Root Canal and Corono Apical Amalgam (Amalgam Post and Core)

Case Study Number 431446

Question one: Casted post or amalgam post and core?

Endodontic post does not increased the strenght of the remaining tooth substance, on the contrary it weakens it as a result of the additional tooth substance loss due to the post hole drilling.

On posterior teeth with enough pulp chamber depth to obviate the need for a post (2 to 4 mm), amalgam is the material of choice. Where a post is required to retain the build-up, amalgam is cheaper and faster than a cast gold core and often less destructive of tooth structure.

Alex McClean, DMD, B.Sc. (Eng.) “Predictably restoring endodontically treated teeth” Web Reference: http://www.cda-adc.ca/jcda/vol-64/issue-11/782.html

Question two: To bond or not to bond amalgam?

As apparently the bond of amalgam to dentin will ultimately degrade, there is concern about increased leakage after bond failure. The bonded surface of the amalgam may be more corrosion resistant than an unbonded amalgam, leading to the risk of increased leakage on a long-term basis.⁹

Alex McClean, DMD, B.Sc. (Eng.) “Predictably restoring endodontically treated teeth” Web Reference: http://www.cda-adc.ca/jcda/vol-64/issue-11/782.html

Nevertheless, amalgam cores should be covered with a crown as soon as possible to prevent corono apical leakage.

Note: Most of the retention needed is located within the pulp chamber.This corono apical amalgam extend too far in the distal root canal, it does not need to be that long. 1 mm lengh would have been enough.

(9. Meiers JC, Turner EW. Microleakage of dentin/amalgam alloy bonding agents: Results after 1 year. Oper Dent 1998; 23:30-3.)