Fiber Post and Composite Restoration of Root-Canal-Treated Maxillary Canine
Pre-Operative Assessment
Evaluate the remaining coronal tooth structure to determine if a fiber post is indicated—posts are necessary when only one wall remains and/or less than one-third of the clinical crown height is present. 1
- Confirm successful endodontic treatment radiographically before proceeding with post placement 1
- Verify adequate root length and canal diameter to accommodate the fiber post system 2
Step-by-Step Procedure
1. Post Space Preparation
- Remove gutta-percha from the canal using the drill provided with the fiber post system, maintaining at least 4-5 mm of apical seal 3
- Prepare the post space to a depth that provides adequate retention while preserving apical seal 3
- Use the manufacturer-provided drill that corresponds to the specific fiber post diameter to ensure proper fit 4
- Clean the prepared canal thoroughly and rinse to remove debris 5
2. Post Selection and Trial Fitting
- Select the appropriate fiber post length based on the prepared canal depth 2
- Trial fit the fiber post to confirm proper seating and length before cementation 6
- The post should extend into the canal to provide adequate retention without compromising the apical seal 1
3. Post Cementation
- Apply a dental adhesive system to the prepared canal walls following manufacturer instructions 6
- Coat the fiber post with dual-polymerizing adhesive resin cement (such as RelyX ARC or equivalent self-adhesive resin cement) 6, 2
- Insert the post into the prepared canal space, ensuring complete seating 6
- Remove excess cement and light-cure according to manufacturer specifications 6
4. Core Build-Up with Composite
- Build up the composite core around the cemented fiber post to restore the missing coronal tooth structure 1
- Use bulk-fill or conventional composite resin to create adequate bulk for crown preparation 3
- Contour the composite core to provide appropriate retention and resistance form for the final restoration 6
- Light-cure the composite core thoroughly in increments if needed 3
5. Final Restoration Preparation
- Prepare the tooth for either a direct composite restoration (if sufficient tooth structure remains) or a full-coverage crown 1
- For maxillary canines requiring crowns, prepare with appropriate reduction to accommodate the restorative material 6
- Ensure the preparation design provides adequate ferrule effect when possible 1
Critical Considerations
Fiber posts demonstrate significantly higher survival rates (94.3%) compared to teeth restored without posts (76.3%) when indicated, and they produce more favorable fracture patterns that allow tooth repair rather than catastrophic failure. 1, 6
- Multiple fiber posts may be considered for teeth with wide root canals, as they provide substantially higher fracture resistance than single wider posts 2
- Quartz fiber posts show significantly higher fracture resistance compared to other post materials in maxillary canines 6
- The primary cause of failure in endodontically treated teeth is root fracture (9.7%), which occurs more frequently in teeth without posts 1
- Fiber posts produce repairable fractures above the bone level, while metal posts often cause catastrophic root fractures 6