Management of a Mutilated Molar Using Custom Cast Post: A Case Report

Tooth number 47 the concerned tooth here was ideally indicated for extraction but the patient was keen to save the tooth, so the treatment plan decided was the rehabilitation of the tooth with custom-designed cast post followed by a metal crown. Informed consent was obtained from the patient. Access cavity was prepared and all caries from the pulp floor were excavated in relation to tooth number 47. Working length was determined using 15K ss hand files (Fig. 2A). Thorough cleaning and shaping was done till size F3 ProTaper files with copious irrigation using 2% chlorhexidine, normal saline, 5% sodium hypochlorite, and then final rinse with saline. Intracanal dressing of calcium hydroxide dressing was placed for 7 days. In the next appointment, obturation was done with F3 ProTaper cones using resin-based sealer (Figs 2B and 3A). While excavating caries during access cavity preparation, a very thin layer of dentin remained as caries were almost involving the furcation. So to reinforce the floor, a layer of MTA was placed on pulpal floor (Fig. 3A) (keeping the canals patent) and on the weakened mesial wall as well. It was then covered with moist cotton followed by placement of a temporary restoration. In the next visit, post space preparation was done in the distal canal with the help of Peeso Reamer up to number 3 (1.1 mm diameter) leaving 5 mm gutta-percha apically (Fig. 3B). GIC was IN T R O D U C T I O N