Dental Post Cementation and Core Build-Up with Cosmecore

hello this is dr. Dennis Hartley Ben

welcome to cosmonauts tip of the month

today's presentation is using cosmic or

for post cementation and direct resin

build up for the debilitated central

incisor so today we're going to be

talking about cosmo dense core build-up

material i'm going to show how i use

that to restore a anterior tooth that

needs a posting core post root canal

therapy and I'm using it to cement the

post and to also use it for the build-up

so we'll go through the technique here

this is a patient that has gone through

periodontal crown lengthening therapy

and was referred to me for the

restorative treatment necessary for the

maxillary anterior segment so as you can

see there is already post placed on to

number seven post incor there's a post

of course placed on number nine so today

we're going to be placing the post in

core for tooth member eight so the

patient is returned back to me after

having an endodontic treatment on tooth

number eight and you can see the amount

of tooth structure that we have

available still is nicely we have enough

ferrule so we want our post to be able

to help maintain the build-up material

so first I'm going to be creating the

post space I will try in my zero post

from Bressler this is a zirconia post

and to be certain that the post doesn't

shift or move while we take the

verification x-ray I'm going to be using

a material from Khaz Modan called ginger

guard ginger guard essentially is a

liquid rubber dam material I'm going to

apply that around the post onto the

tooth structure and we're going to like

your that for ten seconds this material

will maintain its flexibility but it

also will adhere to the tooth structure

slightly and just keep the post stable

while we're taking the x-ray before

cementing the post I'm going to use the

diamond bur that comes with a sear post

kit this is used just to roughen up the

walls of the internal aspect of the root

system to get more mechanical adhesion

with our post imitation so I'm going to

first start out with my 37% phosphoric

acid I'm going to inject that into the

post system and I don't show it but I'm

actually going to apply the etchant onto

the facial surface of

this preparation area as well I leave

that for 15 seconds we're going to rinse

off the excess and I'll be using dry

points to remove any of the excess water

following removal the excess water we

want to leave the dentin moist but not

overly moist I'm going to apply the

adhesive system from Kasbah dad this is

a cosmetic complete dual cure the cosmic

or is a dual cure core material so we

have to make sure that we're using an

adhesive system that is also dual cure

or an adhesive that does not need to be

like cured so with the cosmetic complete

system the red bottle is the fifth

generation adhesive that has a primer

the unfilled resin combined and that

material is light curable but because

we're going to be curing so far down

into the post base it would not be

possible for our light to be able to

travel that far down into the post

system and be confident that we're going

to have great adhesion so we're going to

need to use a dual cure system or add a

catalyst to our cosmonaut complete then

that's a black bottle with the yellow

label so with this system you want to

use two drops of the cosmetic complete

fifth generation primer that's what the

red bottle and one drop of the catalyst

that's with the yellow bottle we're

going to apply multiple coats three to

five coats of our primer with the

catalyst we want to make sure that we

get the adhesive down into the canal

space so I may use dry points again to

make sure that we're getting the

adhesive all the way down into the post

system and then we're going to air thin

and we're going to use high volume

suction to remove the excess and I'll

use dry points to remove the excess

primer adhesive into the post base now

we don't like cure this because the the

catalyst is going to make the system

self curable so that we don't have to

worry about light penetrating all the

way down into that Canales

them using these needlenose tips from

the centric system I'm going to be

injecting the cosmic or dual cure core

building material down into the post

base this is the a - cosmic or and I'm

going to make sure I bring the cosmic or

to fill up the internal aspect of the

canal system and then I'm going to place

some of the cosmic or on to the tip of

the post now the post has been pre

treated with either rocket tech or co

jet that will enhance the bond to the

zirconia post so the cosmic or now is

placed on onto the post and the post is

going to be seated into the canal system

making sure that we bring the post all

the way down to its full extent now I'm

going to start adding more cosmic or

around the post and the thing that's

really nice about this cosmic order as

you'll see on the photographs there's

very little slumping with the cosmic or

it flows very nicely it's easily placed

and I don't have to worry about the thus

lumpiness of the material one of the

other advantages of cosmic order is I

can like cure this in increments so I

can go ahead and add some of the cosmic

or I can light cure for an initial ten

seconds to hold its position and then I

can continue on and add cosmic or to

create the proper form that I want so I

continue to add the cosmic order to make

sure that I'm sealing all the way around

the post and I can use an explorer or

some sort of instrument to get a more

ideal form before I eventually do my

final like here now I'm with a

traditional halogen light I'm going to

light cure my cosmic or for 60 seconds

both from the facial and the palatal to

make sure that the cosmic or the core

building material is sufficiently cured

once the cosmic or has been adequately

polymerized then I can go in with my

traditional crown and bridge birds this

is a bird from brass ler and I'm going

to create my preparation and what you'll

find with cosmic or is that it

perhaps so similar to tooth structure

that it's not too softer material and

it's not too firm and you're able to

through your preparation going in and

refining my preparation and smoothing my

preparation with another of the rest'll

burrs and finally polishing the

preparation with my rubber cups from

Cosmo dent this is the flexi cup system

from Cosmo dent I want to make sure that

the tooth preparation is nice and smooth

which will make it easier and more

predictable for my lab technician and I

want to make sure that the cosmic court

is polished prior to making my

provisional because I want to be certain

that my provisional doesn't bond to the

core building material because this is a

composite material you know very similar

to the best GMA materials we're going to

be using with our Provisionals and there

is a look at the final preparation after

we've completed the post and core

build-up the preparation and the

polishing with the flexi cup system well

I hope you find this tip from Cosmo dent

the tip of the month hopefully you find

this tip helpful if you're interested in

more information on cosmetic dentistry

and anterior bonding or posterior

bonding feel free to like my page on

facebook it's heart leagues seminars and

feel free to ask questions and respond

to the postings I've made on other cases

and I look forward to hearing from you

soon thanks again