Insight 97 — Can a Cast Post and Core Be Temporarily Cemented?

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Sometimes, the quality of the root canal treatment is uncertain, yet the tooth needs a post to retain the restoration. Could temporary cementation of a cast post and core preserve access to the canal?

Question 1

Can a metal post be cemented with Kerr temporary cement for a few months so that it can be removed more easily if endodontic retreatment is needed later?

Answer:

The question is whether this approach is worthwhile.

Suppose you place a metal post in the canal for three months and then want to remove it. Even with temporary cement, the post's substantial frictional retention may make removal very difficult. Cleaning residual cement from the canal presents its own problems.

If you are not planning to place the definitive restoration yet, it may be better to avoid placing a post altogether, establish an adequate seal with a temporary restoration, such as amalgam, and wait a few months.

Question 2

The patient is 15 years old, and the maxillary lateral incisor has undergone root canal treatment. The tooth is extensively damaged, and obtaining an adequate ferrule is difficult. The patient has no symptoms, but I am uncertain about the quality of the root canal treatment. That is why I thought temporarily cementing the post might be a less troublesome option.

Answer:

Under these circumstances, greater caution is needed. Because little tooth structure remains and an adequate ferrule is lacking, a highly retentive post may be difficult to remove, with a risk of root cracking or fracture.

Particularly in a tooth like this, it is not reasonable to undertake treatment unnecessarily when we may have to dismantle it a few months later.

Question 3

If we assume that the post could later be removed easily with ultrasonics, would temporary cementation still be an unsuitable choice?

Answer:

Even if we assume that removing the post with ultrasonics would be easy, this approach still does not seem particularly reasonable.

A few months later, you would need to remove the crown and post, clean the canal, and cement the post and crown again. That means several additional treatment steps, each with its own difficulties and potential to damage the remaining tooth structure.

What advantage is there in taking this route from the outset?

If you are uncertain about the quality of the root canal treatment, first determine whether endodontic retreatment is indicated. If it is needed, it is better to complete it before placing a post.

If you decide to postpone definitive treatment, it is better to choose a temporary treatment that can be removed more easily while also providing an adequate coronal seal.

Overall, temporary cementation of a post does not necessarily simplify treatment. Sometimes it merely adds several extra steps without guaranteeing easy post removal.

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