post and core techniques

[mrlantern]

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Does anyone have good tips for creating post space? ( assuming our armamentarium includes only the typical reamers/gates gliddens and generic gold threaded posts of varying lengths and diameters. NO XRAYS ! ) What do you start with? How do you determine the diameter and length of the post to be used? More importantly, how do you drill so that the selected post is retentive inside the canal?

My school sucked in teaching post and cores. But I don't need any advice on fancy prefab kits ( a la FlexiPost ) that come with color coded drills and posts and easy-to-use instructions on which post length or thickness to use. I'm sure no one else does either.

 

[NAVY DDS 2010]

Does anyone have good tips for creating post space? ( assuming our armamentarium includes only the typical reamers/gates gliddens and generic gold threaded posts of varying lengths and diameters. NO XRAYS ! ) What do you start with? How do you determine the diameter and length of the post to be used? More importantly, how do you drill so that the selected post is retentive inside the canal?

My school sucked in teaching post and cores. But I don't need any advice on fancy prefab kits ( a la FlexiPost ) that come with color coded drills and posts and easy-to-use instructions on which post length or thickness to use. I'm sure no one else does either.

Why don't you tell us what you do, and we can tell you what we feel you should do to modify the technique.

 

[mrlantern]

Why don't you tell us what you do, and we can tell you what we feel you should do to modify the technique.

I don't have much of a technique. I simply use reamer after reamer and then try fitting in a post of certain size. Quite often, I can't get these posts to be retentive in the canal. I often find posts to be loose in the canal, and they don't screw into it easily.

 

[NAVY DDS 2010]

I don't have much of a technique. I simply use reamer after reamer and then try fitting in a post of certain size. Quite often, I can't get these posts to be retentive in the canal. I often find posts to be loose in the canal, and they don't screw into it easily.

So, just to make sure - are you wanting to get recommendations on using the Flexipost or do you want to use a custom made post and core? There are different techniques depending on what you are using.

 

[mrlantern]

So, just to make sure - are you wanting to get recommendations on using the Flexipost or do you want to use a custom made post and core? There are different techniques depending on what you are using.

None of the above. I'm talking about the cheap posts that you commonly see in private practice. I'm referring to generic gold posts. One example of them is from Henry Schein ( Dentatus makes a similar one ) and is inside a wheel-shaped container that hold many posts of varying sizes and diameters. They don't come with instructions and there are no matching drills dedicated solely for these gold posts.

 

[NAVY DDS 2010]

None of the above. I'm talking about the cheap posts that you commonly see in private practice. I'm referring to generic gold posts. One example of them is from Henry Schein ( Dentatus makes a similar one ) and is inside a wheel-shaped container that hold many posts of varying sizes and diameters. They don't come with instructions and there are no matching drills dedicated solely for these gold posts.

The reason why you state Dentatus makes a similar one probably is because Henry Schein is a supplier of Dentatus products. So, which post do you use - model.

I am not sure why you do this, but in almost all your posts, you refrain from giving details. Why? It is not like we know who you are. The only way we can give accurate advice is knowing all the details.

 

[tinman831]

How can you do a post/core without a radiograph? In order to figure out how much gutta percha is in there and how much you can remove to leave an adequate apical seal, you need a radiograph to determine the length of the tooth.

 

[mrlantern]

The reason why you state Dentatus makes a similar one probably is because Henry Schein is a supplier of Dentatus products. So, which post do you use - model.

I am not sure why you do this, but in almost all your posts, you refrain from giving details. Why? It is not like we know who you are. The only way we can give accurate advice is knowing all the details.

They're generic gold thread posts. Like I said earlier, they come inside a brown, circular container. There's a see-thru cover on the container, which you can open and choose a post among the included selection of sizes and thicknesses.

Most offices have them. Not sure how much it'll help but here is Schein's product link:
http://www.henryschein.com/us-en/Shopping/ProductBrowser.aspx?categoryname=Pins+%26+Posts&browsingmode=c&N=4294967113&Reset=4294967113&propertytosortOn=Description&SP=False&PR=True&pagenumber=23

Then click on Screw Post Assortment Kit #403 20Dz for an image.

 

[OceanDMD]

They're generic gold thread posts. Like I said earlier, they come inside a brown, circular container. There's a see-thru cover on the container, which you can open and choose a post among the included selection of sizes and thicknesses.

Most offices have them. Not sure how much it'll help but here is Schein's product link:
http://www.henryschein.com/us-en/Shopping/ProductBrowser.aspx?categoryname=Pins+%26+Posts&browsingmode=c&N=4294967113&Reset=4294967113&propertytosortOn=Description&SP=False&PR=True&pagenumber=23

Then click on Screw Post Assortment Kit #403 20Dz for an image.

Post prepartation should not involve any removal of radicular tooth structure. You remove gutta percha only. Preparation should leave 3-5 mm of gutta percha between the most apical portion of the preparation and the apex. Based on the final size of your rotary instrument, this determines the size of post. Often there are corresponding rotary instruments for the size and type of post (see para post). There are indirect(not often used in private practice) and direct post and core procedures. I assume you know the difference. There is also a procedure called a reverse post/core (if the tooth has already been treated with a crown.

 

[mrlantern]

Post prepartation should not involve any removal of radicular tooth structure. You remove gutta percha only. Preparation should leave 3-5 mm of gutta percha between the most apical portion of the preparation and the apex. Based on the final size of your rotary instrument, this determines the size of post. Often there are corresponding rotary instruments for the size and type of post (see para post). There are indirect(not often used in private practice) and direct post and core procedures. I assume you know the difference. There is also a procedure called a reverse post/core (if the tooth has already been treated with a crown.

With the kind of posts I previously described, I need some instructions on how to drill so that the posts can screw into the canals retentively. Since these posts are generic and don't come with corresponding drills or countersinks, I often use the typical peeso reamers and end up with posts that are loose inside their canals.

 

[mike3kgt]

With the kind of posts I previously described, I need some instructions on how to drill so that the posts can screw into the canals retentively. Since these posts are generic and don't come with corresponding drills or countersinks, I often use the typical peeso reamers and end up with posts that are loose inside their canals.

Dude,

"so that the posts can screw into the canals retentively"

i.e. split the tooth.

"I'm talking about the cheap posts that you commonly see in private practice. I'm referring to generic gold posts. One example of them is from Henry Schein ( Dentatus makes a similar one ) and is inside a wheel-shaped container that hold many posts of varying sizes and diameters."

Seriously, if you are using these posts and are seeing them commonly in practice and don't have x-rays to work with while placing, where are you working? The only time I see these posts is right before I extract because the tooth is failing.

These are cruddy posts that split roots. You want a passive seating, relatively tight fitting post with a similar modulus of elasticity of dentin. i.e. fiber posts. You are much better off using a fiber post, a metal parapost, or heck, a paperclip (which I see in practice also) rather than these posts.

If you insist on using them, just find any post drill that is about the same size as the post, drill until 5mm coronal to the apical GP, fit a post (hopefully passive? w/ cement) and do a core-build up.

Para-Post: Para-Post XT Introductory Kit Ea Item Code: 8882990 (Henry Schein).

Fiber-Post: ParaPost Fiber Lux Kit Intro Ea Item Code: 8882697 (Henry Schein)

Even the public health practice that I worked at had these items (including working x-rays). Don't get suckered into doing sub-par dentistry.

Good luck to you.

 

[OceanDMD]

With the kind of posts I previously described, I need some instructions on how to drill so that the posts can screw into the canals retentively. Since these posts are generic and don't come with corresponding drills or countersinks, I often use the typical peeso reamers and end up with posts that are loose inside their canals.

Why dont you use a LARGER POST. The post shouldn't dictate the preparation. Its the other way around dude.

 

[godbless]

Post prepartation should not involve any removal of radicular tooth structure. You remove gutta percha only. Preparation should leave 3-5 mm of gutta percha between the most apical portion of the preparation and the apex. Based on the final size of your rotary instrument, this determines the size of post. Often there are corresponding rotary instruments for the size and type of post (see para post). There are indirect(not often used in private practice) and direct post and core procedures. I assume you know the difference. There is also a procedure called a reverse post/core (if the tooth has already been treated with a crown.

Pardon my ignorance, but whats the reverse post/core procedure if a crown been placed already?where can I look up more info on this.

 

[godbless]

Seriously, if you are using these posts and are seeing them commonly in practice and don't have x-rays to work with while placing, where are you working? The only time I see these posts is right before I extract because the tooth is failing.

These are cruddy posts that split roots. You want a passive seating, relatively tight fitting post with a similar modulus of elasticity of dentin. i.e. fiber posts. You are much better off using a fiber post, a metal parapost, or heck, a paperclip (which I see in practice also) rather than these posts.

If you insist on using them, just find any post drill that is about the same size as the post, drill until 5mm coronal to the apical GP, fit a post (hopefully passive? w/ cement) and do a core-build up.

Para-Post: Para-Post XT Introductory Kit Ea Item Code: 8882990 (Henry Schein).

Fiber-Post: ParaPost Fiber Lux Kit Intro Ea Item Code: 8882697 (Henry Schein)

Even the public health practice that I worked at had these items (including working x-rays). Don't get suckered into doing sub-par dentistry.

Good luck to you.[/QUOTE]
👍👍

 

[OceanDMD]

Pardon my ignorance, but whats the reverse post/core procedure if a crown been placed already?where can I look up more info on this.

Patient comes into your office, had a crown done 2 years ago and its in his hand. Tooth has had endo, no P/C, and he has half of the tooth inside the crown. What do you do?

As long as the margins are sealed, here is the answer (very simple). Prepare post space, try in post and trim to height were the crown can be seated with post in place. Clean out inside of crown, lubricate with cocoa butter. Etch and apply bonding agent to tooth and post prep, seat post with core material, fill crown with core material, seat crown. Core material must be DUAL CURE (meaning it doesn't HAVE to be light cured). Allow time for material to set, then remove crown. Material will remain on tooth, crown acts as mould. Clean lubricant from crown and your tooth, remove any flash, and now you are ready to recement the crown. This is a reverse post and core procedure.