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

Restore access
With bonded restoration 
Consider root re-inforcement
e.g. Luminex
/
Luscent Anchor / DT light post 
Sufficient coronal dentine to act as/support core?
Yes
No
No post, direct core
(composite or amalgam)
Post required to retain core
Sufficient height of coronal dentine to allow for ferrule? 
No
Yes
Can this be corrected with
surgical crown lengthening? 
High risk of root fracture?
(short root, thin root dentine)
No
Yes
No
Yes
Reconsider options:
XLA, OD, Proceed with post and crown
IF post
Reconsider options: 
XLA, OD, Proceed with post and crown
 
IF post
Consider fibre post
OR
Eccentric/elliptical/
very tapered/very large canal? 
Eccentric/elliptical/
very tapered/very large canal? 
Consider fibre post
and direct composite core
Yes
No
No
Yes
Custom cast post-core 
Large core required?
(i.e. 
no
completely intact walls remaining)
Yes
No
Cast post-core with prefabricated
pattern (e.g. ParaPost)
Prefabricated post and direct
composite/amalgam core 
 
Fig. 4.5
Flow chart for restoration of premolar and anterior teeth (XLA 
=
extraction, OD 
=
over denture).
POOC04 02/18/2005 04:35PM Page 102

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coronal dentine remains to provide strength and aid in retention of a
core, then an indirect post with integral core is indicated (Fig. 4.3). 
In all cases, it is essential that the margin of the subsequent indirect
restoration passes beyond the junction of the core and tooth, i.e. a 
ferrule is present (see Chapter 5).
The above principles for restoration of root-filled teeth are summar-
ised in the flow diagrams in Figs 4.4 and 4.5.