The doctor said my teeth need "piling", what's going on?

"Your tooth needs a post and a crown..."

The doctor gave me this treatment recommendation after I had root canal treatment.

I understand that having a crown is good for protecting your teeth.

But what does piling mean?

———What is tooth “stacking”? ———

Piling is simply adding a post to a tooth to strengthen its retention. Many patients have large tooth defects due to caries, trauma, etc., or only the root of the tooth is left. Because the remaining tooth is too short or too weak to be directly repaired with a restoration, a post needs to be driven into the root of the tooth. The purpose is to strengthen and lengthen the broken tooth so that the restoration can have enough strength to fix it.

The so-called "piling" refers to the use of crowns and piles that match the tooth roots to fix them in the tooth roots, using friction, adhesion and bonding forces to obtain retention, thereby providing retention for the final restoration. Simply put, the benefit of piling is that it can increase the fracture resistance of teeth and improve the shape of teeth.

———Why do we need to “drive piles” into teeth? ———

The main reason is that your tooth defect is too large, the remaining tooth tissue is too thin, or even the entire crown is missing, leaving only the root. Then directly filling the defective part of the tooth with material is very weak, and it will split and break when biting hard or sticky food (that is, the resistance is too poor). Moreover, because there is not enough tooth tissue to wrap it, the area of ​​​​the adhesive is insufficient, and the filling is easy to fall off (that is, the retention is too poor).

Therefore, a post needs to be driven into the tooth root to combine the crown filling with the post to form a whole (post-core) to increase the resistance and retention of the filling. After the post is driven, the bite force is transmitted to the tooth root through the crown, increasing the resistance, and the large area of ​​adhesive inside the tooth root also greatly increases the retention of the filling.

● In these cases, your teeth also need "stacking":

1. Patients with large-area tooth crown defects due to caries (tooth decay), trauma, etc.;

2. The tooth is missing and only the root is left, but the periodontal tissue is healthy and the root is long enough to expose the root surface after crown lengthening surgery;

3. People with misaligned or twisted teeth who are unable to undergo orthodontic treatment or are not suitable for orthodontic treatment.

4. Those with deformed teeth and poor retention of direct molars.

———Does it hurt to have a pile driven into your teeth? ———

I believe that by the time you get to the stage of root canal treatment, your tooth should have undergone complete root canal treatment. Therefore, when the root canal is driven, the nerve of your tooth has been cleaned, so it generally does not cause pain, but you will feel the vibration of the instrument in the tooth, which is normal.

———Can I choose the materials for piling? ———

It is recommended that you follow the advice of professional doctors. Commonly used are fiber posts and metal posts. The materials of metal posts are divided into cobalt-chromium alloy, silver-palladium alloy, gold-palladium alloy, gold-platinum alloy, etc. Dentists generally give material recommendations based on the patient's condition:

● Fiber posts can be selected when the tooth tissue defect is not large because their elastic modulus is close to that of the tooth tissue, they are not prone to root fractures, they do not contain metal and do not affect medical examinations, they are not prone to root fractures, and they have good aesthetic properties.

● Metal posts are very hard and suitable for large tooth defects. However, since they contain metal components, they will affect magnetic resonance imaging.

———What should patients pay attention to when getting a dental pile? ———

Piling will cut the inner wall of the root canal to form a pile channel, so the teeth should avoid chewing hard objects after the pile is placed to avoid stress concentration and tooth fracture. At the same time, if the root apex shadow is obvious, we recommend follow-up observation for a period of time, and then pile treatment can be performed after the shadow disappears or shows a trend of shrinking.