Quick, easy and aesthetically superior
After an endodontic treatment, the hard tooth tissue is, in many cases, significantly reduced and weakened after caries removal and the establishment of the access cavity. It is, therefore, often necessary to establish additional retention for the post-endodontic treatment restoration.
An endodontic post for stabilisation and retention should be used if the endodontically treated tooth has a defect on more than two surfaces. Several post systems are available, which are distinguished from each other by their material of construction, form and cross-section.
The newest generation includes glass fibre reinforced composite posts such as the LuxaPost system by DMG, which was evaluated here.
A big advantage of glass fibre reinforced composite posts over other systems is their modulus of flexibility which is similar to that of dentine. Stress generation can therefore be minimised and root fractures, which are a significant risk especially when metallic screw systems are used, can be avoided.
In addition, adhesive bonding of glass fibre reinforced composite posts guarantees a permanent bond that can help stabilize the dentine walls, especially if they are thin. The conical form of the post ensures good fitting accuracy and minimal substance loss, while their transparency supports high value treatments which are aesthetically pleasing.
The LuxaPost system consists of glass fibre reinforced composite posts in three different sizes (1.25 mm, 1.375 mm and 1.5 mm diameter) with drills adapted to these diameters, a depth marker and a measuring board. Colour-coding guarantees the correct assignment of the post and corresponding drill.
The application of Silane ensures a good bond between the post and the luting cement.
The post can be adhesively bonded in the root canal using the LuxaCore Z-Dual luting cement, after the post has been silanized with Silane and the tooth prepared with LuxaBond-Total Etch. The core can then be rebuilt using LuxaCore Z-Dual.
The patient presented with an endodontically-treated tooth 22. The tooth, which was to be restored later with a crown, exhibited a large amount of substance loss due to caries.
The length of the post was determined with a digital X-ray image, using the measurement function of the software program, and the root canal was subsequently prepared with the appropriate drill at 20,000rpm and water cooling.
Paper points were used to dry the canal. The post was then seated in the canal and correct positioning was checked via another X-ray.
The appropriate post was then used to test whether it made a good contact over the full course of the canal. If desired, the post can be reduced to the desired length using a diamond bur. Following this, the LuxaPost was prepared for adhesive bonding. For this purpose, it was degreased with alcohol and then silanised. I used Silane by DMG, which consists of two components and is mixed in equal quantities immediately before use. After a contact time of one minute, the excess was blown off and the prepared post was put aside ready for use.
This was followed by conditioning the cavity (enamel and dentine) using DMG etching gel, which can be inserted safely down to the bottom of the cavity with a cannula. After 60 seconds contact time of the phosphoric acid on the enamel or 15 seconds on dentine, this was washed off. I used a water-filled disposable syringe with an obtuse Endo-Luer cannula.
The canal was then dried with the help of paper points before the PreBond, from the dual-hardened LuxaBond-Total Etch system, was worked into the etched tooth surface using an Endobrush for 15 seconds. Any excess material was blown off or removed from the canal lumen using paper points.
A drop of each Bond A and B was then mixed together and worked into the tooth substance using an Endobrush for 20 seconds. Attention must be paid to the fact that the curing time of the luting cement in the root canal can be shortened through contact with the PreBond and that consequently, it may become difficult to insert the post fully or even at all into the canal. Excess material must therefore be blown off coronally and absorbed from the canal using paper points to avoid a large puddle of bonding liquid forming at the bottom of the canal. If desired, the post can also be wetted with the bonding material.
The post was then coated with the luting cement – in this case with dual-curing LuxaCore Z-Dual. The luting cement was also applied to the root canal and the post was then inserted in the canal. If desired, the bonding agent and cement can then be polymerized with the help of a curing light, which is transmitted down the root canal by the translucent LuxaPost. Afterwards, the core was rebuilt with the help of LuxaCore Z-Dual. A control X-ray should be performed in each case.
The DMG system for post-endodontic treatment is simple to use and produces consistently good results.
The drills are very smooth-running during preparation and remain sharp for all the posts in the kit. The posts themselves are excellent for aesthetic treatments because the shades are not affected by a dark metal core.
The use of dual-curing bonding agents, as well as luting cements, guarantee curing even in deep canals that are difficult to reach with a curing light. The Endobrush is especially user-friendly for the application of the bonding agents in the canal. Its shape enables penetration of the brush head deep into the canal. The dual function of LuxaCore Z-Dual as luting cement and as a core material simplifies handling and shortens the treatment time. The subsequent preparation of the core is simplified and significantly smoother due to its drilling characteristics, which are similar to those of dentine.
Overall, this is an extremely promising, user-friendly concept for post-endodontic treatments.
All the materials described in this article are distributed in the UK and Ireland by DMG Dental Products (UK) Ltd. For further information, contact your local dealer or DMG Dental Products (UK) Ltd on 01656 789401, fax 01656 360100, emailor visit http://www.dmg-dental.com