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Post and core. Risks and complications


Last Updated: 22.09.2023

Author: George Ghidrai, MD  

After the post and core is cemented inside the root canal space, an impression is taken for the fabrication of a dental crown. The crown can be a single unit crown or a retainer crown for a dental bridge.

If pain, swelling or other symptoms arise in the first days after cementation, it is more likely the consequence of the endodontic therapy conducted prior to post fabrication. Normally, these symptoms go away after a few days.


Risks and complications

1. Endodontic failure

Endodontic failure is one of the major concerns when designing a post and core device. Because the post is placed within the root canal, the tooth must first be endodontically treated.

First, there is the failure risk inherent to any endodontic treatment. Secondly, when the root canal is prepared for the post and core, it is important to leave at least 4 mm of root canal filling at the apex of the root canal.

Otherwise, the chances of microleakage and percolation of microbes are greatly increased, thereby increasing the likelihood of an endodontic failure.

2. Root fracture

This accident is caused by an inappropriate post selection. In most of the cases, it is indicated to use the narrowest and longest post possible. This will ensure that the forces transmitted from the crown are distributed over as much of the root as possible and enough tooth structure is left to support the post and absorb the transmitted forces.

On the other hand, threaded posts actively engage the internal walls of the root canal as they are screwed in, and thus produce high forces on the brittle root structure thereby increasing the risk of root fracture.

metal screw posts

metal threaded posts


3. Post and core detachment

The post can easily detach if the consideration of crown-to-root ratio is overlooked. It is desirable that the post descends not less than the height of the crown inside the root canal.

If, for example, the post is 15 mm long, but only extends 4 mm into root structure, the restoration will have a poor prognosis. In these conditions, even if the post is re-cemented inside the root canal, the restoration prognosis will not change.


4. Post and core fracture

This is a rare accident and is caused by selecting a post that is too short or too thin. If the post fractures at any level, it must be re-fabricated.





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