Saqib Rashid.
Restoration of an extensively broken down Maxillary Molar with Cast Split Post and Core. A Case Report.
J Pak Dent Assoc Jan ;10(1):54-5.

The cast split post and core technique is beneficial for the restoration of extensively broken down and endodontically treated molars exhibiting divergent roots. This case report discusses the fabrication of a cast split post and core for an extensively broken down maxillary molar.

A 46 years old male patient presented with a complaint of persistent food impaction in his left maxillary porcelain fused to metal crown. Clinical examination revealed three crowns on 24, 25 and 26 joined like connectors of a fixed fixed bridge. Caries was detected below the crown of 26 and it was split from the crown of 25. The remaining tooth structure was grossly carious and badly broken down. A periapical radiograph was taken before the start of the treatment and it revealed that 26 was endodontically treated. An extensively broken down maxillary molar as shown in the pre-operative photographs enabled the operator to make the clinical decision of cast split post and core. This clinical decision was made due to the different paths of insertion of the root canals. Gutta purcha was removed from disto buccal and palatal canals leaving adequate gutta purcha for the apical seal. Both disto buccal and palatal canals were prepared with Parapost drills on a slow speed hand piece. (Parapost system Whaledent Ny). Impression was taken in vinyl polysiloxane (3M Express light body and putty) by using burn out impression posts available in the Parapost system. The cast post and core was initially cast in the disto buccal canal, while the second post was fabricated using the palatal canal. The latter was hollow and made to cover the previously cast post and core. The cast posts were sand blasted using 50 gm aluminium oxide particles. The two pieces should fit intimately as well as passively orb the working die. The post and cores were initially tried separately and then combined together. The cast post and cores were cemented with luting glass ionomer. (Hy-Bond Glass Ionomer, Shofu Japan). A cast post and core was also fabricated for 25 which was previously endodontically treated. 24 was endodontically treated by the operator. The teeth were cleaned and a second impression using polyvinyl siloxane (3M express putty and light body) was made. Three porcelain fused to metal crowns were fabricated and cemented with luting glass ionomer cement (Hy-Bond Glass lonomer, Shofu Japan).

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