I read with interest Dr. Barry F. McArdle’s article, "Enhancing the Retention of Prefabricated Metal Posts and Resin Cores" (October JADA). The illustration on page 1471 shows a parallel post in the canal with the sharp right angle of the end of this metal insert very close to the external surface of the apical one-third of the root.
Ever since these parallel posts have been in vogue, we have seen countless perforations and split and fractured roots. The primary cause is that these supports do not follow the natural tapered canal shape. In addition, the ability of the dentist to place a small bit of composite on the retentive end of these items does not lend itself the strength to support the crowns, especially in bridge abutments.
The cast gold post and core properly cast with a minimum of expansion and passively cemented in the normal canal space has been demonstrated as one of the most compatible mechanisms to provide artificial dentin in severe crown fractures. This one-piece casting also has only one interface, the root, whereas preformed posts have an interface with the root and the composite with the end of the post. It has also been demonstrated that the cast gold post and core can provide a ferrule to encompass the root face to help resist root fracture.
I realize the cast gold post and core takes two appointments. The cost is certainly not a factor because of the small amount of gold used. In my opinion, the cast gold post and core has no equal in restorative dentistry.
