Core build Up in Dentistry
Core build-up, or post build-up, describes an artificially created tooth core.
If a tooth has been destroyed by a deep cavity so that there is nothing left of the tooth’s original crown, then it won’t be possible to fit that tooth with a crown, because the crown won’t have any hold. However, if the roots are still healthy, then a good root canal treatment and the build-up of the tooth core can create retention for the crown. A dental crown supported by an artificial build-up is called a post crown.
In the video "Core Build Up", you see a patient’s plaster impression. There is nothing left of the tooth, but a small part protrudes from the gums. A dental bridge wouldn’t have any hold on this core. By building up the core, the bridge can be fastened; in this case, the post tooth does not support a single crown, but a bridge.
The important thing when building up the post tooth is a good root canal treatment and a sufficiently deep excavation for the post in the root canal.
The post should reach at least 1/3 into the root, as this reduces the leverage force acting on the dental root and consequently, the risk of a root fracture. When posts are too short, root fractures may result due to chewing forces – more about this in the video Post Tooth Fracture.
In the video you will see a core build-up. First, the tooth core is shown while the old amalgam filling is being removed. The tooth is surrounded by a cofferdam. The dark areas below the amalgam filling are either amalgam discolorations or cavities. The caries are removed.
Now, the tooth core is built up. In order to do this, retention must be created; this is why a glass fiber post is fastened in the rear dental root. In the video you see how the dental root is excavated first. The drill that is used for excavation corresponds to the diameter of the glass fiber post.
Then, the drill hole is cleaned and seared and then treated with various other chemicals. Finally, the bonding agent is inserted together with the glass fiber post. Everything hardens for a few minutes and then the protruding remains are removed and the rest of the core is built up.
The plaster impression shows the core build-up; the dental bridge now has stability again. It is important that the margins the crown produced – or in this case, the bridge – don’t end in the tooth core build-up, but that the bridge margins end in healthy tooth substance. In other words, the bridge/crown must cover the entire core build-up.
Posts can be divided into pre-manufactured posts and those custom-made by the dental technician.
Nowadays, pre-manufactured posts are used more and more often, as can be seen in these images. These are increasingly made of glass fibers. There are no alternatives to the core build-up, except for pulling the root of the tooth and producing a different artificial tooth such as, for example, a prosthesis or an implant – more on that in the video "Implant".
The risks of core build-up are negligible when performed by an experienced dentist. Nevertheless, complications may occur in individual cases, possibly requiring additional measures. Every additional measure may in turn lead to complications that may eventually result in tooth loss. At this point, we will only discuss the specific complications encountered with core build-up. These are, for example:
- Post tooth fracture – more on that in the video by the same title
- Root perforation during excavation – more on that in the video by the same title
Luckily, such complications have become very rare due to positive developments in medicine in the last few decades.
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