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Progressive, innovative methods for restoring wide, flared, and overprepared canals

Daniel H. Ward, DDS

Endodontics | Earn 2 Credits

Fiber-Reinforced Composite Post and Core Techniques

Objective: To study the progression ofendodontic posts from earlier cast metal versions to more modernfiber-reinforced options, highlighting their advantages in different situationsinvolving non-standard canal spaces and briefly discussing the techniques usedto place them that offer advantages such as greater strength and resistance tofracture.
Clinical implications: One of the goals of Splendor®Universal is to provide the smallest cement line possible, replacing it with abiocompatible material with superior properties, and thus improve therestoration's resistance to fracture and survival rate.
Post-sleeve system: An adjustable post-sleevesystem comprised of a parallel post and a conical sleeve made of the samematerial has recently been introduced to the market.When necessary, the sleeve can be used tocustomize the post in cases involving enlarged or over prepared canals.After inserting the post, the sleeve slides overit and into the enlarged canal until mechanical imbrication is achieved (Fig.7). The sleeve significantly reduces the volume of cement required to fill thecoronal area of the pulp chamber and is stronger than many resins used for thesame purpose.
Preserving naturaltooth structure has become the standard of care in all aspects of dentistry,including root canal preparation and coronary access. In addition, as rootcanal preparations have become more conservative, posts have followed thisfeature. This can be challenging when rehabilitating a tooth with a very wideroot canal or uncommon anatomy. It is important to fill the coronal area thatis in contact with the post with a high resistance material. The excess of cement(resin or other) may not have enough filler or crosslinking to provide strengthto the set. Resin-based cements perform well in small thicknesses less than 100µm, but a post “swimming in a pool of cement” should be avoided. Replacingcement with a biocompatible and mechanically compatible material with superiorproperties is the goal to improve the overall fracture resistance and survivalrate of the restoration.