Solomon C S, Osman Y I
Department of Prosthetic Dentistry, Oral Health Centre, Faculty of Dentistry, University of the Western Cape.
SADJ. 2003 Nov;58(10):370, 373-6, 381.
The amount of tooth structure that remains after endodontic therapy and post preparation is of prime importance as the strength and resistance to root fracture of an endodontically treated tooth is directly related to the amount of residual dentine. The desired post diameter is determined by tooth morphology and the endodontic procedures (for root canal debridement) with the aim being to avoid removing too much tooth structure. Increasing the diameter of the post does not provide a significant increase in the retention of the post; it only increases the stiffness of the post at the expense of the remaining dentine and the fracture resistance of the root. There is little indication for increasing the post width beyond the endodontic cleaning and shaping procedures for all post systems. The post diameter needs to be controlled to preserve the radicular dentine, reduce the potential for perforations, and permit the tooth to resist fracture. However, endodontic treatment often involves wide flared canals where cast posts are the standard method of treatment. These thin-walled canals are then further compromised by the placement of a tapered cast post--thus increasing its risk for fracturing. The Luminex light, transmitting posts provide an alternative treatment option by strengthening weakened, endodontically treated teeth by the combined bonding action of dentine bonding agents and composite resin restorative material. The paper reports on a case where a wide flared root canal was rehabilitated with composite resin using a light-transmitting post.
根管治疗和桩预备后剩余的牙体组织量至关重要，因为根管治疗后牙齿的强度和抗根折能力与剩余牙本质的量直接相关。理想的桩直径由牙齿形态和根管治疗程序（用于根管清创）决定，目的是避免去除过多的牙体组织。增加桩的直径并不会显著增加桩的固位力；它只会以剩余牙本质和牙根抗折性为代价增加桩的刚度。对于所有桩系统，几乎没有迹象表明在根管清理和成形程序之外增加桩的宽度。需要控制桩的直径以保留根管牙本质，降低穿孔的可能性，并使牙齿能够抵抗折断。然而，根管治疗通常涉及宽大的喇叭口状根管，铸造桩是标准的治疗方法。这些薄壁根管随后因放置锥形铸造桩而进一步受损——从而增加了其折断的风险。Luminex透光桩通过牙本质粘结剂和复合树脂修复材料的联合粘结作用增强根管治疗后变弱的牙齿，提供了一种替代治疗选择。本文报道了一例使用透光桩用复合树脂修复宽大喇叭口状根管的病例。
