Dentin Post: An Innovative Method For Restoring Endodontically Treated Teeth
Dentin Post: An Innovative Method For Restoring Endodontically Treated Teeth
Dentin Post: An Innovative Method For Restoring Endodontically Treated Teeth
ISSN No:-2456-2165
Abstract:- The aim of this case report is to describe a II. CASE REPORT
treatment option for the fractured anterior teeth by using
autogenous dentin post. A 28 year old male reported to A male patient, age 28, reported to the Department of
the department with the history of trauma for esthetic and Conservative Dentistry and Endodontics with a cracked upper
functional rehabilitation. Root canal treatment followed front tooth as his chief complaint and a history of a fall three
by dentin post placement followed by prosthetic months earlier. There were no notable findings from the
rehabilitation was planned. extraoral examination. Upon clinical examination, it was
discovered that teeth 11, 21, and 22 all had crown fractures,
I. INTRODUCTION with 22 having a mobile palatal fragment that extended below
the level of the gingiva. He had started his root canal
Restoration of endodontically treated teeth is important treatment in private clinic a month back. 22 responded to
for restoration of function and esthetics. Posts are needed to percussion and palpation with a small amount of pain. The
keep the core in place in endodontically treated teeth with intraoral periapical radiograph showed inadequate obturation
poor crown structure. (1) with 21 and a small widening of the periodontal ligament
space with 21 and 22( figure b). Also pinpoint crown
Post material is important for the biomechanical perforation was seen with 21 (figure a). Crown and root
performance of the restored tooth and it should have physical fracture with regard to 22 and crown fracture with respect to
properties similar to those of dentin. The post should also 11 and 21 were determined based on clinical and radiographic
bond in a predictable manner to the root dentine. To provide evidence. After extraction of the palatal fragment of the 22,
intraradicular retention and stability of severely compromised the tooth would not be restored due to the extension of the
anterior teeth, a variety of post systems, including custom- fracture which involved the pulp space of radicular portion
built or prefabricated posts composed of fiber glass, carbon and decreased root length and it need to be extracted (figure
fiber, metal, or ceramic, can be employed. Commercially c).
available posts, however, are unable to fully satisfy the
mechanical or biological criteria. (2) Dentin itself is the only Additionally, the patient desired the treatment to end as
substance that can possess all of the qualities. Few cases have soon as possible, therefore orthodontic extrusion was
shown successful outcome using dentin as a post material. (3, eliminated. He couldn't afford an implant, thus it was decided
4)
This case report describes the restoration of a fractured to perform an endodontic retreatment with 21 followed by
maxillary central incisor using an autogenous dentin post. post and core, post core with 11, and FPD. The biological post
from the lateral incisor was used for 21, as extraction of tooth
22 was anticipated.
(c) Extension after extraction of palatal fragment (d) Radiograph after retreatment witth 21
(e) Clinical image after extraction with 22 (f) Post space preparation with 11 and 21
(g) Inlay wax impression of post space with 21 (h) Impression of maxillary arch with pinjet impression of 21
(i) Trail fit on prepared cast (j) Dentin post prepared from 22
(k) Intermittent trial fit of dentin post (l) Core buildup with 21
To remove the smear layer, the canal was etched for 15 In this case report, a severely damaged tooth was
seconds with 37% phosphoric acid, rinsed with distilled restored utilizing an autogenous dentin post, which was
water, and dried with paper point. Cementation was done chosen as a suitable replacement due to the tooth's resilience,
using dual cure self-adhesive resin cement (Calibra Universal great adhesion, dentin preservation, and lack of promotion of
Dentsply) which was injected into the post space and applied dentin stresses.
over the dentin post prior to its placement into the prepared
post space. To account for curing shrinkage, the post was REFERENCES
gently kept in place during the initial curing. Light curing was
done for 30-40 seconds. Core buildup was done with [1.] Sorensen JA, Martinoff JT. Intracoronal reinforcement
composite with 21(figure l). Post space preparation was done and coronal coverage: a study of endodontically
with 11 and restored with a cast post restoration (figure f, m). treated teeth. The Journal of prosthetic dentistry. 1984
Fixed prosthesis was given for rehabilitation of these teeth Jun 1;51(6):780-4.
(figure n). The occlusion of the patient was evaluated, and [2.] Cheung W. A review of the management of
changes were made as necessary. The patient was given endodontically treated teeth: Post, core and the final
dietary guidelines as well as specific advice on hygiene and restoration. The Journal of the American Dental
dental care to prevent undue strain on the teeth, which could Association. 2005 May 1;136(5):611-9.
increase the risk of tooth breakage. [3.] de Alcântara CE, Corrêa-Faria P, Vasconcellos WA,
Ramos-Jorge ML. Combined technique with dentin
III. DISCUSSION post reinforcement and original fragment reattachment
for the esthetic recovery of a fractured anterior tooth:
With better endodontic therapy predictability and A case report. Dent Traumatol 2010;26:447-50
efficacy together with a greater focus on maintaining and [4.] Remires-Romito AC, Wanderley MT, Oliveira MD,
preserving natural dentition, post endodontic restoration is a Imparato JC, Corrêa MS. Biologic restoration of
challenge in itself.(5) The skill of the operator is particularly primary anterior teeth. Quintessence Int 2000;31:405-
necessary for the new advancements in restorative materials 11
and adhesive protocols, which are technique-sensitive. It is [5.] Swarupa CH, Sajjan GS, Bhupahupathiraju VL,
possible to classify the use of natural tooth fragments as a Anwarullahwarullah A, Sashikanth YV. Biological
biological method of restoration when treating anterior teeth dentin post for intra radicular rehabilitation of a
that have fractured. Autogenous bonding involves bonding a fractured anterior tooth. Journal of Clinical and
patient's own tooth fragment for the best possible fit and Diagnostic Research: JCDR. 2014 Feb;8(2):242.