Cast post and core
prefabricated post and core
Post and cores are divided into two main groups: prefabricated and cast
1. Prefabricated post and core
Prefabricated post and cores take less time to place, as they do not involve any lab work and can be inserted immediately upon the decision to utilize them, once the endodontic therapy has been completed.

prefabricated post and core
Prefabricated posts are either screwed inside root canals or cemented with composite materials or dental cement.
After the prefabricated post is cemented (or screwed) in the root space, the small core that protrudes from the root is packed with a dental composite material. After the material has been cured and adjusted, an impression can be taken for the fabrication of a prosthetic crown (see prefabricated post and core procedure).
Prefabricated post and cores are manufactured in a range of shapes and sizes ; the one that best fits the clinical application is selected. They are normally delivered in specific sets that also contain endodontic files of various sizes (image bellow). The files are needed for root canal preparation.

Material
Prefabricated post systems are made of various metal alloys : base metals, titanium. Very often, the posts are plated with noble metals (gold, silver) to prevent corrosion.
Metal prefabricated post systems are gradually replaced by fibre-reinforced composite resin post systems which offer improved resistance to fracture and superior aesthetics.

titanium screw posts

fibre-reinforced composite resin posts
Metal prefabricated posts are also known as screw posts. That is because they are screwed inside the root space with specific screw-keys. On the other hand, fibre-reinforced posts are cemented inside root canals with composite materials.
2. Cast post and core
Cast post and cores are utilized when a prefabricated post is not a good match for the post space. A cast post and core is a one-piece unit that is custom fabricated for the tooth at the dental laboratory.
When the tooth has more than one root canal, a cast post and core can have two or three (rarely) posts. In contrast to the prefabricated post, placing a cast post and core is a two-appointment process.

cast post and core with two posts

cast post and cores after cementation
There are two ways of constructing a cast post and core : the direct method and the indirect method, which involves a dental impression. After the fabrication, the cast post and core is cemented inside the canal space with composite materials or dental cement.
The metal core is shaped so it resembles a prepared tooth. After cementation, an impression can be taken for the fabrication of the prosthetic crown.
Materials
Cast post and cores can be made of various metal alloys : gold, titanium or another metal. Where a metal post could be difficult to conceal, a custom post made of zirconia can be constructed ; its tooth colour leaves less of a shadow under the final restoration.

metal alloy cast post and core

zirconia post and core
When metal alloys are used, the post and core is fabricated using a wax technique. Zirconia post and cores are manufactured with the CAD/CAM system.
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