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Fabrication of a cast post and

core by direct technique


Parul Agarwal, B.D.S., M.S.
Michael Linebaugh, D.D.S., M.S.
Scott Joslin, R.D.H.
Cast Post and Core
The cast post and core is utilized in situations
when inadequate coronal tooth structure
remains to support a crown. The cast post and
core utilizes the retention available in the canal
space remaining post endodontic treatment. As
the retention of the CPC is achieved through
cement contact to internal canal surface area, it
is still necessary to have adequate ferrule of
3mm to support the crown.
Armamentarium
Crown and Bridge cassette
Including GC Pattern Resin
Endo cassette
Including Gates Glidden setup
High and Low speed handpieces
Parapost Kit
Torch
NaOCl and Syringe
Cast post and core
There are several steps to the fabrication of the
cast post and core. Depending on the situation,
other steps may also be necessary
Canal Preparation
Resin pattern fabrication
Finishing and cementation of the post and core
Cast post and core
Canal Preparation
The tooth was prepared for a crown, note that all of the unsupported tooth
structure and coronal undercuts were removed.
Cast post and core:
Canal Preparation
A pre-operative radiograph is
needed to determine the
length of the canal
Remember that it is
imperative to allow 4-5mm
of remaining Gutta Percha
apically
Also look for canal
curvatures as they will not be
able to be negotiated in the
post preparation
Cast post and core:
Canal preparation
Once the length of post
preparation is determined,
canal preparation is needed
Several methods exist for
preparation
Warm Instrument Searing
Peeso Reamers
Gates Glidden
Cast Post and Core
Canal Preparation

Warm Instrument Searing
Mark desired depth with and
endodontic stopper
An endodontic plugger is heated
until it is glowing red
The plugger is inserted into the
canal with apical pressure
When resistance is achieved the
plugger should be rotated from
side to side, to prevent pulling out
all of the remaining gutta percha,
and removed
This should be performed until
ineffective and followed with
rotary instrumentation

Cast post and core:
Canal preparation
GatesGlidden drill
Mark depth with endo
stopper
Place a drop of NaOCl
in the canal for
lubrication
Begin preparation with
bur spinning prior to
canal entry
DO NOT FORCE
THE BUR, yield to
resistance and
reevaluate
Cast post and core:
Canal preparation
Gates Glidden
taken to length
Remember the
minimum width
acceptable is a
yellow post which
corresponds to a
#4 Gates Glidden
Cast post and core:
Canal Preparation
Post preparation after removal of Gates Glidden
Flush with NaOCl, take care if no isolation is in place
as NaOCl is caustic

Cast post and core:
Resin pattern fabrication
Following space preparation,
Fabrication of the resin pattern
occurs
A SERRATED plastic post or
metal post can be used.
When a plastic post is used, the
pattern completely burns out, and
the post is formed entirely in the
casting alloy.
When a metal post is used, molten
alloy is cast around the post,
which mechanically interlocks with
previously developed notches to
produce a rigid structure.
Cast post and core:
Resin pattern fabrication

The metal post is notched occlusally so that good
interlocking with the core material can be achieved.
Cast post and core:
Resin pattern fabrication
In this post and core fabrication a plastic post
has been used.
Note that the posts in both instances are the
SERRATED variety, do not use the smooth
posts
Cast post and core:
Resin pattern fabrication

Plastic post
Cast post and core:
Resin pattern fabrication
GC Pattern Resin
Cast post and core:
Resin pattern fabrication
When adding the
GC Resin to the
plastic or metal
post, a salt and
pepper technique is
utilized
For finer additions,
the brush can be
cut to a point with
sharp scissors
Cast post and core:
Resin pattern fabrication

Cutting the brush to a point
Cast post and core
Resin pattern fabrication

Note the finer tip on the cut brush on the right
Cast post and core
Resin pattern fabrication
Trying in the plastic post
Cast post and core
Resin pattern fabrication

Once the post is in place, grab it at the coronal most extent of the preparation
with the cotton pliers, remove it and re-measure to confirm the post is fully
seated
Cast post and core
Resin pattern fabrication

The preparation is cleaned and dried with air and paper points
It is then lightly lubricated with petroleum jelly to prevent adhesion
Cast post and core:
Resin pattern fabrication

GC Pattern Resin application using the Salt and Pepper
Technique
Cast post and core:
Resin pattern fabrication


Resin is added by the Salt and Pepper technique, dipping a
small brush in a monomer and then into polymer and applying it
to the post. Before it fully hardens, it is loosened and reseated
several times. This is why it is important to leave the remaining
coronal extent of the post.
Cast post and core

The core is slightly overbuild and is let to polymerize fully. The
shape of the pattern should resemble an ideal preparation and
should be completely sealed at the apical margins.
Cast post and core:
Resin pattern fabrication
The core is then
shaped with a coarse
diamond bur as if the
tooth were being
prepared for a crown.
Water spray is used to
prevent overheating of
the acrylic resin.
Be sure to keep
pushing the core back
in to place as they have
a tendency to loosen.
Cast post and core:
Resin pattern fabrication

The resin pattern is removed and the excess plastic
sprue is cut off
Replace the Pattern to confirm all margins are closed
Cast post and core:
Resin pattern fabrication
Resin pattern is then sent to the laboratory for sprueing and
casting in the desired alloy.
Laboratory Wait Time
As the Cast post and Core is a Laboratory
dependent procedure, a wait time is necessary
while the lab fabricates the alloy core from the
pattern
Be sure to ask your lab how long they want for
fabrication time.

Cast post and core:
Finishing of the post and core
Cast Post and Core returned from the lab
Be sure to check for flashing and bubbles in the finished product
as these may inhibit the CPC from fully seating
Cast post and core:
Finishing of the post and core
Try in the CPC
Check for
Draw
There should be no adhesions with insertion
Marginal Fit
Adjust as necessary until desired fit is achieved
It is important that you make a mental note of the fit
so that when you are cementing the CPC you have a
reference to be sure it is adequately and completely
seated
Cast post and core:
Cementation of the post and core
Lentulospiral rotary paste
fillers are used to fill the post
space completely.
It is important to fill all the
dead space within the root
canal system.
Voids may be a cause of
periodontal inflammation via
the lateral canals.
Cast post and core:
Cementation of the post and core
Required components for cementation
Cast post and core:
Cementation of the post and core
Choose the cement to be used for seating the CPC
Cast post and core:
Cementation of the post and core
Fuji Cem application
Cast Post Core Cementation
After assembling all of the cementation
components, be sure to isolate the tooth and
prepare/dry the canal as prescribed depending
upon the type of cement you are using
Be sure all of the temporary cement is removed
from the canal and preparation as it may inhibit
seating of the CPC or setting of the cement
Cast post and core:
Cementation of the post and core

The canal is dried with a paper point prior to cementation.
Cast post and core:
Cementation of the post and core
Placement of the cement on the Lentulospiral
Cast post and core:
Cementation of the post and core

Place the CPC in the post space and apply apical pressure
Clear the excess cement from the margin and check to make sure
it is completely seated
Cast post and core:

Clearing cement from the margin after cement setting
Be sure not to disturb the post when the cement is setting as this
may weaken the cement bond
Cast post and core:
Finished CPC
Cast post and core:

Often, minor preparation may be needed after seating the CPC
BE SURE the cement is completely set before doing this
Cast post and core:
Final restoration

Cast post and core:
Cementation of the final restoration

References
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Spoolnik KJ
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Standlee JP, Caputo AA et al J Prosthet Dent 1980;44:398-404
Barkhordar RA, Radke R, Abbasi J J Prosthet Dent. 1989
Jun;61(6):676-8.
Gargiulo et al J Periodontol 1961;32:261
Sorensen JA, Engelman MJ. J Prosthet Dent. 1990 May;63(5):529-36.
Reinhardt RA et al J Dent Res 1983;63:1002-1008
Morgano SM J Prosthet Dent 1996;75:375-80