Sometimes the destruction caused by carious processes or various traumatic injuries is extensive, affecting the entire dental crown.
In order to preserve the tooth in question and maintain its place on the arch, we opt for a corono-radicular reconstruction.
The operation is carried out by means of a corono-radicular device which, as the name suggests, engages at root level and forms the coronal support for the prosthetic work applied subsequently.
The materials used can be metal, zirconium or carbon fiber.
Conditions that make the insertion of a Screw Post viable
Absence of inflammatory processes: a tooth with an inflammatory process will react with an abscess when a root canal device is applied.
Absence of periodontal damage: periodontal retraction leads over time to the mobilization of teeth from the arch and their loss. A root canal restoration is therefore useless as the root of the periodontally affected tooth is unable to support the prosthetic piece.
The existence of roots that are as straight as possible and properly treated endodontically: correct endodontic treatment seals the periapical space from surrounding bacteria. Straight roots facilitate both correct endodontic treatment and optimal insertion of the root portion of the prosthesis. Curved roots can be perforated by the root canal device.
Although the root canal device engages the root of the tooth, there must also be a minimum of 1 millimeter of coronal portion of the tooth, which is the supporting portion of the prosthetic. If this is not the case, the dentist will indicate that a gingivectomy should be carried out, which consists of sectioning and shaping the gingiva in such a way as to obtain favorable conditions for the application of a corono-radicular device.
Indications for corono-radicular devices
Extensive carious processes: in large losses of tooth substance, traditional fillings no longer have walls to hold them in place and will soon fall out.
Fractured teeth: the fracture line may also affect the pulp chamber or the lost tooth segment is large. Any tooth reconstruction will be doomed to failure.
Teeth with large fillings: the original morphology of the tooth cannot be restored and there is no guarantee of the strength of the fillings. Furthermore, a bulky filling can lead to fracture of the remaining tooth. Thus, replacement of large fillings with coronal root canal devices is indicated.
Poorly positioned teeth: by changing the angulation of the root canal appliance we can restore harmony to the dental arch. Slight malposition can be corrected prosthetically.
The first step in the application of a Screw Post (root canal device) is endodontic treatment of the tooth in question.
If the tooth has already been treated in the past, its correctness is radiologically examined.
Retraction may be indicated if the periapical space is not completely sealed. The dentist will then mill a portion of the canal, making room for the root segment of the prosthetic piece.
An impression will be taken and the technical laboratory will make the root canal appliance.
Once cemented, the prosthetic piece will take the shape of a prepared tooth, a bridge, on which the superstructure must be added. Depending on the case, the superstructure can be metal or ceramic, more aesthetic, indicated in areas uncovered during the shaving.
Corono-radicular devices are an alternative to the extraction of teeth with advanced crown destruction.
Conclusions
Even if they require more appointments at the dentist’s office, the aesthetic and mechanical results are durable and economical compared to the cost of dental implants as a prosthetic alternative. The cost of a Screw Post can be as much as ten times less than a dental implant.
