The Diary of an Endodontist - Episode 18 - Fibre Post

hello everyone and welcome back to the 18th episode of The Diarrhea of an endodontist and today I'll be discussing with you why I chose a fiber post for this case so stay with [Music] me this case was referred to me and as you can see it has three teeth with problem in the upper right quadrant so the patient must have having pain and there was a buckle fistula between the upper right four and upper right five as you can see here there is a a deep fiber metal post untreated canals and misal Carries on the

upper right five on the upper right four ber AP corage lucency possibly on the five as well and on the upper right three deep carries quite large carries compromising the pp chamber with then took a cbct where it confirms untreated Canal here on the upper right five perap coral lucency on the four as you can see here which is probably where there is um a buckle fistula and I can see on that image I can't see the three the patient wanted me to treat the four only and when I did a clinical examination there was

quite a deep probing area on the disto of the upper right five and I could see rucy in both both sides and I said to the patient this truth will need extraction there was also an image of an external root resorption that I will show you next so that was the the root resorption so anyway that tooth was sent for extraction this tooth was sent for we did the root canal treatment as you can see uh remember that there was a short root here palatally and that's where we can see over there and also the

lateral Canal uh The Joint here in the canals as well so all good I've also discussed with the patient at that time that he needed the the upper right three needed a root canal treatment the patient wanted to wait so three months later patient came back and now with the part of the tooth missing and I think because there was a tooth over there hollow but a a buckle aspect of the truth was there the patient was not too bothered but when uh missed when that that Buckle part fractured then it was compromising the aesthetic

and it was time for the patient to come back in this case we know that there is not enough rule in that tooth and it will need a post however uh in the X-ray I could see a little bit of um the bone was quite deep so we could do a crown lengthening we could expose a little bit of the margin but it was a long a long can K9 quite destroyed K9 and as you know K9 is quite important for uh dis occlusion and lateral Excursion so we decided to put some sort of post

um between the fiber post and the metal post I decided to put the fiber post I think the modulus of elasticity is similar to the tooth and I think it will work better when you have tooth the structure so we chose to do the root treatment and restor that tooth because it had a long route as you remember we adapted the the clamping it the anterior clamp did I SM into V T to expose the margin completely it was quite calcified after removing the the Decay I could see that it was quite calcified but it

of course it needed a root canal treatment so we then did the root canal treatment as you can see here and remember I discussed that the bone level was okay and I chose the pose the fiber pose did a very conservative approach not enlarging too much cervically to give enough Toth the structure selected the fiber pose which match the the canal instead of preparing the canal to match a fiber post and did the core build up everything needs to be done done under the rubberdam the only time you take the rubberdam off is now when

you need to uh adjust the core and do your temporary crown you could do as well under the rubber Dum but for sometimes it's easier for aesthetic reasons to make sure uh you are under control it's all sealed there is no problem sometimes I do Under the rubber Dum even the part of The Temper Crown I quite like it but sometimes if it's like a getting on the way the clamp is not too good in in a good position because the tooth was too destroyed then I I we can remove it it won't contaminate the

tooth you just rep prepare the core make a nice tamery crown and and then you send the patient back with the temper Crown in place that x-ray was done as soon as I removed without the temper Crown yet but as you can see here the lateral canals are filled in both both teeth so the tooth is stable and that tooth needs extraction patient knows that needs extraction but remember that this x-ray is three months after the root canal treatment and now you can confirm the healing on the upper right four and which made the fistula

to disappear but again I we I told the patient again that that five can be treated at all and it was sent for extraction thank you very much for staying with us for being so supportive and I hope you are enjoying every case and if there is anything you want me to discuss please let me know and I'll see you next time and don't forget to subscribe if you haven't yet and to share that with your colleagues so we can build up a good Community a good endodontic community that we can have better discussions thank

you very much [Music]