Nama : Dini Anita Marlin

BP : 1711412019

PROSEDUR POST AND CORE

Tiga tahap operasional preparasi gigi post and core :
1. Mengeluarkan bahan pengisi saluran akar
2. Pelebaran saluran akar
3. Preparasi struktur koronal gigi

1. Mengeluarkan bahan pengisi saluran akar

a. Jika bahan pengisi saluran akar silver point harus dilakukan perawatan ulang dengan mengganti
bahan pengisi dengan gutta percha
metode mengeluarkan gutta percha
a) Menggunakan endodontic plugger yang dipanaskan
b) Menggunakan rotary instrument dengan chemical agent
b. Sebelum mengeluarkan bhn pengisi saluran akar, perlu dihitung panjang post
c. Panjang post sebanding dengan panjang anatomis mahkota atau 2/3 panjang akar
d. Apical seal ditinggal 5 mm atau minimal 3 mm
e. Panjang post dapat diperkirakan dengan panjang rata-rata akar gigi
f. Pilih endodontik kondenser dengan besar yang sesuai
g. Beri tanda pada instrument endodontik (kurang 5 mm dari panjang kerja)
h. Panaskan dan letakkan dalam saluran akar agar gutta percha melunak
i. Jika gutta percha sudah lama dan kehilangan daya thermoplasticity gunakan rotary instrumen
j. Penggunaan high speed instrumen dan bur konvensional merupakan kontra indikasi
k. Jika menggunakan rotary instrument, pilihlah agar sedikit lebih sempit daripada saluran akar.
l. pastikan instrumen berada di tengah gutta percha dan tidak mengenai dentin
m. jika telah dikeluarkan , bentuk saluran akar sesuai kebutuhan dengan endodontic hand instrument
atau low-speed drill

2. Pelebaran saluran akar

 Pilih jenis post yang akan digunakan
 Bentuk saluran akar dengan endodontic file atau low speed drill
  Prosedur ini untuk menghilangkan undercut dan mempersiapkan saluran akar untuk menerima
post yang sesuai ukurannya
 Ukuran post tidak boleh lebih dari 1/3 diameter akar
a. Pelebaran saluran akar prefabricated
 Lebarkan sal akar dengan 1 atau 2 ukuran drill endodontic file atau reamer yang sesuai
dengan ukuran Post
 Jika menggunakan rotary instrument dapat digunakan Peeso Reamer dan twist drill
 Gunakan prefabricated Post yang sesuai dengan ukuran endodontic instrument.
 Jika retensi kurang tambahkan groove
 Hati-hati membuang dentin pada apical

b. Pelebaran saluran akar custom made

 Custom made Post digunakan pada saluran akar yang tidak bulat atau sangat meruncing
(elips)
 Hati-hati melakukan pelebaran sal akar, dapat terjadi perforasi
 Pelebaran sal akar tidak perlu banyak
 Hati-hati pada molar bawah dapat terjadi perforasi pada bagian distal akar mesial atau bagian
mesial akar distal karena bentuk interradikular yang konkaf

3. Preparasi koronal gigi

 Preparasi mahkota yang tersisa

 Pastikan struktur gigi dikurangi secara memadai untuk estetika.
 Kurangi semua undercut yang ada di internal dan eksternal
 Kurangi semua struktur gigi yang tidak didukung, tetapi pertahankan mahkota sebanyak
mungkin.
 Pastikan jaringan koronal tegak lurus dengan post
 Selesaikan preparasi dengan menghilangkan sudut tajam dan membentuk akhiran yang halus

Prosedur Custom made post

Direct procedure:
1. Lightly lubricate the canal and notch a loosefitting plastic dowel (Fig. 12-33, A). It should extend to
the full depth of the prepared canal.
2. Use the bead-brush technique (Fig. 12-33, B) to add resin to the dowel (Fig. 12-33, C) and seat it in
the prepared canal. This should be done in two steps: Add resin only to the canal orifice first. An
alternative is to mix some resin and roll it into a thin cylinder. This is introduced into the canal and
pushed to place with the monomer-moistened plastic dowel.
3. Do not allow the resin to harden fully within the canal. Loosen and reseat it several times while it is
still rubbery.
4. Once the resin has polymerized, remove the pattern (Fig. 12-33, D).
5. Form the apical part of the post by adding additional resin and reseating and removing the post,
taking care not to lock it in the canal.
6. Identify any undercuts that can be trimmed away carefully with a scalpel.
Indirect procedure :
1. Cut pieces of orthodontic wire to length and shape them like the letter J (Fig. 12-35, A).
2. Verify the fit of the wire in each canal. It should fit loosely and extend to the full depth of the post
space. If the fit is too tight, the impression material will strip away from the wire when the impression
is removed.
3. Coat the wire with tray adhesive. If subgingival margins are present, tissue displacement may be
helpful. Lubricate the canals to facili tate removal of the impression without distortion (die lubricant
is suitable).
4. Using a lentulo spiral, fill the canals with elastomeric impression material. Before loading the
impression syringe, verify that the lentulo will spiral material in an apical direction (clockwise). Pick
up a small amount of material with the largest lentulo spiral that fits into the post space. Insert the
lentulo with the handpiece set at low rotational speed to slowly carry material into the apical portion
of the post space. Then increase handpiece speed and slowly withdraw the lentulo from the post
space. This technique prevents the impression material from being dragged out. Repeat until the post
space is filled.
5. Seat the wire reinforcement to the full depth of each post space, syringe in more impression
material around the prepared teeth, and insert the impression tray (see Fig. 12-35, B).
6. Remove the impression (see Fig. 12-35, C, evaluate it, and pour the working cast (see Fig. 12-35,
D) as usual (see Chapter 17).
NOTE: Access for waxing is generally adequate without placement of dowel pins or sectioning of the
cast.
7. In the laboratory, roughen a loose-fitting plastic post (a plastic toothpick is suitable) and, using the
impression as a guide, make sure that it extends into the entire depth of the canal.
8. Apply a thin coat of sticky wax to the plastic post and, after lubricating the stone cast, add soft inlay
wax in increments (Fig. 12-36). Start from the most apical and make sure that the post is correctly
oriented as it is seated to adapt the wax. When this post pattern has been fabricated, the wax core can
be added and shaped.
9. Use the impression to evaluate whether the wax pattern is completely adapted to the post space.
Prosedur prefabricated post (carbon fiber) :
A, The C-Post system is available in various sizes and configurations.
B, Gutta-percha is removed with hot instruments or a Gates Glidden drill. The canal is prepared
sequentially with the drills provided by the manufacturer.
C, The post is seated in the canal and shortened with a diamond rotary instrument or disk. Wire
cutters should never be used to cut carbon fiber composites, because they crush and weaken the
composite structure.
D, The canal is prepared by etching and priming according to the manufacturer's recommendations.
The n the post is prepared by airborne particle abrasion.
E, The luting resin is introduced into the canal with a lentulo spiral.
F, The post is seated and the core built up with the recommended core resin.
G, The preparation is finalized.
H, The completed restoration.
Core Fabrication

1. Plastic filling materials (amalgam, glass ionomer, composite resin)

2. Cast metal

Amalgam core procedure:

1. Apply the rubber dam and remove guttapercha from the pulp chamber as well as 2 to 4 mm into
each root canal if less than 4 mm of coronal height remains. Use a warmed endodontic instrument.
2. Remove any existing restoration, undermined enamel, or carious or weakened dentin. Establish the
cavity form using conventional principles of resistance and retention form. Even if cusps are missing,
pins are not normally required because adequate retention can be gained by extending the amalgam
into the root canals.
3. If you suspect that the floor of the pulp chamber is thin, protect it from condensing pressures with a
cement base.
4. Fit a matrix band. Where lack of tooth structure makes the application of a conventional matrix
system difficult, an orthodontic or annealed copper band may be used.
5. Condense the first increments of amalgam (select a material with high early strength) into the root
canals with an endodontic plugger.
6. Fill the pulp chamber and coronal cavity in the conventional manner.
7. Carve the alloy to shape. The impression can be made immediately. Alternatively, the amalgam can
be built up to anatomic contour and later prepared for a com-plete crown. Under these circumstances,
avoid forces that would fracture the tooth or newly placed restoration.
Cast Metal :

1. Direct (autopolymerizing resin)

a. Single root
b. Multiroot
2. Indirect

Pattern Fabrication with Autopolymerizing Resin

1. Use a prefabricated metal or custom acrylic resin post.
2. Add resin by the "bead" technique, dipping a small brush in monomer and then into polymer and
applying it to the post. Some experts recommend light-cured resin to facilitate this step."
3. Slightly overbuild the core and let it polymerize fully
4. Shape the core with carbide finishing burs or paper disks. Use water spray to prevent overheating of
the acrylic resin. Correct any small defects with wax.
5. Remove the pattern, sprue and invest it immediately.
Direct Pattern for Multirooted Teeth
1. Fit prefabricated posts into the prepared canals. One post is roughened; the others are left smooth
and lubricated. All posts should extend beyond the eventual preparation.
2. Build up the core with autopolymerizing resin, using the bead technique.
3. Shape the core to final form with carbide finishing burs.
4. Grip the smooth, lubricated posts with forceps and remove them.
5. Remove, invest, and cast the core with the roughened single post. When this has been done, the
holes for the auxiliary posts can be refined with the appropriate twist drill.
6. After verifying the fit at try-in, cement the core and auxiliary posts to place.
Indirect Pattern for Posterior Teeth
1. Wax the custom-made posts as described previously.
2. Build part of the core around the first post.
3. Remove any undercuts adjacent to other post holes and cast the first section.
4. Wax additional sections and cast them. Using dovetails to interlock the sections makes the
procedure more complicated and is probably of limited benefit, especially because the final buildup is
held together by the fixed cast restoration.