Direct or indirect post crowns to restore compromised teeth: a review of the literature

Key Points

  • Suggests there is no strong evidence to suggest either direct or indirect posts are more successful in most clinical situations.

  • Suggests that certain canal shapes may benefit from a cast post in order to achieve close fit of the post to the dentine structure.

  • Highlights that the condition of the remaining tooth structure is one of the most important factors in predicting the success of a post crown restored tooth.


Post crowns are restorations which utilise the root canal space to improve the retention and resistance form of teeth which lack coronal tooth structure. In recent years there have been significant developments in the materials, systems and evidence-base surrounding the provision of post crowns. This review aims to refresh the general dental practitioner's (GDPs) knowledge of the different factors that must be considered when placing a post crown, and how these factors can help guide the dentist in their decision to provide either a direct or indirect post and core.

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Figure 1
Figure 2: a) Photograph showing a failed composite core and b) carbon fibre post in situ.
Figure 3: Radiographs and photographs of a threaded post being removed and replaced.
Figure 4: a) A long direct metal post in 22 with associated periapical radiolucency.
Figure 5: a) Radiograph showing a cast metal post, diverging slightly mesially from the canal.


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Correspondence to T. A. Owen.

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Owen, T., Barber, M. Direct or indirect post crowns to restore compromised teeth: a review of the literature. Br Dent J 224, 413–418 (2018).

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