Endodontic Posts in Primary Teeth: A Complete Clinical Guide

Preserving primary (baby) teeth is an essential part of pediatric dentistry. When severe decay or trauma causes extensive loss of tooth structure, endodontic posts allow dentists to restore function, esthetics, and stability after pulp therapy. This guide explains the types of endodontic posts used in primary teeth, clinical tools, case analysis, healing expectations, and professional best practices.

Why Endodontic Posts Are Used in Primary Teeth

Endodontic posts are indicated when more than half of the coronal structure of a primary tooth is lost after pulpectomy. Instead of extracting the tooth, a post provides internal support for composite or crown restorations, helping maintain chewing efficiency, speech development, and space for permanent teeth.

• Prevents premature tooth loss
• Maintains proper arch length
• Improves aesthetics in anterior teeth
• Supports long-term oral development

Types of Endodontic Posts Used in Primary Teeth

Biological Post

Biological posts are fabricated from sterilized extracted dentin. They offer excellent biocompatibility and bonding but are rarely used due to limited availability and strict sterilization requirements.

Carbon Fiber Post

Carbon fiber posts provide high fracture resistance and good stress distribution. However, their dark color limits their use in anterior primary teeth.

Modified Omega Post

The modified omega post is a stainless steel wire bent into an omega shape. It is affordable, easy to fabricate, and commonly used in pediatric dental clinics, especially in resource-limited settings.

Polyethylene Post

Polyethylene fiber posts are flexible and bond well with composite materials. Their elasticity reduces stress on primary tooth roots, making them suitable for moderate crown loss.

Ribbond Post

Ribbond is a woven polyethylene fiber ribbon embedded in composite. It offers excellent esthetics and force distribution, making it ideal for anterior restorations and strip crowns.

Glass Fiber Post

Glass fiber posts are considered the preferred option in modern pediatric dentistry. They are tooth-colored, strong, and have an elastic modulus similar to dentin, reducing the risk of root fracture.

Dental Tools and Materials Used

• Pediatric hand files
• Resorbable obturating materials (Vitapex or Metapex)
• Flowable and packable composite resin
• Adhesive bonding system
• Strip crowns
• Light-curing unit

Clinical Case Study

Patient: 5-year-old child
Chief Complaint: Broken front teeth with pain during eating
Diagnosis: Severe Early Childhood Caries (ECC)

Clinical Findings

• Extensive coronal destruction
• Intact root structure
• No pathological root resorption
• Tooth expected to remain functional for several years

Treatment Procedure

1. Pulpectomy using resorbable obturation material
2. Post space preparation limited to 3–4 mm
3. Glass fiber post placement
4. Composite core buildup
5. Strip crown restoration

Treatment Outcome

The patient experienced immediate pain relief, improved chewing ability, restored esthetics, and normal speech. The tooth remained stable during follow-up visits.

Teeth Condition Analysis Before Post Placement

Proper case selection is critical. Dentists must assess root length, resorption stage, periapical health, occlusal forces, and the child’s age. Endodontic posts should not be placed if advanced root resorption is present.

Professional Practice Guidelines

• Limit post depth to the cervical third of the canal
• Use only resorbable obturation materials
• Prefer fiber-based or flexible post systems
• Avoid long or rigid metal posts
• Ensure strict moisture control during bonding
• Schedule regular six-month follow-ups

Healing Timeline and Aftercare

Healing after post placement in primary teeth is usually rapid. Mild tenderness may occur within the first few days, with full functional recovery expected within 7 to 14 days.

• Avoid hard foods for 48 hours
• Maintain good oral hygiene
• Attend routine dental checkups

Conclusion

Endodontic posts in primary teeth provide a safe and effective way to restore severely damaged baby teeth. When modern materials and proper clinical protocols are followed, these restorations preserve function, esthetics, and oral development until natural tooth exfoliation occurs.

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