOL. 30, NO. 5, MAY 2004
 Anterior Teeth

13
Biomechanical considerations for the restoration of endodontically
treated teeth: A systematic review of the literature. Didier Dietschi,, Ivo
Krejci, Quintessence international Volume 39 number 2 february 2008
 Anterior Teeth

14
Biomechanical considerations for the restoration of endodontically
treated teeth: A systematic review of the literature. Didier Dietschi,, Ivo
Krejci, Quintessence international Volume 39 number 2 february 2008
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 Considerations for posterior teeth

 Endodontically treated posterior teeth are subject to

greater loading than anterior teeth, because of their
position closer to the insertion of the masticatory mus­
cles. This, combined with their morphologic
character­istics, makes them more susceptible to
fracture.
 Posterior teeth
The results showed that the clinical
15

success rates of endodontically treated premolars

restored with fiber posts and direct composite
restorations or full coverage with metal-ceramic
crowns were highly successful without any
failures, even after 3 years of service .
J Prosthet Dent 2002 Sep;88(3):297-301. Three-year clinical survival of
15

endodontically treated premolars restored with either full cast coverage or

with direct composite restoration. Mannocci F, Bertelli E, Sherriff M, Watson
TF, Ford TR
 CASE REPORT
Post-endodontic restoration of a
deeply decayed tooth - options and
limitation Michael Bruder, DDS.
Jounal of oral science,11: 2;2007.
 Posterior teeth

Molar teeth rarely require a post unless

16

there has been significant loss of tooth

structure. A coronal-radicular core buildup
with silver amalgam utilizing the pulp
chamber, and possible 2 mm canal extensions,
has proved very effective in vitro and in vivo.

Nayyar, A., An amalgam coronal-radicular dowel and core technique for

16

endodontically treated posterior teeth. J Prosthet Dent, 1980. 43: p. 511.

 CASE REPORT
Reconstruction of Endodontically Treated
Posterior Teeth—with or without Post?
Maciej Zarow, Walter Devoto. The European
Journal Of Esthetic Dentistry. Volume
4,number 4,december 2009.
Tooth fracture of an endodontically treated maxillary
molar restored with a bonded composite restoration.
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 COMPONENTS OF FINAL
RESTORATION

A. Posts
B. Cores
C. Crowns
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 POSTS
 Role of posts
 Indications
 Post selection:Factors to be considered
 Ferrule effect
 Types
 Procedure
 The Role of Posts in the Restoration
of Endodontically Treated Teeth
 18The primary purpose for a post is to retain a
core that can be used to support the final
restoration.
 Posts do not reinforce endodontically treated
teeth, and a post is not necessary when
substantial tooth structure is present after a
tooth has been prepared.

18
W. Cheung, “A review of the management of endodontically treated teeth:
post, core and the final restoration,” Journal of the American Dental
Association, vol. 136, no. 5, pp. 611–619, 2005.
 INDICATIONS
19
Post placement is indicated if both of the
following clinical conditions exist:
The remaining coronal tooth structure is
inadequate for the retention of a restoration.
When there is sufficient root length to
accommodate the post while maintaining an
adequate apical seal.

Stockton LW.Factors affecting retention of post systems:

19

A literature review. J Prosthet Dent 1999;81:380–385.

FACTORS TO CONSIDER

Post length
Post diameter
Post design

Stockton LW.Factors affecting retention of post systems:

20

A literature review. J Prosthet Dent 1999;81:380–385.

 Post length
Guidelines:
21

1. The post should more than the incisocervical

or occlusocervical dimension of the crown.
2. The post should be longer than the crown.
3. The post should be 1 1/3 the length of the
crown.
4. The post should end halfway between the
crestal bone and the root apex.
Stockton LW.Factors affecting retention of post systems:
21

A literature review. J Prosthet Dent 1999;81:380–385.

Ideal tooth
preparation
for post
placement
 Post Size and Length
22
Post length is unique and individualized for each
case. The clinician should have a thorough
The effect
knowledge of the
of root embedded before
morphology depth of posts aonpost.
placing
retentive capacity has been shown to be
The longer the post, the greater the retention. A
significant
guideline of one half to three quarters of the root
length is often followed but may not be reasonable
for extremely long, short, narrow, or curved roots

Retention of endodontic dowels: effects of cement, dowel length, diameter, and

22

design. Standlee JP, Caputo AA, Hanson EC: J Prosthet Dent 39:401, 1998.
 Post diameter
 The diameter of the post is dictated by
23

the root canal anatomy.

 A minimal dentin thickness of 1 mm around
the post should be provided.

23
Lloyd PM, Palik JF. The philosophies of dowel diameter preparation: A
literature review. J Prosthet Dent 1993;69:32–36.
The diameter of the post is dictated by the remaining root
substance and root canal space: (A) too narrow; (B) optimum
size post; (C) too large.
 Post design
 24
Posts can be serrated,
smooth, roughened or
threaded.
 Parallel, serrated posts
are cemented into the
canal passively. They are
retentive and produce less
stress in the root dentine
than threaded systems

Post Placement and Restoration of Endodontically Treated Teeth: A

24

Literature Review. Richard S. Schwartz, et al. Journal of

Endodontics:VOL. 30, NO. 5, MAY 2004
 Ferrule Effect
 25The ferrule is the circumferential ring of
sound tooth structure that is enveloped by
the cervical portion of the crown
restoration. A minimum sound dentine
height of 1.5-2 mm is required between the
core and crown margins.

Sorensen JA and Engelman MJ. Ferrule design and fracture resistance of

25

endodontically treated teeth. J Prosthet Dent 1999;63:529-536.

 Importance of ferrule
The ferrule provides bracing or casing action
to protect the integrity of the root.
 Effect of a crown ferrule on the fracture
26

resistance of endodontically treated teeth

restored with prefabricated posts
 STATEMENT OF PROBLEM: Root fracture is
one of the most serious complications following
The resultsofofendodontically
restoration this study showed thatteeth
treated an increased
amount of coronal dentin (ferrule) significantly increases
 Fifty freshly extracted canines were
the fracture resistance of endodontically treated teeth.
endodontically treated. The teeth were randomly
divided into groups of 10 and prepared according
to 5 experimental protocols

26
Effect of a crown ferrule on the fracture resistance of endodontically treated
teeth restored with prefabricated posts.
Pereira JR, de Ornelas F, Conti PC, do Valle AL
J Prosthet Dent. 2006 Jan;95(1):50-4.
 An incomplete crown ferrule is
27

associated with greater variation in load capacity

and, despite high fracture values, inclines to
fracture.

27
Effect of incomplete crown ferrules on load capacity of endodontically
treated maxillary incisors restored with fiber posts, composite build-ups, and
all-ceramic crowns: an in vitro evaluation after chewing simulation.
Naumann M, Preuss A, Rosentritt M.
Acta Odontol Scand. 2006 Feb;64(1):31-6.
 27
CHARACTERISTICS OF AN
IDEAL POST:
 Minimum preparation.
 Resistance to fatigue.
 Elastic modulus similar to dentin.
 Non corrosive.
 Retentive (post & Head).
 Easy to adjust and fit.
 Radiopaque.
 Adequate material
 Easy Removal

27
Factors determining post selection: A literature Review.
Fernandes A., Shetty Sh., Coutinho I.-
J Prosth. Dent. Dec. 2003.
 28
TYPES OF POSTS
METALLIC NON-METALLIC
 Stainless Steel
 Titanium  Carbon Fibre
 Titanium Alloy  Ceramic
 Gold-Plated  Glass-fibre
brass reinforced
 Composite
Fundamental of fixed prosthodontics 3 editions
28

Herbert T. shillingburg
Page no 345
Types of Posts
Prefabricated posts
 Custom made posts
 Direct Technique
 Indirect Technique

Wax pattern before casting.

 Custom cast post and core
Advantages: Disadvantages:
 Preservation of maximum  Less stiff than
tooth structure wrought
  Time consuming,
Provision of anti-rotational
properties complex procedure
 Core retention
 Recommended Use:
Less chances of vertical Elliptical canals
fractures during preparation Flared canals
 High strength
 29
Prefabricated Tapered Post
Advantages: Disadvantages:
 Conserves tooth  Low retention
structure  Longitudinal
 High strength and splitting of
Recommended Use:
remaining root
stiffness Small circular canals or
Small circular canals or
Very tapered canals

29
Post placement and restoration of endodontically treated teeth: A
literature review.
Schwartz. R, Robbins. J.
J Endodon 2004, 30: 289-301.
 30
Prefabricated Parallel - Sided
Smooth Post
Advantages: Disadvantages:
 Excellent clinical  Precious material
retention post expensive
 Minimal stress  Corrosion of
production within stainless-steel
root  Less conservative of
 Ease of placement tooth structure
 Superior rating
Color Atlas of Endodontics. , 2nd edition
30

William T.Johnson, page no 133-134.

 31
Prefabricated Threaded Posts

Advantages: Disadvantages:
 High retention  Stresses generated in
canal may lead to
fracture
Recommended Use:  Does not conserve
Only when maximum coronal and radicular
retention is essential
tooth structure

Color Atlas of Endodontics. , 2nd edition

31

William T.Johnson, page no, 133-134.

 32
Carbon Fiber Post
Advantages: Disadvantages:
 Dentin bonding  Low strength
 Easy removal (compared to metal)
 Lack of radiopacity
Recommended Use:
Can be used in posteriors  Carbon color
with moderate loss of presents an esthetic
coronal structure problem
Post Placement and Restoration of Endodontically Treated Teeth: A
32

Literature Review. Richard S. Schwartz, et al.

Journal of Endodontics:VOL. 30, NO. 5, MAY 2004
 33
Fiber Reinforced Post
Advantages: Disadvantages:
 Esthetic  Low strength
 High failure rate
Recommended Use:
Should not be used where remaining
tooth structure is less than ideal or where
high occlusal forces are present.

Aesthetic posts and cores for metal free restoration of

33

endodontically treated teeth. Adriana Quintas, Jose Dinato. Pract

Periodont Aesthet Dent; 12(9): 875-884
 34
Zirconia Ceramic Post
Advantages: Disadvantages:
 Esthetics  Expensive
 High stiffness  Uncertain clinical
 High modulus of performances
elasticity
Recommended Use:
High esthetic demands
 Procedure

Textbook of Endodontology 2 editions

Preben Hørsted-Bindslev
Page no 326
 A review of the studies
done on the various post
systems suggests that the
fiber posts are the most
reliable!!!
 Background: Post design and material has very
important effects on dentinal stress distribution since
the post placement can create stresses that lead to
Fiber posts show more
root fracture.
35
Materials:
homogeneous stress distribution
4 metallic posts (ParaPost XH, ParaPost XT,
ParaPost XP, than metallic and
and Flexi-Flange) posts.
1 fiberglass post
(ParaPost Fiber Lux) were used.

35
Influence of different post design and composition on stress distribution in
maxillary posterior teeth. Finite element analysis.
Natercia R Silva, Carolina G Castro, Paulo CF Santos-Filho.
Indian journal of dental research 2009 vol 20
Purpose. This in vitro study compared the effect of
titanium, quartz fiber, glass fiber, and zirconia posts
systems on the fracture resistance and fracture patterns of
crowned, endodontically treated teeth
Results. Teeth restored with quartz fiber posts exhibited
significantly higher resistance to fracture than the other 3
Good
Fractures strength
allow repair
groups. Teeth restored with glass fiber and zirconia posts
were statistically similar.
Fractures that would allow repair of the tooth were
observed in quartz fiber and glass fiber , whereas
unrestorable, catastropic fractures were observed in
titanium and zirconia post groups.
36
Resistance to fracture of endodontically treated teeth restored with different
post systems.
Akkayan B, Gulmez T.
J Prosthet Dent. 2002;87:431–437.
  Conclusion: The fiber posts evaluated
provided an advantage over a conventional
post that showed a higher number of
irretrievable post and unrestorable root
Readily
fractures. retrievable
The fiber posts were readily
retrievable after failure, whereas the
remaining post systems tested were non
retrievable.

37
In vitro comparison of the fracture resistance and failure mode of fiber,
ceramic, and conventional post systems at various stages of restoration.
Cormier CJ, Burns DR, Moon P.
J Prosthodont. 2001;10:26–36.
  PURPOSE: This retrospective study evaluated
treatment outcome of cast post and core and
Composipost systems after 4 yrs of clinical
service.
Better than cast post
 The results of this retrospective study indicated
system
that the in the long
Composipost(95% success)term
system(fiber-
reinforced epoxy resin posts) was superior to the
conventional cast post and core system(84%
success) after 4 yrs of clinical service.

Clinical evaluation of fiber-reinforced epoxy resin posts & cast post & cores.
38

Ferrari M, Vichi A, Garcia-Godoy F.

Am J Dent. 2000;13:15B–18B.
 PURPOSE: This study aggregated literature data on in
vitro failure loads and failure modes of prefabricated
fiber-reinforced composite (FRC) post systems and to
compare them to those of prefabricated metal, custom-
cast, and ceramic post systems.
More favourable
 RESULTS: Custom-cast post systems showed higher
failure loads than prefabricated FRC post systems,
whereas ceramic showed lower failure loads.
Significantly more favourable failures occurred with
prefabricated FRC post systems than with prefabricated
and custom-cast metal post systems.
39
A structured analysis of in vitro failure loads and failure modes of fiber,
metal, and ceramic post-and-core systems.
Fokkinga WA, Kreulen CM, Vallittu PK, Creugers NH.
Int J Prosthodont. 2004;17(4):476–482.
 MECHANICAL PROPERTIES
Material Flexural Tensile Elastic
strength Strength Modulous
Gpa MPa GPa
Stainless 800 n/a 200
Steel
Titanium 1000 n/a 110
Alloy
Zirconium 820 n/a 200
Oxide
C-Post 1100 2900 17.8
(64% Carbon)
Evolving Technology in Endodontic Posts.
40

Pitel M., Hicks N

Comp. Of Cont. Educ. in Dent. January 2003.
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III. Crowns
 CORES
 Indications
 Principles
 Types of core build up
 Procedure
 INDICATIONS
Core restorations are indicated if any of the
following clinical conditions exist:
The replacement of missing coronal tooth
structure is necessary.
When the enhanced retention and resistance
to displacement of the final restoration is
necessary.
Fundamental of fixed prosthodontics 3 editions
41

Herbert T. shillingburg
Page no 367
 MATERIALS USED FOR
CORE BUILD UP
DIRECT PLACEMENT:
1.Composite resin
2.Amalgam
3.Glass ionomer resin
INDIRECT PLACEMENT:
Casting
Fundamental of fixed prosthodontics 3 editions
42

Herbert T. shillingburg
Page no 369
 Composite resin core
Advantages: Disadvantages:
 Good compressive  Polymerization
strength shrinkage
 Easy to manipulate  Poor dimensional
 Rapid stability
polymerization Recommended Use:
 Dentin bonding Excellent build-up material
for posterior and anterior
teeth if isolation assured
 Amalgam core
Advantages: Disadvantages:
 Reduced marginal  Mercury sensitivity
leakage  Low tensile strength
 Better dimensional  Corrosion with base
stability metal
 Better compressive
strength Recommended Use:
Molars with adequate
 Better modulus of coronal tooth
elasticity structure
 Glass Ionomer resin core
Advantages: Disadvantages:
 Anticariogenic  Low resistance to
 Adhesive fracture
  Low retention to
Easy to manipulate
preformed post
 Sensitive to moisture
Recommended Use:
Teeth with minimum
tooth structure missing
So which is the best
material for core
buildup???
 The modulus of elasticity of amalgam is
significantly higher than all other material
tested and is closer to that of dentin
 Prepared core build-ups in a hybrid
composite material provided the highest
fracture resistance

Fracture resistance of five pinretained core buildup materials on teeth

46

with and without extracoronal preparation.

Burke, FJT, Shaglouf, AG, Combe, EC, Wilson, NHF.
Operative Dentistry 2000; 25: 388-394.
 This study showed that the tensile and
flexural strengths of composite are
significantly higher than that of amalgam
and glass ionomer.

47
Kovarik, Robert E., Breeding, Larry C., Caughman, W. Franklin. Fatigue
life of three core materials under simulated chewing conditions.
The Journal of Prosthetic Dentistry Oct 1992; 68(4): 584-589.
  Tensile strength and modulus of elasticity of
glass ionomer cements are significantly
Based
lower than on the
dentin andabove
amalgam stated
evidence,
 Glass ionomerscomposite seems
are relatively to be
slow-setting
thetheir
and bestearly
choice as a core
resistance build up
to moisture is poor
material.

Mechanical properties of direct core buildup materials.

48

Combe, E.C., Shaglouf, A., Watts, D.C., Wilson, N.H.F.

Dental Materials 1999; 15: 158-165.
 CONTENTS
 Introduction  Anterior teeth
 History  Posterior teeth
 Need for final  Components of final
restoration restoration:
 Objectives I. Posts
 Classification II. Cores
III.Crowns
 CROWNS
 Indications
 Advantages
 Disadvantages
 Types
 CROWN PLACEMENT
INDICATIONS
Better esthetics
Situations in which the structural integrity of
natural crown is compromised

CONTRAINDICATIONS
Anterior teeth have only have conservative
access opening
Textbook of Endodontology
49

Gunnar Bergenholtz Page no 317

 CROWNS
Advantages: Disadvantages:
 Durable  Loss of tooth structure
 Good esthetics  Expensive
 Restoring dental
function
 Good Form
 Protection of tooth
Textbook of Endodontology
50

Gunnar Bergenholtz Page no 317

 METAL-CERAMIC
CROWNS
 It consists of a ceramic layer bonded to a
thin cast metal coping that fits over the
tooth preparation.
 It combines the strength and accurate fit of
a cast restoration with the esthetic effect of
a ceramin crown.
 Less tooth preparation required compared to
all ceramic crowns.
 PORCELAIN JACKET
51

CROWN
 It consists of a crown entirely made up of ceramic.
 Superior esthetics and excellent translucency.
 Good tissue response even with subgingival
 margins.
 But is has reduced strength and is the least
conservative of all tooth preparation.

Endontics Problem-Solving in Clinical Prctice

51

TR Pitt Ford, BDS, PhD

Page No.161
 52
FULL CAST METAL
CROWNS
 Cast metal crown is a full crown restoration which
is cast with dental alloy.
 It had high strength, is long lasting and requires
the least amount of tooth preparation.
 Cannot be used in areas where esthetics is of
prime concern.

Endodontics Problem-Solving in Clinical Practice

52

First published in the United Kingdom in 2002

ISBN 1-85317-695-8
TR Pitt Ford, BDS, PhD Page no 161,
 PARTIAL CAST METAL
53

CROWNS
Partial cast metal crowns may be used when the
buccal surface of the tooth is intact. They are more
conservative of tooth tissue than complete crowns,
but they are more demanding technically both for
clinician and in the laboratory

Color Atlas of Endodontics.

53

William T.Johnson, 2nd edition, 133-134.

 54
TEMPORARY CROWNS
 Temporary crowns are used to protect a tooth that
has been prepared for a permanent crown while
the patient waits for the permanent crown to be
fabricated by the dental lab.
 Types:

i. Polycarbonate
ii. acrylic temporary
iii. Custom-cast temporaries
iv. Composite resin

Color Atlas of Endodontics.

54

William T.Johnson, 2nd edition, 133-134.

Conclusion
 Anterior Tooth

Class I - III Class V

Class IV

Complete
Complete Coverage Complete Coverage
Coverage is
is required is required
not required

Prefabricated fiber post with

Conservative Trt
composite core
Resin composite
full ceramic crown
 Posterior Tooth

Class I-III Class V

Class IV

Pre-fabricated fiber
post
Conservative Trt
Composite Core Composite Core
Onlay
Fiber post Metal Ceramic
Metal Ceramic crown
Crown
Thank You