Restoration of pulpless teeth: application of traditional principles in present and future contexts

Posts were recommended more than 100 years ago to retain artificial crowns. Recent studies suggest that posts can weaken teeth; therefore restorative procedures that help preserve pulpal vitality and eliminate the need for posts are desirable. If endodontic therapy is unavoidable, conservation of remaining tooth structure is most important. When a post is required to retain a core for an artificial crown, a custom cast post is the most effective means of conserving tooth structure. The length of the post should not be compromised, although 4 to 5 mm of apical gutta-percha must be maintained. The restorative prognosis is improved if the width of the post does not exceed one half the width of the root, and the cemented artificial crown should extend apical to the core to provide a 1.5 to 2 mm ferrule. Complex procedures have allowed the dentist to restore extensively damaged teeth. However, extraction and replacement with implant-supported prosthodontics may be more prudent with severely compromised teeth.