Dental Post and Core Crown

A dental post is a metal shaft that is implanted into the root canal of the tooth. This is usually placed if a tooth is too weak to support a tooth or a dental appliance. There are two different types of dental posts. A custom-made post is made in a lab and consists of an impression of the root canal and will have the core built onto it. A prefabricated post comes in various shapes and sizes and is placed straight into the root canal. They can be stainless steel or carbon fibre.

A post crown is an amalgamation of a post that goes deep into the root canal, a core and a dental crown. These three elements are always present, although sometimes the core may be made into the post or built up over the post after it has been cemented in. A post and core crown can only be done if the tooth has had prior root canal treatment as the post goes deep down into the root canal for extra support of the core.

If there is enough tooth left, a filling may be the suitable restoration for the tooth. If there is a small amount of tooth a filling will be a lot weaker and may fracture and will not last which is why post and core crown will be the best option. Placing the post first will strengthen the whole structure and will make it easier to bond onto the remaining tooth. If a tooth has already had root canal treatment than the post can go into the root canal straight away to build up a core to place a crown. If the tooth has not had root canal treatment, this will have to be done first to place the post. Otherwise, the tooth will have to be extracted and an implant is the only other option. If root canal treatment has been completed but the tooth is weak, a post will help provide structure for a stronger core and crown. This is usually used to prevent a crown breaking off with a core inside it. If this occurs a post can be placed into the root canal and a core can be built up over it with a better grip for the crown to then be put on.

The procedure of a dental post and core crown includes drilling into the widest root canal and placing the post in it. The longer the post the more support the core and crown will have. It is important to leave part of the root filling at the bottom of the root to keep it sealed. An x-ray will then be taken to ensure that the post is far down enough and is in line with the canal. Once the post is put in place, composite filling will be built up around it. This is known as a direct post and core. A custom-made post and core may be an option if the canal is an awkward shape. An impression post with material will be placed in the canal to copy the shape and will then be sent to a lab. It will then return with the core attached to the post so there is no need for the composite build up. Once this post and core is fitted impressions will be taken for the crown and placed once it has come back from the lab. A crown must be placed over any tooth with a post to protect it.

Frequently Asked Questions

What Problems can I get with Post Crowns?

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Here are some problems that may occur with a post crowned tooth:

If a post is done incorrectly there is a higher risk of fracture. Roots which are small and thin like in lateral incisors have a higher risk of fracture which will lead to the tooth needing to be extracted.

If a post is not long enough it can become weak with the stress of the core and crown on it and can come out. If the tooth has come out because the cement did not work, it can usually be stuck back in.

If you are consistently getting pain and infections this could mean that the root canal treatment has failed which will make it difficult for a re treatment with a post. They can sometimes be taken out but it is difficult without the risk of a fracture which will then mean an extraction is needed.

Sometimes if a root is curved a post can come out the side which is called perforation. This can sometimes be fixed but to prevent this a custom-made post is usually the best option.

What is the Success Rate of a Post Crown?

The success rate of a post and crown depends on the particular patient or case. If a post is going to fail, it will usually happen within 12 months. If a post lasts over 3 years the chances of it lasting over 10 years are much higher. If a patient has good oral hygiene with daily brushing and flossing a post and core crown can last over 15 years.

Does a post and core hurt?

Before a post and core treatment a patient will be given anaesthetic to numb the area. The dentist will then test the area to ensure it is completely numb before starting treatment. Once numbed the patient should not feel any pain but may feel pressure from some of the instruments used. Here at Smile Hub Dental Clinic, we also offer sedation for our nervous patients to put them at ease.

Can a dental post be removed?

It is difficult to remove a dental post but it can be done. A dental post will usually be removed if a tooth needs root canal re-treatment or if the post has fractured in the canal. If the post has fractured, the tooth will usually need to be extracted.

Is a post and core necessary?

A post and core is necessary in cases where there is very little core structure of the tooth left. Posts are not always needed as the core can sometimes be held in by the canals and pulp chambers. A post will be needed if the root canals are to weak to hold the core in place.