For most teeth, 8 mm's is the best hole depth, measured apically from the orifice. This will avoid disturbing the apical 5-6mm of gutta percha and keep you safely away from the narrow and curved portion of the root. A peeso #3 has 8mm of cutting flutes.

 

2-CHOOSE A GOOD POST

 

I feel the flexipost, size #1 red, with the last 2mm removed, is the best choice in most cases. It is highly retentive without relying on dentin bonding and has a second tier for coronal stability.

 

3-ISOLATION

 

Yes, rubber dam in the posterior region! It avoids saliva contamination of the canal and prevents aspiration of posts and wrenches.

 

4-CORD PACKING

 

This exposes subgingival decay, prevents flash from bonding to the root, and prevents bleeding from interfering with the core's bond.

 

5-CARIES FINDER SOLUTIONS

 

The pulp is gone so you may as well be aggressive in removing any hint of decay.  

 

6-EVALUATE THE FERRULE AND THE BIOLOGIC WIDTH

 

Posts only work when they are not needed! You must be sure the crown will engage 2mm or more of tooth structure 360 degrees around the tooth. If this brings the crown margin closer than 3mm to the bone, osseous surgery will be needed to avoid eternally inflammed tissues.

 

7-USE A MATRIX BAND

 

A band will protect the adjacent teeth from the etchant and bonding resin. It will prevent overhangs that may inflame tissues if the crown is postponed. It also more clearly delineates the tooth/gum interface for more accurate crown preparation.

 

8-USE AN IRRIGATION SYRINGE

 

This is the best way to flush out loose debris and etchant  from the canal. It also can be used to aspirate excess water and bonding agent from the canal.

 

9-BOND YOUR CORES

 

Use a bonding agent known to work with self-cure resins as most do not. Bonding the core improves retention and provides a seal to enhance endodontic success.

 

10-CREATE  CORRECT CONTOURS AND OCCLUSION

 

Proper crown preparation requires depth cuts into a tooth that has  near-ideal dimensions and contours.

An added bonus is that a preoperative impression can be made and used for temporization.

In many cases, the crown is postponed and the post core must function as an interim restoration. 

 

ARMAMENTARIUM:

-matrix-supermat (retainerless) matrix-Kerr

-bonding agent-one step-Bisco

-flexipost size #1-EDS

-cord-Ultradent

-caries indicator-seek-Ultradent

-irrigation syringe 23 gauge-Monoject

-diamond for access and post reduction-2424c-Microcopy