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Rehabilita)on of Severely Damaged Tooth Through Using a Customized Cast Post    
 

Vol 13 No 1 (2025)    DOI 10.5195/d3000.2025.828 

 h#p://den*stry3000.pi#.edu 

The Rehabilitation of Severely Damaged Tooth Through 
Using a Customized Cast Post 
 
Maher M. Jwaid1, Qabas Alanni1, Zainab Tariq Al-Atya 2, Rand Mohammed Falah1, Ali Radhi Ibrahim1 

1 College of Dentistry, Al-Hadi University, Baghdad, Iraq 

2 College of Dentistry, Al-Bayan University, Baghdad, Iraq

Abstract 

Posts have been proposed to reinforce weak teeth that have undergone endodonBc treatment, by 
transferring twisBng pressures through the denBn of the tooth roots to the surrounding supporBng 
Bssue. The subsequent case studies applied an interdisciplinary approach in uBlizing custom cast posts 
to restore severely damaged treated teeth, resulBng in the complete restoraBon of their appearance 
and funcBonality. Ensuring a saBsfactory outcome and saBsfying the paBent required the careful 
coordinaBon of prostheBc and endodonBc treatments, considering the paBent's expectaBons and needs. 
TradiBonally, a durable metal post and core were commonly employed over an extended duraBon to 
serve as the foundaBonal restoraBon for a prostheBc crown. The cast post and core system offer the 
advantage of having the core seamlessly integrated with the post. The purpose of the post is to maintain 
the core restoraBon, which involves rebuilding the damaged coronal structure. This arBcle discusses the 
use of cast post and core and zirconia restoraBons for a maxillary leK premolar that has been damaged. 

Keywords: Full crown, Cast metal post and 
core, Post and core, ProstheBc rehabilitaBon 

Cita9on: Jwaid MM, et al. (2025) The Rehabilita9on of 
Severely Damaged Tooth Through Using a Customized 
Cast Post. Den9stry 3000. 1:a001 
doi:10.5195/d3000.2025.828 
Received: January 18, 2025  
Accepted: February 16, 2025 
Published: April 11, 2025 
Copyright: ©2025 Jwaidi MM, et al. This is an open 
access ar9cle licensed under a Crea9ve Commons 
AWribu9on Work 4.0 United States License. 
Email: maher.m@huc.edu.iq 

Introduction 

We are often required to repair 
teeth that have had endodontic 
treatment before the final 
restoration can be made [1]. Root 
canal-treated teeth, which had 
fractures, dental cavities, and 
previous restoration and 
endodontic procedures, have been 
found to be challenging to restore 
[2]. There are currently multiple 
techniques and materials that can 
be used to secure permanent 
restorations in place, and repair 
teeth that had root canal 
treatment with significant loss of 
the upper part of the tooth [3]. 
When additional support is 
needed to maintain the core and 
coronal restoration in place, a 
supplemental post is put into the 

root of a tooth with insufficient 
structural support [4]. The primary 
objective of the post and core is to 
restore an adequate amount of 
coronal tooth structure, ensuring 
proper retention and resistance of 
the crown while also restoring the 
tooth's function and look. Metal is 
the most prevalent form of post 
utilized to secure the core in 
position [5]. A post-core 
restoration is recommended for a 
tooth that has experienced 
significant loss of the crown, is at 
risk of fracturing in the cervical 
area, is visibly discolored, has lost 
two adjacent surfaces, is shorter in 
length, has a weak retention 
structure, and is in good overall 
periodontal and periapical health 
[6]. The decision to employ a cast 
post or a prefabricated post is 

influenced by two factors: the 
geometry of the canal and the 
amount of surviving tooth 
structure. According to claims, a 
properly fitted cast post and core 
is said to be more retentive than a 
prefabricated post that does not 
match the canal pattern, 
especially when the canal requires 
significant preparation [7]. The 
cast post and core, specifically 
engineered to endure torsional 
forces, are placed into the 
prepared root canal space [8]. This 
case report describes the process 
of rehabilitating a severely 
damaged premolar tooth using a 
custom-made cast support and a 
zirconia crown. 
 
Case Report 



Rehabilita)on of Severely Damaged Tooth Through Using a Customized Cast Post    
 

Vol 13 No 1 (2025)    DOI 10.5195/d3000.2025.828 

 h#p://den*stry3000.pi#.edu 

A 33-year-old male patient 
presented to the Department of 
Dentistry at Al-Hadi University, 
Teaching Dental Clinics in Baghdad, 
Iraq. The patient's main concern 
was the unsatisfactory appearance 
caused by a dislodged restoration 
in the upper left region of the jaw. 
The patient expressed a wish to 
have the restoration replaced. The 
clinical examination identified the 
presence of secondary cavities 
together with dislodged 
restorations on tooth #24. The 
tooth had endodontic treatment as 
observed on the radiography 
examination. Periapical infection 
and periodontal widening were not 
observed. Therefore, our objective 
was to repair and restore the 
missing tooth structure to its 
original form and function. The 
treatment approach for the 
affected tooth included the use of 
a specially crafted cast post and 
core, followed by the application of 
a zirconia crown that fully covers 
tooth #24. 
 
Treatment Steps 
After the elimination of secondary 
caries, a post space was made 
using a peezo-reamer (MANI Inc., 
Japan) and an endodontic hand 
device to accommodate the post. 
The canal was meticulously 
prepared to guarantee a 4 mm 
layer of gutta-percha, which serves 
to maintain the periapical seal. The 
assessment of the apical seal and 
post-space preparation was 
conducted (Figure 1). 
A non-direct method was 
employed in the production of 
metallic posts. The separating 

media was placed to the prepared 
post space, and a 24 impression 
was taken by Zetaplus C Silicone 
Impression Material (Zhermack, 
Germany) with the assistance of a 
dental wood wedge (Figure 2). 
 
 
Discussion  

 

 

 

 

 
Figure 1. Space prepara`on for a 
custom-made cast post. For an 
apical seal, it was lea at least 4 mm 
of guba-percha in the canal and a 
prepara`on up to the #5 peeso 
reamer was done. 
 
 

The first result of this study 
indicated that Iranian dentists are 
under high levels of stress during 
the COVID-19 pandemic. They 
reported concerns about being 
infected by a new virus while  

The post was affixed with Breeze 
Self-Adhesive Resin Cement (Kerr, 
USA). Subsequently, the teeth had 
preparation with a circumferential 
chamfer (Figure 3). Impressions 
were created using silicone 
impression material. The process 
of selecting shades has been 
completed. The ZIRCONIA crown 
was cemented using dual cure 

resin cement (breeze, Kerr, USA), 
as shown as Figure 3. 
Impressions were created using 
silicone impression material. The 
process of selecting shades has 
been completed. The ZIRCONIA 
crown was affixed using breeze, as 
shown as Figure 4. 
 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 3. A custom-made cast post 
was created and cemented 
intraorally. 
A: Cobalt-chromium alloy cast 
post; B: Ferrule preparation for 
remaining coronal tooth structure 
and cemented cast post. 
 

 

 

 

A 

B 



Rehabilita)on of Severely Damaged Tooth Through Using a Customized Cast Post    
 

Vol 13 No 1 (2025)    DOI 10.5195/d3000.2025.828 

 h#p://den*stry3000.pi#.edu 

 

 

 

 

 

 

 

 

 

 

 
Figure 4. Zirconia-ceramic crowns 
with #24. 
A: Metal-ceramic crowns seated on 
the cast; B: Crowns cemented 
intra-orally with light cure resin 
cement. 
 
Discussion 
Custom cast post fabrication is the 
preferred method for achieving 
optimal retention and resistance 
when rehabilitating both the 
aesthetic and functional aspects of 
teeth. Post and core restoration is 
considered the fundamental 
process for repairing damaged 
teeth. In 2020 Phang ZY et al. 
assessed the long-term success 
rate of metal posts in the follow-
ups and compared the success 
rates of cast and metal posts over 
a 7-year period [8]. 
Suleiman AB et al In a 52.9-month 
follow-up study, the outcome of 
ETT restored with CMCPC was 
favorable. CMCPC may be 

regarded as a viable restorative 
option for structurally deficient 
ETT [9]. 
The primary objective of this 
procedure is to ensure the core 
restoration, which replaces the 
missing coronal structure, is in 
position by providing retention. 
Both prefabricated composite and 
one-piece customized posts and 
cores are viable alternatives.[10] 
In this case report, custom cast 
posts and cores were the most 
advanced method of restoring 
teeth that had previously 
undergone endodontic treatment. 
In the present day, prefabricated 
posts are frequently preferred to 
custom cast posts and cores. On 
the other hand, cast posts and 
cores offer their own benefits, 
including the preservation of the 
maximum quantity of tooth 
structure and improved flexibility 
in the root canal. It is not 
necessary for the post to retain its 
essence, as it is an intrinsic 
component. An additional 
characteristic is an anti-rotational 
property. Conversely, it 
necessitates numerous visits [11]. 
The prefabricated posts (Zirconia) 
are available with metal posts 
(stainless steel, titanium), fiber 
posts (carbon, glass), and ceramic 
posts. The prefabricated posts may 
have a circular cross-section and 
may have a variety of surface 
characteristics, including serrated, 
smooth, threaded, and 
roughened. Parallel and tapered 
post configurations are available 
for use, and corresponding drills 
are included to create post gaps 
[12]. 

 
Conclusion 

When selecting the optimal post 
and core systems, it is important 
to examine factors such as the 
quantity and quality of maintained 
tooth structure, esthetic needs, as 
well as the indications, 
advantages, and disadvantages 
associated with each option. 
Extensive research exists that 
compares the efficacy and 
utilization of different types of 
posts and the diverse materials 
employed in their construction. 
Further research is needed to 
validate the approach outlined in 
the case report, although it is a 
straightforward, efficient, and 
offers a possible substitute for 
preserving extensively damaged or 
rotting teeth. The procedure of 
fabricating a distinct post and core 
has yielded favorable results 

Conflicts of interest 

The authors declare no competing 
interest. 

References 

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Rehabilita)on of Severely Damaged Tooth Through Using a Customized Cast Post    
 

Vol 13 No 1 (2025)    DOI 10.5195/d3000.2025.828 

 h#p://den*stry3000.pi#.edu 

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