Rehabilitation of a Structurally Compromised Endodontically Treated Tooth with a Custom Cast Post and Core: A Case Report

Abstract

Background: Successful rehabilitation of endodontically treated teeth depends largely on the amount of remaining tooth structure and the selection of an appropriate post system. Custom cast post and core restorations provide superior adaptation and retention in teeth with extensive coronal loss or flared canals.
Case Presentation: A 32-year-old female presented with a fractured maxillary left lateral incisor following trauma. Clinical and radiographic findings revealed an Ellis Class III fracture with significant coronal destruction and a diagnosis of irreversible pulpitis with asymptomatic apical periodontitis. Root canal treatment was performed followed by post space preparation while maintaining 5 mm of apical gutta-percha. A custom cast post and core was fabricated using an indirect technique and cemented, and the tooth was restored with a porcelain-fused-to-metal crown.
Conclusion: Custom cast post and core remains a reliable option for restoring structurally compromised endodontically treated teeth, providing adequate retention, strength, and long-term functional and esthetic rehabilitation.