Post-endodontic crown restorations in three steps 

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post-endodontic crown restorations

This article is brought to you by Avant Dental.

Ian Feigen, Technical Services Director at Avant Dental laboratory, explains how to fit post-endodontic crown restorations in three simple steps.

After a root canal or endodontic treatment, a dental crown may be recommended to provide structural support and prevent the tooth from fracturing or breaking—typically because a tooth that has undergone a root canal no longer has a live nerve or blood supply, making it more susceptible to damage. 

Placing a crown over the treated tooth acts as a protective barrier against potential sources of infection by sealing the treated tooth, preventing bacteria from re-entering.

Step 1: Post placement

Posts may be required to provide additional support and retention for a dental crown when a significant portion of the natural tooth structure has been removed as part of the treatment. 

The dentist creates a space within the canal for the post and selects a suitable post based on the size, material, and design needed for the specific case. The post is then placed into the prepared post space. Dental cement is often used to secure the post. 

Posts should extend above the gumline to provide a foundation for the final crown restoration. The dentist may also further reduce the tooth structure and shape it to accommodate the crown.

An intraoral scan or impression can now be taken to capture the post and prepared tooth for the fabrication of the crown by your dental lab.

Step 2: Cement selection 

Bonding the crown onto the post typically requires the use of dental cement. Selecting the appropriate dental cement for crown cementation depends on various factors, including the type of crown material, specific clinical situation, and the dentist’s preference. 

Zinc phosphate cement is composed of zinc oxide powder and phosphoric acid liquid, and is suitable for the cementation of metal crowns. It has good strength and durability, however, excess cement needs to be carefully removed to avoid irritation to surrounding tissues.

Glass ionomer cement is generally a more versatile option, and can be used for cementing metal, porcelain-fused-to-metal (PFM), and all-ceramic crowns. It bonds well to tooth structure, however may not be the best choice for high-stress areas. 

Resin-modified glass ionomer cement, however, typically delivers improved strength compared to traditional glass ionomer cement and is suitable for cementing metal, PFM, and some all-ceramic crowns.

Resin cement is also ideal for cementing all-ceramic crowns, and offers excellent bond strength, aesthetics, and durability – but may require additional steps such as adhesive application and light curing. 

Step 3: Crown material

Choice of crown material depends on factors such as the location of the tooth, functional requirements, aesthetic considerations, and patient preferences.

e.max®, or lithium disilicate, is a high-strength ceramic that offers good durability and resistance to fracture. e.max® is known for its excellent aesthetics, and often requires less tooth reduction compared to some other materials.

In cases of heavy bruxism or parafunctional habits, a more robust material like zirconia might be recommended. Zirconia is renowned for its exceptional strength and durability, can withstand high occlusal forces, and is typically less prone to chipping and fracture than some other ceramics.

PFM also provides excellent strength and durability for cases with heavy biting forces and is generally more cost-effective than other materials. 

Despite the clear benefits of PFM restorations, most dental labs no longer make them. Avant Dental is different. We pride ourselves on designing and manufacturing superior-quality PFM restorations that benefit your practice and your patients.  

Avant Dental is a full-service dental laboratory. For more about working with us on post-endodontic and root canal restorations, please visit our website at  www.avantdental.com.au

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