Jurnal Endo

557

Q U I N T E S S E N C E I N T E R N AT I O N A L

VOLUME 45 • NUMBER 7 • JULY / AUGUST 2014

Restoration of endodontically treated teeth:

Criteria and technique considerations

Richard D. Trushkowsky, DDS1

The restoration of endodontically treated teeth is often required and may represent a challenge as there is no consen-sus on ideal treatment. The failure of endodontically treated teeth is usually not a consequence of endodontic treatment, but inadequate restorative therapy or periodontal reasons. Prior to the initiation of endodontic treatment the restorability, occlusal function, periodontal health, biologic width, and crown-to-root ratio need to be assessed. If acceptable, the appropriate technique, material, and type of restoration to re-

store function need to be considered. Posts are used to provide retention for the core material and to replace missing tooth structure. The residual amount of tooth structure will deter-mine its stability for restoration. The creation of adequate fer-rule (approaching 2 mm circumferentially is ideal) minimizes the damaging effects of lateral and rotational forces on the restoration and post. (Quintessence Int 2014;45:557–567; doi: 10.3290/j.qi.a31964)

Key words: core, endodontically treated tooth, post

ENDODONTICS

Richard D. Trushkowsky

weaken the tooth. The prognosis of endodontically

treated teeth is contingent not only on apical seal but

also on the coronal sealing of the canal thereby reducing

leakage of oral fluids and bacteria into the periradicular

areas (Fig 1).3 The neurosensory response apparatus is

impaired with the removal of the pulpal tissue, which

may result in decreased protection of the endodontically

Caries and trauma are the most frequent causes of irre-

versible pulp damage resulting in root canal therapy. The

restoration of these endodontically treated teeth is often

required and may represent a challenge as there is no

consensus on ideal treatment. However, endodontically

treated teeth have been reported to have a reduced

survival rate compared to vital teeth.1 The failure of end-

odontically treated teeth is usually not a consequence of

endodontic treatment, but inadequate restorative ther-

apy or periodontal reasons.2 Excessive removal of tooth

structure during mechanical instrumentation of the root

canal system, mechanical pressures during obturation,

lack of cuspal protection, and large restorations can

1 Clinical Associate Professor, Associate Director, The Advanced Program for

International Dentists in Esthetic Dentistry, New York University College of Den-

tistry, New York, USA.

Correspondence: Dr Richard D. Trushkowsky, The Advanced Program for International Dentists in Esthetic Dentistry, New York University Col-lege of Dentistry, 345 E 24th St, New York, NY 10010, USA. Email: [email protected]

Fig 1 The coronal seal is important to prevent micro-leak age. Decementation and micromovement produce microleakage. Where there is presumed shrinkage, the bac-teria can infiltrate, causing secondary decay.

bacteria

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Trushkowsky


treated tooth during mastication.4 Prior to the initiation

of endodontic treatment the restorability, occlusal func-

tion, periodontal health, biologic width, and crown-to-

root ratio need to be assessed. If acceptable, the appro-

priate technique, material, and type of restoration to re-

store function need to be considered.5 An ideal

permanent restoration should restore esthetics and func-

tion, and protect the endodontically weakened tooth.6

INDICATIONS FOR A POST

The indications for a post have been modified in recent

years based on the advantages of adhesive restor-

ations, which may obviate the need for posts.7 Posts are

used to provide retention for the core material and to

replace missing tooth structure. The residual amount of

tooth structure will determine its stability for restor-

ation. Preparation for pulpal access diminishes mechan-

ical strength by about 5%, but a mesio-occlusal-distal

(MOD) cavity will result in a 63% reduction in strength.7

The importance of the marginal ridge was specified by

Strand et al.8 The loss of tooth vitality does not result in

a substantial change in moisture content compared to

vital teeth.9 Unfortunately, the degree of remaining

tooth structure left to require a post has not been delin-

eated. Preoz et al7 established five classes depending

on the number of axial cavity walls remaining:

• Class 1 teeth have four remaining cavity walls, with

a thickness greater than 1 mm. In this case, it was

felt a post is not necessary and any final restoration

can be utilized.10

• Class II and Class III have two or three remaining

cavity walls. These teeth can possibly be restored

without a post. The use of an adhesive core can

provide adequate fracture resistance without the

need for a post.11

• Class IV teeth have one remaining wall, and the core

material will provide minimal or no effect on the

fracture resistance of the endodontically treated

tooth.12 The use of the tooth as an abutment for a

fixed or removable partial denture will result in

reduced fracture resistance as a consequence of

crown preparation.13

• Class V teeth have no remaining walls, and a post

will be required to provide retention for core ma-

terial. A ferrule, which is characterized by a

360-degree metal crown collar surrounding parallel

walls of dentin and extending coronal to the shoul-

der of the preparation, would greatly increase the

fracture resistance of the tooth.14 If a ferrule cannot

be obtained, surgical crown lengthening or forced

eruption may be required.

INDICATIONS FOR A CROWN

Baba and Goodacre15 suggest that most endodontically

treated posterior teeth require a crown for longevity.

However, although crowns improve the success of pos-

terior teeth, this was not demonstrated for anterior

teeth.16 Anterior teeth with minimal loss of tooth struc-

ture can be conservatively restored with composite in

the lingual access opening and no post.17 A post provides

minimal or no benefit for a structurally sound tooth.18

Many classical indications for the use of a crown

have also been questioned.19 Unfortunately, the litera-

ture is equivocal as to the requirement for full cover-

age, although cuspal coverage is often recommended.

Rocca and Krejci20 report that currently available

adhesive techniques permit the use of direct composites

and an endocrown (a circular butt-joint margin and a

central retention cavity inside the pulp chamber, lacking

intraradicular anchorage). The basis of this technique is

to use the surface available in the pulpal chamber to

assume the stability and retention of the restoration

through adhesive procedures. The endocrowns provide

full occlusal coverage and the use of the pulp chamber

increases the available surfaces for adhesion.

A variety of materials can be used including feld-

spathic porcelain, glass ceramic (eg, IPS e.max, Ivoclar

Vivadent), or CAD/CAM blocks of either ceramic or

composite or combinations of the two (Lava Ultimate

Restorative, 3M ESPE). Molars can more readily be uti-

lized in this fashion. Premolars are more in danger if

canine guidance is absent as group function may per-

mit a combination of both axial and shear forces on the

premolar cusps.

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DESIGN AND TYPE OF POSTS

Posts can be active (most retentive, eg, ParaPost XT,

Coltène Whaledent; Flexipost, Essential Dental Sys-

tems), passive parallel or passive tapered (least reten-

tive, eg, ParaPost Taper Lux, Coltène Whaledent), dou-

ble tapered (DT Light-Post Illusion X-RO, Bisco), or par-

allel tapered (TENAX® Fiber White, Coltène Whaledent;

ParaPostXP No-Ox, Coltène Whaledent). Regarding post

shape, parallel-sided posts provide better retention,

less stress formation, and increased fracture resistance

than tapered posts.21

Regarding surface design, serrated posts provide

better retention than smooth-sided posts, and

threaded posts provide even better retention (Fig 2).22

An increase in post length has also been shown to

be beneficial, but an apical seal of approximately 5 mm

of gutta-percha is required.23 Excessive length can also

become detrimental as the dentin in the apical third is

very thin and perforation or increasing root fracture can

become a possibility. The length of custom metal posts

is usually recommended as two-thirds to three-quarters

of root length, and equal to or more than the length of

the crown to be fabricated.24

Posts can be metallic (either custom cast posts or

prefabricated) or fiber (custom [Fig 3] or prefabricated).

Since their introduction in 1990,25 fiber posts have

changed in shape and mechanical physical properties.

Initially the posts were quartz or carbon fiber but now

most are glass fibers, possessing a translucency that

makes an esthetic restoration more easily obtainable.

They also allow some degree of light transmission so

that dual-cure cement can be used (Fig 4),26 as the

translucency helps to provide adequate polymerization

of dual-cure cements. However, the light intensity at

the apical portion may be inadequate because of the

distance from the light source and the light-scattering

nature of the resin cement and the post. The quantity of

light that is absorbed, reflected, and transmitted seems

to be related to the resin matrix, the fiber composition

of each post, and the intensity of the light source.27

Post shapes have been modified from a retentive

shape to cylindrical or oval, which is more anatomical.

Posts of this type provide better adaptation and

remove less remaining root dentin.28

Fig 2 A wide variety of post shapes and materials is available.

Fig 3 An anatomic glass fiber post conforms to the root shape.

Fig 4 A glass fiber post provides a degree of light conduction into the canal and allows more complete polymerization. (Cour-tesy of Coltène Whaledent.)

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Teeth restored with metal posts many times fail

catastrophically with root fracture (Fig 5). The most

frequent cause of failure in teeth reconstructed with

fiber posts is not root fracture but debonding of the

post, which can occur at the post-cement interface

and/or between cement and root dentin.29

Boschian et al30 underscored the effect of elastic

modulus of the post material on stresses transferred to

tooth structures as an important factor. They reported

that post materials that have a higher elastic modulus

than dentin are capable of causing dangerous and non-

homogenous stresses in root dentin. The authors con-

cluded that the arrangement that best preserves the

integrity of the root, post, and core unit is when fiber

posts are used for restoration. Unlike cast posts, post

length, post diameter, or taper of the post do not mean-

ingfully affect the adhesion and the long-term behavior

of glass fiber posts. However, the low modulus of elas-

ticity of fiber posts (which is similar to dentin) creates a

root strain similar to that of an intact tooth at 8 to

10 mm, and a shorter length (5 mm) causes reduction of

the absorptive forces of the post system. This creates a

transfer of forces to the less rigid dentin in the cervical

area and possible fracture.31 In addition, glass fiber

posts are biocompatible and their esthetic appearance

does not cause discoloration at the gingival margin.32

Endodontically treated teeth that are used as abut-

ments for fixed partial dentures (FPDs) have a higher

failure rate than vital abutment teeth.33 The FPD can

consist of a short span, long span, or be cantilevered.

Fig 6 An ideal post should fit the morphology of the canal and not remove unnecessary tooth structure.

1+ mm 1+ mm

parallel post space narrow

walls

<1 mm

Fractured Post and Crown Fractured Post

and Crown

Vector of Force

Vector of Force

a

Fractured root Fractured

root

Vector of Force

Vector of Force

b

Figs 5a and 5b Failure can be more catastrophic with a metal post than a glass fiber post. (a) Potential fracture location with glass fiber–reinforced composite posts. (b) Potential fracture location with metal posts.

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These abutment teeth undergo both horizontal and

torqueing forces when used for FPDs or removable

partial dentures (RPDs).33,34

CEMENTS AND CEMENTATION

The main reason for failure of glass fiber posts is

debonding, which occurs mainly because of the diffi-

culties in achieving proper adhesion to intraradicular

dentin and to the post.35 Posts cemented with compos-

ite cements exhibit enhanced retention, and the roots

are more fracture-resistant because of more uniform

stress distribution.36

Dual-cured resin cements and adhesive systems are

usually suggested as merging self-curing and light-

curing. Despite the use of two initiation systems by

some products, adequate light transmission is required

to get light activation and the best results.37

Self-adhesive cements have been promoted as

being simpler and less technique-sensitive, but some of

them demineralize the dentin, and the depth of resin

penetration is not equivalent. In addition, residual

acidic monomers may be present, reducing adhesion

capabilities.38 However, some studies favor the use of

self-adhesive cements.39 The retention of glass fiber

posts that had been pretreated with silane has been

reported to be higher compared with posts that were

not pretreated or that were pretreated with other prod-

ucts.40 However, fiber-reinforced posts that have highly

cross-linked polymers in the matrix do not have func-

tional groups that can chemically interact with silane.

Microabrasion with 50-mm aluminum oxide at 2.8

bar (0.28 MPa) pressure for 5 seconds has also been

shown to increase surface area and minimize damage.41

Another problem is the bond to intraradicular dentin,

as it is variable. The number of tubules declines toward

the apical region, and the ratio between the peritubular

and intertubular dentin changes significantly from the

apical to the coronal third.42

An ideal adaptation of the post is a crucial factor for

an adequate cement thickness, as the clinical success of

a tooth rebuilt with a glass fiber post is given mainly by

its ability to limit root dentin removal and to fit to it.

The availability of fiber posts with different shapes

reflects the different morphologies of human root

canals that they need to fit (Fig 6). Root canal cross-

sectional shapes can be classified as round, oval, long

oval, flattened, or irregular. Among these, the oval and

long oval shapes are the most common. Recently, a

new type of fiber post and fiber mesh (Fibercone, a

small, slender fiber post, and pre-cut sections of Quartz

Splint Unidirectional; RTD) that address the problem of

restoring wide, oval, flared, or otherwise large or irregu-

larly shaped root treatment spaces in combination with

a master fiber post and any resin cement and core com-

posite, has been introduced to avoid excessive removal

of residual dentin and to obtain a more uniform

cement layer (Figs 7 and 8).43 If the post does not fit

well, there will be an excessively thick layer of cement,

especially at the coronal level, where air bubbles or

voids could be incorporated, predisposing to debond-

ing. Many authors have investigated the influence of

cement thickness on the bond strength of fiber posts.

As yet, there is no agreement in the literature on the

ideal cement thickness or on the influence of voids

(gaps, air bubbles, emptiness within the cement layer,

or at the post-cement and cavity-wall–cement inter-

face) on the bond strength of fiber posts and their clin-

ical consequence.

Fig 7 Fiber post with sur-rounding Quartz Splint Unidi-rectional. (Courtesy of RTD Dental.)

Fig 8 Fiber post with acces-sory Fibercones. (Courtesy of RTD Dental.)

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The application of NaOCl could act as a polymeriza-

tion inhibitor of resin materials due to the formation of

an oxygen-enriched dentin surface.44 However, NaOCl

is the most commonly used irrigant because it has the

ability to remove the smear layer, which is created on

the dentin surface during the post space preparation.

The removal of the smear layer, which contains organic

and inorganic components, sealer and gutta-percha

remnants, microorganisms, and infectious deteriorated

dentin is necessary for the penetration of the adhesive

system and resin cement into the dentin tubules.45 Ide-

ally the root canal should be irrigated with chlorhexi-

dine (eg, Endo-CHX, Essential Dental Systems) or sterile

saline solution before post cementation in order to

eliminate the negative effect of NaOCl on the adhesive

bond to dentin. The smear layer, consisting of sealer

and gutta-percha remnants, is plasticized by the heat of

the drill bur during the post space preparation, and can

act as insulation against any kind of adhesive material

intended to bond to the root canal dentin.46 In addition,

this smear layer can also reduce the chemical action of

orthophosphoric acid to provide an ideal bonding sub-

strate. GuttaFlow (Coltène Whaledent) can be used to

fill the canal, and this contains a silicone that can also

make the smear layer more resistant to acid etching.47

FERRULE

A dental ferrule is an encompassing band of cast metal

around the coronal surface of the tooth. The ferrule may

resist stresses such as functional lever forces, the wedg-

ing effect of tapered posts, and the lateral forces exerted

during the post insertion.48 Some clinicians interpret the

ferrule as the amount of dentin above the finish line but

it is the definite bracing of the crown encompassing the

tooth structure that establishes the ferrule.

Eissmann and Radke49 discussed the importance of

the ferrule effect for preventing tooth fracture and rec-

ommended a ferrule height of at least 2 mm. Libman

and Nicholls50 compared the effect of different ferrule

heights (0.5, 1.0, 1.5, and 2.0 mm) of a maxillary incisor

under fatigue loading. They found the minimum

1.5-mm ferrule height meaningfully improved crown

resistance. This in vitro study tested the breakage of

cement seal (which can lead to secondary caries, crown

dislodgement, or tooth fracture) in a clinically pertinent

manner using dynamic repetitive loading.50 In addition,

ferrule effect increases the post/core ratio and prevents

the luting cement from being washed away, in turn

improving post retention. Hsu et al51 demonstrated that

the total bonding area between dowel-core and tooth

structure meaningfully influenced crown resistance. It

was demonstrated that the type of cement used for

both the dowel-core and crown can significantly affect

the durability of the restoration and the tooth.51 Unfor-

tunately, many of these studies were done on maxillary

central incisors and may not pertain to posterior teeth.

There are many factors that have to be considered in

the effectiveness of the ferrule: ferrule height, ferrule

width, number of walls, ferrule location, type of tooth,

lateral loads, type of post, and type of core material.52

Ferrule height

Most studies have indicated that a ferrule height of 1.5

to 2 mm of vertical tooth structure would be the most

beneficial.53 The crown should encompass at least

2 mm past the tooth core connection to achieve the

most protective ferrule effect.54

Ferrule width

Esthetic restorations often require fairly aggressive

preparations at the gingival margin and sometimes

buccal defects such as abfraction may compromise the

buccal dentin wall. Generally it has been accepted that

the walls are considered too thin if they are less than

1 mm in thickness, and would negate the ferrule effect.

Therefore crown lengthening on teeth with conical

roots may add dentin height but the dentin width at

the margin may not be adequate.

Number of walls and ferrule location

A circumferential ferrule would be optimal but caries

may affect the interproximal areas and abrasion or ero-

sion the buccal walls. A crown preparation will further

reduce the wall thickness and only a partial ferrule will

remain. Al-Wahadni and Gutteridge55 found having a

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3-mm ferrule on the buccal aspect was better than hav-

ing no ferrule at all. It created a significantly higher

resistance to fracture.55 Ng et al56 proposed that the

location of the sound tooth structure to resist occlusal

forces is more significant than having a circumferential

dentin wall. The authors demonstrated that the pres-

ence of a palatal wall allowed resistance of forces

applied in function to a maxillary incisor. A maxillary

incisor with three walls present but no palatal wall

demonstrated poor fracture resistance.56 This may indi-

cate that a partial ferrule provides a degree of fracture

resistance, although it is not as ideal as a 360-degree,

2-mm ferrule.

TYPE OF TOOTH AND DIRECTION OF LOAD

Anterior teeth are loaded non-axially while posterior

teeth usually are loaded in an occluso-gingival direc-

tion. Lateral forces usually are more detrimental to the

tooth restoration interface. The restoration of anterior

or posterior teeth may require an altered approach.

Anterior teeth with a deep overbite and parafunction

are at a higher risk of failure. Posterior teeth with differ-

ent occlusal arrangements and cuspal heights affect

the direction and nature of the load applied to each

tooth. Teeth that are in group function with long maxil-

lary buccal cusps produce higher lateral forces than if

there was canine guidance. As the cusps wear, lateral

forces may be converted to vertical trajectories.57

TYPE OF POST

Clear guidelines for the selection of the type of post are

lacking.7 However, the existence of a 1.5- to 2-mm fer-

rule of sound coronal tooth structure is more important

than the post itself.58 Cast posts have been used for

many years for the support of the final restoration.

However, in recent years this type of restoration has

been progressively replaced by composite cores with a

glass fiber post or metal post.59 Fiber-reinforced posts

have found favorable use, notwithstanding their sig-

nificantly lower bearing values. Their performance is

favorable because this type of post is shielding the

remaining tooth structure by failing in a more non-

catastrophic form (Fig 5).

FIBER POST CEMENTATION AND CORE BUILDUP

The literature on when to prepare the post space is

inconclusive. Gutta-percha or Resilon (eg, Epiphany,

Pentron Clinical Technologies) are removed with heat

(eg, System B, Sybron Endo) or with rotary instru-

ments.60 Ideally there should be minimal enlargement

of the canal past that incurred during endodontic

instrumentation.

1. Select prefabricated post suitable for both the tooth

and the restoration being utilized.

2. Prepare the coronal residual tooth structure to

accommodate the crown with a minimal wall thick-

ness ≥ 1.5 mm and determine if the post is going to

be fabricated by direct or indirect means depending

on residual tooth structure.

3. Determine the prerequisite preparation depth and

mark this length on the corresponding instruments

with silicone stoppers.

a. The remaining root canal filling from the post

terminus to the apex should be no shorter than

4 mm.

b. The length of the post within the canal should

be at least equal to coronal length of the final

restoration.

4. Remove the root canal filling with a Gates-Glidden

or Peeso reamer to the desired length.

5. Prepare the post space to the same depth with the

appropriate size drill that corresponds to the size

post selected.

6. If necessary apply antirotation protection.

7. Rinse the canal and flush with alcohol.

8. Clean the canal with a CanalBrush (Coltène Whale-

dent) or similar.

9. Check proper fit of the post

10. Shorten the post as necessary with rotary diamonds.

11. Fiber posts should be cleaned with phosphoric acid

for 60 seconds then washed and dried. Metal posts

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can be micro-etched and a metal primer applied

(eg, Alloy Primer, Kuraray).

12. Some fiber posts benefit from silane application (eg,

Monobond-S, Ivoclar Vivadent) for 60 seconds.

13. Air dry and do not touch with fingers.

14. Adhesive cementation of the post can be with

either a dual- or self-curing luting composite (eg,

Multilink Automix or Variolink II, Ivoclar Vivadent). A

total etch, self-etch, or an adhesive cement can be

used (eg, RelyX Ultimate Adhesive Resin Cement,

3M ESPE). If a total etch is used, place 37% phos-

phoric acid in the canal for 10 to 15 seconds. Irrigate

with water in an irrigating syringe, then use the

high volume vacuum and a paper point to dry the

canal (Fig 9).

15. Use the specific instructions of the cementation

system. If an adhesive is used (Fig 10), a paper point

or preferably an endo brush is used to place the

dual-cured adhesive in the canal and remove excess

(longer cylindrical shape) (Fig 11).

16. If available, use an endo-tip to place the cement into

the canal (Fig 12). Immediately place the fitted post.

17. If a dual-cure luting cement is used, polymerize for

20 seconds from the occlusal aspect of the post and

as near to the post as possible, or wait 5 minutes to

allow self-curing initially and then light cure (Fig 13).

18. Ideally the core can be built up using the same lut-

ing material. After proper contour is achieved of the

dual-cure material, light cure for a final 40 seconds

(Fig 14). A highly filled core such as MultiCore Flow

or MultiCore HB (Ivoclar Vivadent) can be sculpted

as it is placed.

19. The tooth is then prepared for the final restoration

located on 2 to 3 mm of natural tooth structure.

Fig 9 After etching with phosphoric acid, the canal should be rinsed and dried with high volume suction. (Courtesy of Premier Dental.)

Fig 12 An endo-tip allows the dual cure cement to be placed in the canal without bubble formation if it is kept immersed. The post is placed immediately. (Courtesy of 3M ESPE.)

Fig 10 A dual-cured bonding agent should be mixed and placed in the canal. (Courtesy of Premier Dental.)

Fig 13 An automix syringe with two dif-ferent diameter tips expedites both place-ment of cement into the canal and the core build-up. The cement is then allowed to self-cure or it can be light-cured for 20 seconds. (Courtesy of Premier Dental.)

Fig 11 The bonding agent is placed in the canal with a cylindrical microbrush. (Courtesy of Premier Dental.)

Fig 14 The final core build is cured for 40 seconds. (Courtesy of Premier Dental.)

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Figs 15a to 15e The ParaPost direct technique for a cast post. (a) Post space preparation. (b) Keyway. (c) Direct wax-up on burnout post. (d) Provisional crown with temporary post. (e) Final cast post and core. (Courtesy of Coltène Whaledent.)

Fig 16 A plastic post with GC Pattern Resin is used to shape the post and core.

Fig 17 The pattern is removed from the mouth to be cast.

Fig 18 The cast post duplicates the pattern previously formed.

Fig 19 The cast post is then cemented and the preparation refined.

Figs 20a to 20e The ParaPost indirect casting system will allow the laboratory to create the post pattern. This is espe-cially useful if multiple teeth are involved. (a) Post space preparation. (b) Impression with impression post. (c) Provisional crown with temporary post. (d) Wax-up with burnout post. (e) Final cast post and core. (Courtesy of Coltène Whaledent.)

11 mm1.5 mm(min.)

5 mm

9 mm7 mm

a b c d e

11 mm1.5 mm(min.)

5 mm

9 mm7 mm

a b c d e

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Alternatively a cast post can be fabricated directly

(Figs 15 to 19) using Pattern Resin LS (GC America) and

ParaPost Burnout Posts - Serrated and Vented (ParaPost

XP Casting System-Plastic Burnout, Coltène Whale-

dent), or an indirect casting technique with an impres-

sion post (ParaPost XP Casting System) (Fig 20).

CONCLUSION

The restoration of endodontically treated teeth encom-

passes many different materials and techniques. There

is no consensus of opinion on the need for a crown,

and in the anterior with only a lingual access a compos-

ite restoration will suffice. Posts are only indicated

where inadequate tooth exists to retain a core if a

crown is required. Preparation for a post should wher-

ever possible maintain coronal and radicular tooth

structure. No post is ideal for all clinical situations and

the selection of a post should depend on the tooth pos-

ition in the arch, possible abutment, and occlusion. The

post should provide all the mechanical requirements to

restore the tooth. The creation of adequate ferrule

approaching 2 mm circumferentially would be ideal

and minimize the damaging effects of lateral and rota-

tional forces on the restoration and post.

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