What are the pros and cons of cast gold posts?
Often anterior teeth that need posts and cores can benefit from gold posts as opposed to prefabricated one visit bonded posts. This is especially true for teeth lacking in tooth structure (ferule)to hold a crown . When this is the case sometimes a cast gold post is the way to go. This type of post requires a second visit since it is made in the laboratory using the lost wax technique. It doesn't take long for laboratories to fabricate a cast post, usually only a couple of days and certainly no more than a week.
Gold posts can provide a solid build up for teeth and are especially good for anterior teeth especially when using a prefabricated post and composite build up might result in a thin and breakable core being prepped for an anterior crown. Gold will allow the amount of reduction that these teeth need even when there is a "tight bite" and even when there is a deep overbite.
Gold crowns also allow for the fabrication better fitting posts that conform to canals anatomy even when they are more oval than round. Although gold posts can be bonded in with a modified resin cement, they also work well with a more traditional cement like ZOP or Glass ionemer (both non resin cements).
What are the cons for gold posts. First of all fabrication involves two visits plus a lab bill. Temporization for this procedure tends to be somewhat loose fitting and if left too long in the mouth the temporary can become loose and the root canal system contaminated. Most endodontists feel that root canals that are not sealed should be retreated if they are left exposed in the mouth for an extended period (thirty days or more). When this occurs the endodontic literature maintains that the canal loses it seal and can become contaminated with bacteria. There for, if a patient doesn't return in a timely manner for the try in and post cementation it can lead to a compromised root canal.
Another draw back for Gold posts is they are not ideal for translucent all porcelain restoration since they may show through the cemented restoration.
Fabrication of gold posts can be more technique sensitive since fitting gold posts can be tricky. Sometimes, if they end up having too tight a fit the pressure involved with their seating may end up making cracks in the root.
Prefabricated posts on the other hand, can be made of many materials ( steel, titanium, fibre or graphite) and can also be luted with either traditional or bonded resin cements. I have successfully used all of these types of prefabricated posts and in the proper circumstances, all work well. The only real contraindications are that they are not ideal for use in a tooth lacking sufficient supra gingival tooth structure (lacking 2-3 mm of ferrule), or having a canal having a oval or extremely tapered shape, or in situations that the composite core will end up to thin to be able to withstand the horizontal forces that they will be subjected to by a patients occlusion.
The truth in many situations, either a gold post or a prefabricated post and core work well and the choice should be made based on an individual basis considering the time involved for patient treatment, their finances and the previous mentioned pros and cons. Also the fact individual dentists may be better and have more confidence using one or the other system and that is a factor that should enter into which system they choose, since they probably should use the technique that works the best in their hands.
from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/06/what-are-pros-and-cons-of-cast-gold.html - http://lspindelnycdds.blogspot.com/
Gold posts can provide a solid build up for teeth and are especially good for anterior teeth especially when using a prefabricated post and composite build up might result in a thin and breakable core being prepped for an anterior crown. Gold will allow the amount of reduction that these teeth need even when there is a "tight bite" and even when there is a deep overbite.
Gold crowns also allow for the fabrication better fitting posts that conform to canals anatomy even when they are more oval than round. Although gold posts can be bonded in with a modified resin cement, they also work well with a more traditional cement like ZOP or Glass ionemer (both non resin cements).
What are the cons for gold posts. First of all fabrication involves two visits plus a lab bill. Temporization for this procedure tends to be somewhat loose fitting and if left too long in the mouth the temporary can become loose and the root canal system contaminated. Most endodontists feel that root canals that are not sealed should be retreated if they are left exposed in the mouth for an extended period (thirty days or more). When this occurs the endodontic literature maintains that the canal loses it seal and can become contaminated with bacteria. There for, if a patient doesn't return in a timely manner for the try in and post cementation it can lead to a compromised root canal.
Another draw back for Gold posts is they are not ideal for translucent all porcelain restoration since they may show through the cemented restoration.
Fabrication of gold posts can be more technique sensitive since fitting gold posts can be tricky. Sometimes, if they end up having too tight a fit the pressure involved with their seating may end up making cracks in the root.
Prefabricated posts on the other hand, can be made of many materials ( steel, titanium, fibre or graphite) and can also be luted with either traditional or bonded resin cements. I have successfully used all of these types of prefabricated posts and in the proper circumstances, all work well. The only real contraindications are that they are not ideal for use in a tooth lacking sufficient supra gingival tooth structure (lacking 2-3 mm of ferrule), or having a canal having a oval or extremely tapered shape, or in situations that the composite core will end up to thin to be able to withstand the horizontal forces that they will be subjected to by a patients occlusion.
The truth in many situations, either a gold post or a prefabricated post and core work well and the choice should be made based on an individual basis considering the time involved for patient treatment, their finances and the previous mentioned pros and cons. Also the fact individual dentists may be better and have more confidence using one or the other system and that is a factor that should enter into which system they choose, since they probably should use the technique that works the best in their hands.
from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/06/what-are-pros-and-cons-of-cast-gold.html - http://lspindelnycdds.blogspot.com/
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