Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

Choice of direct or indirect post-retained core
As with all indirect techniques, an indirect post will require an unim-
peded path of insertion with no undercuts. In some situations in
which a reasonable amount of dentine remains, placement of a direct
post and direct core material (amalgam, resin composite etc.) will
avoid unnecessary removal of sound tooth structure. When little 
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Chapter 4
Fig. 4.3
Direct and indirect intra-radicular posts.
POOC04 02/18/2005 04:35PM Page 100

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Access cavity/existing restoration small occlusal?
Yes
No
No cuspal coverage required 
Bonded restoration
Cuspal coverage required, place core first
One or more well-
supported cusps remaining with
reasonable amount of coronal dentine? 
 
No
Yes
Any coronal dentine?
Amalgam dowel core 
No
Yes
Canal(s) suitable for post placement?
Canal(s) suitable for post placement?
Yes
No
No 
Yes
Reconsider
ability to restore
?Amalgam dowel core
OR bonded core 
Eccentric/elliptical/ 
very tapered/very large canal? 
Eccentric/elliptical/ 
very tapered/very large canal? 
No
Yes
Yes
No
Custom cast post-core
Consider split core if more than 
one canal can be utilised 
Cast post-core with prefabricated pattern 
(e.g. ParaPost) OR consider split core if 
more than one canal can be utilised 
Prefabricated post 
(in suitable canal)
and amalgam dowel core 
Fig. 4.4
Flow chart for restoration of molar teeth.
POOC04 02/18/2005 04:35PM Page 101

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Crown required?
(i.e. Premolar with more than occlusal cavity or anterior tooth with large access cavity/restoration)
Yes
No
Large canal with thin periphery of root dentine?
No
Yes