Mamoun John
Sunbeam Dental - General Dentistry, Manalapan, NJ, USA.
J Adv Prosthodont. 2017 Jun;9(3):232-237. doi: 10.4047/jap.2017.9.3.232. Epub 2017 Jun 19.
Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.
牙医常常在经过牙髓治疗的基牙上进行桩核修复,以进行冠桥修复。本文分析了在经过牙髓治疗的牙齿上放置核或桩核的生物力学目的、优缺点,并回顾了有关桩核生物力学的文献。作者评估了以下观点的科学依据:一种观点认为桩的主要目的是固定核,另一种观点认为桩会削弱牙齿。更有可能的是,桩的主要功能是帮助防止粘固了冠的基牙在大约理论上位于冠(或箍)边缘水平的骨折平面处发生骨折,从而使基牙与牙根分离。桩实质上改善了局部固定义齿修复体所提供的箍效应。本文还探讨了因固位不足或锥度过大导致的冠生物力学失败与冠桥修复体中箍效应欠佳导致的失败之间的差异。