Restoration of fractured endodontically treated mandibular first molar using custom made cast post and core

The successful treatment of posterior tooth with substantial damage to the tooth structure not only depends on root canal treatment but also by prompt restoration of lost coronal tooth structure. Endodontically treated teeth undergo loss of tooth substance due to dental caries, endodontic therapy or previous restoration and changes in physical characteristics, such as a reduced modulus of elasticity, which often leads to increased fracture susceptibility when compared to unrestored vital teeth.(1) Restoration of endodontically treated posterior teeth is more challenging because of their additional functional requirements. The restorative treatment of such teeth includes the decision of whether or not a post should be used. Post is a dental material placed in the root of structurally insufficient tooth when additional retention is needed to retain the core and coronal restoration.(2,3) However, preparation of a post space adds a certain degree of risk to restorative procedure like perforations and root fracture, especially if an over sized post channel is prepared.