Articulos

Factors determining post selection: A literature review
Aquaviva S. Fernandes, BDS, MDS,a Sharat Shetty, BDS, MDS,b and Ivy Coutinho, BDS, MDSc
Goa Dental College, Bambolim Goa, India; Kargar Dental College, Mumbai, India
Most endodontically treated teeth require a post-and-core build-up for restoring the teeth to optimum
health and function. Selection of an appropriate post-and-core systemfrom the wide variety of those
available may be a clinical dilemma. Therefore, the purpose of this article is to review the literature to
identify the various factors that influence the selection of the post-and-core assembly. English-language
peer-reviewed articles between 1961 and 2002 were identified using MEDLINE, as well as a hand
search. The following key words were used: post, design,retention, fracture resistance, survivability,
and esthetics. Selection of a post and core system should satisfy many interrelated biologic, mechanical,
and esthetic factors to optimally restore the endodontically treated tooth to adequate form and function. This review may serve as a guide to aid the clinician in the selection of a post-and-core system.
(J Prosthet Dent 2003;90:556-62.)

The longevity of endodontically involved teeth has
been greatly enhanced by continuing developments
made in endodontic therapy and restorative procedures.
It has been reported that a large number of endodontically treated teeth are restored to their original function
with the use of intraradicular devices.1 These devices
vary from a conventional custom cast post and core to
one-visittechniques, using commercially available prefabricated post systems.2,3 In the last few decades, various prefabricated posts systems have been developed.
The selection of post design is important, because it may
have an influence on the longevity of the tooth.4
This article reviews the literature to determine the
various factors influencing the post selection for restoring an endodontically treatedtooth. The English-language literature from 1961 to 2002 was searched using
MEDLINE. This was complemented with a manual
search. The following key words were used: post, design,
retention, fracture resistance, survivability, and esthetics. According to the reviewed articles, the factors influencing post selection were root length, tooth anatomy,
root width, canal configuration, amount of coronaltooth structure, torquing force, stresses, development of
hydrostatic pressure, post design, post material, material
compatibility, bonding capability, core retention, retrievability, esthetics, and crown material.

ROOT LENGTH
The length and shape of the remaining root determines the length of the post.5 It has been suggested that
root length should be considered for the selection of theideal post length.6 It has been demonstrated that the
greater the post length, the better the retention and
stress distribution.5-9 However, it may not always be
possible to use a long post, especially when the remaina

Lecturer, Department of Prosthodontics, Goa Dental College.
Lecturer, Department of Prosthodontics, Kargar Dental College.
c
Lecturer, Department of Prosthodontics, GoaDental College.
b

556 THE JOURNAL OF PROSTHETIC DENTISTRY

ing root is short or curved. Several studies suggest that it
is important to preserve 3 to 5 mm of apical gutta-percha
to maintain the apical seal.10,11 When the root length is
short, the clinician must decide whether to use a longer
post or to maintain the recommended apical seal and use
a parallel-sided threaded post. On theother hand, the
result of an in vitro investigation has demonstrated that
reinforced composite luting agents may compensate for
the reduced post length.12 For molars with short roots,
the placement of more than one post will provide additional retention for the core foundation restoration.6,12

TOOTH ANATOMY
Each tooth in the arch exhibits anatomic characteristics such as root curvature,...