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    How to use a novel glass fiber post system for tricky restorations

    Atypical root canal anatomy can make for difficult restorations, but new materials can help.

    An endodontically-treated molar with extensive crown destruction is a quite common clinical condition that demands restoration.

    Depending on the situation, an endocrown or a post and core along with full-coronal restoration can be used to restore the tooth. The endocrown can be fabricated when the pulp chamber still remains,1 as it provides retention for the crown by itself.

    On the other hand, the absence of the pulp chamber walls forces the use of an intraradicular retention to anchor the restoration. Besides the use of a cast metal post that demands more than one appointment to be concluded, the use of composite resin associated with a pre-fabricated fiber post is probably the most common alternative chosen by the dentist to solve this problem.

    Fiber posts are made from a pack of pre-stretched fibers positioned in the longitudinal direction and impregnated within a resin matrix.2 Glass fibers are widely used in its manufacture.3 To adapt it into the canal, a drill with the same shape and diameter of the post should be used, but this adaptation is not so perfect when the tooth presents atypical endodontic canal morphology.

    In this clinical report, we present a case where an innovative post composed of a bundle of thin glass fiber reinforced resin posts (Rebilda Post GT, VOCO) was used to build up a post and core.

    Case study

    A 70-year-old female patient came to our clinic to restore a root endodontically treated just a few hours before. In the clinical examination, we observed a severely damaged left mandibular first molar.

    Figure 1Fig. 1As the remaining pulp chamber walls were impaired, we decided to build up a core anchored by a glass fiber post intraradicularly placed and subsequently fabricate a full-coronal restoration to be cemented over it.

    The root presented just one canal with a wide orifice (Fig. 1). Rebilda Post GT System, together with Rebilda Form (VOCO), was chosen to build up the core. Rebilda Post GT is a glass fiber-reinforced resin post indicated for treating teeth with atypical root canal anatomies, such as taper shaped like in this case. Unlike the regular glass fiber post, it is in fact a set of fine and flexible individual posts measuring 0.3 mm in diameter that can be placed without any further root canal preparation using drills.

    After tooth isolation with a rubber dam, we selected the measure of the post to be used (Fig. 2). Depending on the diameter, there is a variation on the number of individual thin posts. For this case, we chose the 1.2-mm post, composed of nine thin individual posts. On its surface, we applied one coat of silane Ceramic Bond (VOCO) for one minute (Fig. 3) and air dried.

    Figure 2Fig. 3

    Fig. 2                                                                                                          Fig. 3

    With the Endo Tim brush (VOCO), we applied the dual-cured, universal adhesive Futurabond U (VOCO) in self-etch mode to the inside of the root canal, lightly rubbing it against the walls for 20 seconds (Fig. 4). A regular brush was used to apply the same adhesive outside the canal for the same amount of time (Fig. 5).

    Figure 4Figure 5

    Fig. 4                                                                                        Fig. 5

    We gently air dried the whole tooth and removed any excess adhesive in the canal with an endodontic paper point.

    Dr. Mauricio Watanabe
    Dr. Mauricio Watanabe specializes in oral and maxillofacial surgery, as well as prosthodontics. He is a scientific council member of the ...

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