Controversy still exists about how to minimally invasively restore teeth that are post endodontically coronally compromised. The treatment proposed consists of using pin retained amalgam cores, non-bonded pin retained composite cores, and bonded cores. Good engineering involves not only great adhesives and core materials, but it also needs to address intracanal retention utilizing state-of-the-art quartz fiber composite posts that are designed to fit in the narrowest canals without removing dentin that the endodontist left for us. Geometry must be utilized with consideration to force vectors and directional reinforcement, i.e. Roman arch principles. Today's composite/fiber technology makes post placement easier and in a lot of ways safer than placing brass pins!
Objectives:
1. Is the tooth restorable?
2. Can we get by with just an adhesively bonded core?
3. If a post is initiated, how do I determine what post to use--what constitutes a high-quality, engineered post?
4. How many posts should be placed to take advantage of geometry and 5. where should they be placed?
5. If a post is placed and requires removal for retreatment of the endo, what is the best way?
6. Learn how to restore the coronal/radicular assembly without charging a higher fee
Published July 8, 2021.
Review completed January 31, 2024. Credit valid for three (3) years from review date.
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Dr. Patrick Roetzer
Dr. Patrick Roetzer is a 1974 graduate of Marquette University. Subsequent to completing a one-year general practice Residency he founded the Carquinez Dental Group, now a major Prosthodontic group in Northern California. During his early years of practice, he engaged in education and dental research, resulting in multiple patents on devices and systems for restorative dentistry. Among his patents is the Unicore Post and Drill System marketed by Ultradent, Inc. His current focus is on the Occlusinator PRO System for decreasing finishing time on posterior composites. He also served four years as Professional Relations Director/Regulatory Compliance Officer for Danville Materials. After serving at Danville Materials he assumed the position of Director of Operative Dentistry at the University of the Pacific/Arthur A Dugoni School of Dentistry in San Francisco where he teaches full time to this day. He has lectured nationally and internationally throughout his career. Roetzer is a member of ADA, CDA, as well as holding fellowships in the American and International Colleges of Dentistry. He is a member of the Pierre Fauchard Association.
