FERRULE

Dr.Kalpana Pandey
JR 2nd year
Department Of Conservative Dentistry &Endodontics
 What is Ferrule ?
 Comes from latin
 FERRUM means iron

 VIRIOLA means Bracelet

(Bowen 1993 )
 FERRULE

A metal band or ring used to fit the root or crown of a tooth.”

( GPT - 9 )
A ferrule has been defined as ‘a 360 degree metal collar of the crown surrounding

the parallel walls of the dentine extending coronal to the shoulder of the
preparation”
(Sorensen & Engelman)
Ferrule improves the biomechanical stability of a tooth by “shifting” the

interfaces that resist stresses from weak tooth, core, and post interfaces to
a strong tooth, core, and post interface located at the ferrule margin

Lack of adequate ferrule increases risk of failure due to

- Post – crown dislodgement

- Post fracture
- Root fracture
 Functions of Ferrule
Resists lateral forces from post.

Resists leverage from crown in function.

Increases resistance and retention of the restoration.

Dissipates forces concentrating at cervical area of clinical crown

Protects integrity of root by bracing action

FACTORS AFFECTING
FUNCTIONALITY OF
FERRULE
 DIRECT FACTORS
a)Ferrule height INDIRECT FACTORS
b) Ferrule width e)Type of post
c) Number of walls and f) Type of core
ferrule location material.
d) Type of tooth and the
extent of lateral loads
 Ferrule height
 Greater the height of remaining tooth structure above the margin of the
preparation, the better fracture resistance
 Ferrule effect of 1.5-2 mm resists vertical tooth structure.

Some authors suggest that the crown must extend at least 2 mm beyond the tooth

core junction to ensure a protective ferrule effect

 Sorensen and Engleman (1990) advised that as much coronal tooth as possible
should be preserved , and a butt joint margin between the core and tooth be used
The amount of remaining tooth structure is the most important predictor of the

clinical success
The presence of 1.5 to 2mmferrule has a positive effect on fracture resistance of

endodontically treated teeth

Ferrule Width
 It is the thickness of the coronal extension above the crown margin

Glass fiber posts - no increase in fracture resistance was found with

increasing ferrule thickness

Cast post and core without ferrule :- presents a lower occurrence of

failures.
For teeth with a 0.5-mm-thick ferrule, both cast post and core and fiber

post were associated with a similar percentage of unfavorable failures.

 For teeth with a 1-mm-thick ferrule, the use of the fiber post could be the

appropriate clinical decision.

 Thicker dentine of 2 mm increased the resistance to fracture, however, the

presence of a cervical collar had no influence on the point of failure.

Number of walls and ferrule location
a full 'all around' ferrule is needed in every case.

a non-uniform ferrule is still superior to no ferrule at all.

location of sound tooth structure to resist occlusal forces is more important than

having 360° of circumferential axial wall dentin

Type of tooth and extent of lateral load
The direction of functional forces transitions from primarily vertical

(compressive) in posterior region to lateral (tensile or shear) in anterior

These tensile forces tend to displace crown/ core

Need for additional retention is greater in anterior region and a post may be

required
In posterior teeth, even though forces are greater, forces are usually vertical and

sufficient resistance and retention form for core is obtained by extending into
pulp chamber
Anterior teeth protect posterior teeth from lateral forces through

anterolateral guidance
In cases of very steep anterior guidance and deep vertical overbite,

maxillary anterior teeth are sustaining higher protrusive and lateral forces
from the mandibular anterior teeth.
Restoration should be designed to resist flexion
In case of parafunctions, protection by anterior contacts is reduced or lost and

posterior teeth are submitted to more lateral stresses, generating a higher demand
for restorative materials
Group functions situations ,longer maxillary buccal cusp – higher lateral force

compared to canine guidance

Posterior teeth with high cusp translate higher lateral forces compared to severly

to severly worn down teeth

e) Type of post
Fibre reinforced composite posts have shown positive results compared to metal

posts.
Fibre post more favourable because failure of this type of post seems to be

protective of the remaining tooth structure by displaying a more favourable failure

pattern, with virtually no root fracture.
 Fracture of the remaining tooth structure has been shown to occur more occlusally

with fibre posts, making these failures restorable vs. a more apical positioned
fracture occurring with metal posts, rendering such teeth nonrestorable.
 Core Materials
Influencing factor on the effect the differing thickness of remaining dentine.

 Composite resin with dentin bonding agent has frequently been implicated as

materials that can strengthen the tooth and reinforced cusp as comparable to
amalgam
 Types of Fracture
Repairable Fracture : above CEJ ,horizontal cervical fracture, core tooth fracture

Non Repairable Fracture : entirely below CEJ ,fracture in the middle or apical

third of root ,Vertical root fracture

Non Repairable Fracture are more common with cast metal post and 2 mm
ferrule
Repairable fracture are seen with fiber reinforced posts and 2mm ferrule
HOW TO CREATE FERRULE IN A NO FERRULE CASES ?
Crown lengthening

Orthodontic extrusion
CROWN FERRULE :- Ferrule
with 1 to 2 mm of vertical
tooth structure doubles the •UNIFORM FERRULE : which
resistance to fracture than in
encircles the tooth entirely
teeth without any ferrule •NON-UNIFORM FERRULE
effect.
TYPES
SECONDARY/CORE
FERRULE :- Sometimes a
contrabevel is given on a •PARTIAL FERRULE where
tooth being prepared for cast the core extends significantly
post with collar of metal beyond the margin
which encircles tooth. •FULL FERRULE where the
This serves as secondary core extends significantly
ferrule independent of beyond the margin
ferrule provide by cast crown
Four aspects relating to the remaining natural tooth structure were considered
important factors when analysing the potential ferrule present in a structurally
compromised tooth.
1. The height of remaining dentine after tooth preparation. A wall is considered
to contribute to the ferrule only if it is 2 mm of height and continues along
more than half of the tooth surface
2. The thickness of remaining dentine after tooth preparation. A wall is
considered to contribute to the ferrule only if it is 1 mm thick
3. The number of remaining dentine walls, and their location (location is
represented by corresponding side)
4. The lateral vectors of load on the tooth. These are defined as light lateral
loads or heavy lateral loads based on the type of tooth and occlusal scheme .
 Classification of Ferrules into Categories is based on the risk factor –
Category B – Low Risk Category C – Medium Risk
Category A – No • Compromised or no ferrule present on • Two compromised proximal
anticipated risk either proximal surface. (ie less than 2 walls on a tooth that
• 4 walls intact mm height and/or 1 mm thickness) OR undergoes heavy lateral loads
• 2mm length • two compromised proximal walls on a OR
• 1mm width tooth that undergoes light lateral • a compromised buccal or
loads.. lingual wall on a tooth that
undergoes light lateral loads.

Category D – High Risk

• Compromised buccal or lingual wall on a tooth Category X
that undergoes heavy lateral loads OR a No ferrule can be
compromised buccal, and lingual wall on any established, such that
tooth OR a tooth that has only two adjacent walls the tooth is non-
or only a single wall remaining. restorable.
• alternate treatment modalities should be
considered and may be more appropriate.
Conclusion
Based on the results from the various in vitro and in vivo studies, the presence of

ferrule has a positive effect on fracture resistance of endodontically treated teeth

More successful prognosis could be expected if healthy dentin extending 1.5–2

mm coronal to the margin of the crown is provided circumferentially.

If the clinical situation does not permit a 360° circumferential ferrule because of

extensive caries lesions, previous restorations, or fractures, an incomplete ferrule

is still considered to a better option than a complete absence of ferrule
REFERENCES
 Lowe RA. Post and Core Foundations for Esthetic Restorations.
 Ch T, Shaik I, Dasari B, Raza A, Abdurahiman VT, Mustafa M. Revisiting Ferrule Effect in
Endodontology: A Review. Journal of Advanced Medical and Dental Sciences Research. 2020 Sep
1;8(9):110-2.
 Dental Post and Core: No Ferrule, No Party! by Andrea PanarelloJune 16, 2020
 Kurtzman AD. Restoration of endodontic teeth: An engineering perspective.
 Stankiewicz N, Wilson PR. The ferrule effect: a literature review. International endodontic journal.
2002 Jul;35(7):575-81.
 Jotkowitz A, Samet N. Rethinking ferrule–a new approach to an old dilemma. British dental
journal. 2010 Jul 10;209(1):25-33.
 Juloski J, Radovic I, Goracci C, Vulicevic ZR, Ferrari M. Ferrule effect: a literature review. Journal
of endodontics. 2012 Jan 1;38(1):11-9.