Risks of Cast Post and Core Reconstruction: a Case Report

Objectives: Restoration of severely damaged non-vital teeth requires the use of an intra-radicular retainer, despite the evolution, failures are still a concern when restoring endodontically-treated teeth even with fiber posts due to post-loss of retention, while metal post failures were mostly related to root fracture. In fact, the treatment with the different post and core systems available requires the preparation of the root canal carried out without direct visibility, which exposes to many risks increased by the possible morphological particularities of the teeth concerned. Also, the transmission of functional stresses via the post to the root weakens the supporting tooth throughout the service of the prosthesis. Therefore, this case report aims to list the recommendations and clinical approaches when using these intra-radicular retainers to optimize the retention objectives and especially limiting the risks to dental tissues in this therapy as much as possible.
Methods: The clinical case illustrates the treatment of a root perforation during the preparation of the root canal using biodentin material. In this work, visual enhancement with an operative microscope is discussed, with a focus on how these risks can be prevented and what are the therapeutic solutions in case of failure.
Results: Treatment of the perforated root canal with Biodentin is successfully performed with a microscopic aid, the cast post and core was realised and the prosthetic treatment is completed with a ceramo-metallic crown.
Conclusions: The preparation of a root canal to receive a dental post is a risky situation that should be well performed to prevent failure situations
In the case of root perforation, there's solutions to conserve the tooth which should be well known by practitioners.