Dental abutments: types, price and benefits

Many patients wonder what they can do when a tooth becomes very loose or fractures. Is a dental implant necessary? Or can the natural tooth still be saved?

In such situations, a dental post may be the ideal solution. This small but essential component in prosthetic restoration stabilises the tooth root and allows for the complete reconstruction of the tooth crown. Essentially, the dental post restores the tooth’s strength and natural appearance, saving it from extraction.

In this article, the specialists at DENT ESTET explain what a dental post is, when it is used, what the main types of dental posts are — from metal posts to those made of fibreglass or zirconia —, as well as how much a dental post costs and what advantages each option offers.

Read on to find out how this procedure can help you keep your natural tooth and maintain a healthy smile for many years to come. 

A dental post is a support structure for a root-canal-treated (nerve-free) tooth, which is inserted into the root canal (root) to strengthen and support the future prosthetic restoration of the tooth.  

Essentially, the post is a method of strengthening the structure of a tooth that has had its nerve removed following root canal treatment.  

Patients often confuse a dental post with a dental implant, but the difference between a pivot and a dental implant is that the implant is inserted directly into the bone to completely replace the tooth root, whilst the pivot remains fixed within the remaining root in the patient’s mouth. 

At DENT ESTET clinics, patients benefit from the latest generation of biocompatible and durable dental abutments.

Every patient is unique, and every clinical case requires a different approach. That is why DENT ESTET dentists select a personalised dental abutment solution, based on the treatment requirements and the structure of the tooth.

The general options for posts are as follows: metal posts, fibreglass posts and zirconia posts. Fibreglass posts are prefabricated and come in standardised sizes, whilst glass and zirconium posts are manufactured in our own dental laboratory. These are customised based on a scan of the root canal using our state-of-the-art intraoral scanner, which is capable of recording every millimetre of the root canal.  

To gain a broad understanding of how we go about choosing the right post, it is important to analyse the general characteristics of each type of post individually.  

Metal dental post – advantages and disadvantages

Metal posts provide support by restoring the tooth walls and offer the advantage of mechanical strength. This category of posts withstands very well the high forces to which teeth are subjected during the mastication process, forces which average between 100 and 150 Newtons.

This aspect is of particular clinical interest to us, particularly in cases where the post is to be placed in the teeth that play the most active role in the mastication process, namely the molars, which bear around 50–60 kg during mastication.

In particular, in patients with bruxism, these masticatory forces must be taken into account, as we are talking about pressures that can vary on average from 22.5 kgf and can rise to 81.2 kgf or higher.

Metal posts, unlike fibreglass posts, are designed to restore the tooth’s original shape by rebuilding the missing walls. Clinically, this means that they can be used on teeth that have been severely decayed or on which the dental crown has fractured.

However, the following disadvantages are worth noting:  

• According to recent studies, metal posts have a lower durability compared to fibreglass posts. Nevertheless, their durability need not be a concern for patients as long as proper oral hygiene and preventive care are maintained.  

“In my clinical practice, the cases where the posts failed were those in which the bacterial plaque index across the entire oral cavity far exceeded the accepted standard,” explains Dr Maria Ruse.

• They become unsightly. Over time, they discolour the gums to greyish-ash tones, resulting in what is known as ‘gum tattooing’. A simple explanation is that the metal ions in the pivot migrate into the gum tissue. From a clinical point of view, over the years, a grey discolouration appears around the tooth with a metal post.  

This characteristic means we must be very cautious when choosing this type of post for areas where perfect aesthetics are required. For this reason, the metal post is more of an option for the posterior region, where premolars and molars are located, rather than for the anterior teeth.  

• For certain teeth, it is far too rigid, increasing the risk of tooth fracture.  

Fibreglass dental post – aesthetics and strength

Fibreglass posts have the following advantages:

• They are aesthetic. They do not show through the crown and do not cause gingival staining. Their colour is very similar to that of the tooth.  

Because of this, we can use them in both the anterior and posterior regions of the dental arch.  

• Studies show that fibreglass posts have a modulus of elasticity similar to that of natural dentine, which contributes to a more uniform distribution of masticatory forces and significantly reduces the risk of fracture.  

This type of post can be used for incisors as well as premolars or molars.  

• They offer superior adhesion to the restorative materials that will subsequently cover the post.
• High biocompatibility due to materials that are very well tolerated by oral tissues.  

On the other hand, they also have disadvantages. Fibreglass posts cannot reconstruct the tooth walls on their own if these are missing. They are prefabricated components primarily intended for teeth that still have lateral walls and for teeth lacking only a small amount of hard dental tissue.

Zirconia dental post – the premium option  

Zirconia dental posts stand out for their excellent aesthetics, thanks to their colour and translucency, which are similar to those of natural teeth. As such, they blend perfectly into the dental arch without giving the impression of an artificial restoration.

Like fibreglass posts, they do not stain the gums and help maintain the long-term health of the gum tissue, thanks to zirconia’s superior biocompatibility. Recent studies confirm that this material does not cause inflammatory reactions in the gums and is well tolerated by the body (Frontiers in Dental Medicine, 2021).

Another major advantage is their increased rigidity, which provides excellent stability for future prosthetic restorations. Clinical research shows a survival rate of approximately 96% over 3–6 years for teeth restored with zirconia posts fabricated using CAD/CAM technology (BMC Oral Health, 2022).

In another study published in MDPI Materials (2024), the authors confirm that zirconia possesses superior mechanical and aesthetic properties, noting that it represents a promising alternative for restorations following endodontic treatment, owing to its rigidity and fracture resistance.

At present, the zirconia post is considered the gold standard in tooth reconstruction, as it offers perfect aesthetics, does not look like a false tooth, is durable and has excellent biocompatibility. 

The placement of a dental post always takes place after endodontic treatment (root canal treatment) and is an important stage in the reconstruction of the tooth.

• Firstly, the dentist removes the affected nerve, cleans and disinfects the root canals, and then seals them with a special material. This step ensures the health of the root and eliminates any infection.
• Once the root canal treatment is complete, the dentist removes a small portion of the filling material to create space for the post to be inserted.
• Depending on the position of the tooth, the extent of crown destruction and aesthetic requirements, the dentist selects the appropriate type of post — metal, fibreglass or zirconium.
• The post is secured in the root canal using a special adhesive (dental cement), which ensures stability and a perfect seal between the root and the prosthetic restoration.  
• The abutment (the upper part of the tooth) is then built over the post to support the permanent crown. This is the final stage, through which the tooth is fully restored — both functionally and aesthetically.

In the case of metal or zirconia posts, an additional appointment is required: a digital scan of the root canal to create a perfectly fitted post in the dental laboratory.

The entire procedure is painless and does not require any additional anaesthesia, as the tooth has already been devitalised during endodontic treatment.

Recommendations following the placement of a dental post

Once the dental post has been fitted, the treatment is not yet complete. To ensure the tooth remains stable and healthy, it is important for the patient to follow a few simple recommendations:

1. Complete the treatment by fitting a dental crown. The
post is merely an intermediate step. It is essential for the patient to return to the dentist to have the permanent dental crown fitted, which protects the tooth from fracture and ensures normal chewing function.

2. Avoiding hard foods in the first few days.
After the post has been fitted, the tooth may be temporarily more sensitive. It is recommended to avoid chewing hard foods (nuts, shells, tough meat) until the permanent crown has been fitted.

3. Careful oral hygiene. Brush your
teeth twice a day using a soft-bristled toothbrush, and use dental floss and mouthwash to help remove food debris.

Once treatment is complete, when the patient receives the permanent crown on the dental post, the following is still recommended:

1. Regular check-ups.
It is recommended that the post and crown be checked every 6 months as part of a routine dental check-up to prevent loosening or the development of microcracks.

2. Avoiding habits that may damage the teeth. 
Patients who grind their teeth (bruxism) should wear protective mouthguards, and those who smoke or consume acidic drinks should be aware that these can reduce the lifespan of the restoration.

Following these recommendations helps to extend the lifespan of the dental post and crown, maintaining the tooth’s functionality and aesthetics in the long term.

“I always advise patients not to delay the final stage — the fitting of the permanent dental crown,” explains Dr Maria Ruse, a dentist at the DENT ESTET clinics.

“Once the dental post has been fitted, it is essential to proceed with the final restoration. The post is only part of the treatment, an intermediate step that strengthens the root. It is the dental
crown that protects the tooth and restores its stability, preventing fractures and providing a long-term functional and aesthetic result. 
This is how we manage to save teeth that would otherwise have been extracted and restore patients’ healthy, attractive smiles.” 

The final cost may be influenced by the type of post (metal, fibreglass or zirconium), as well as by associated treatments — such as the fabrication of the dental crown, which is the final stage of the restoration.

For an accurate estimate, a specialist consultation is recommended, during which the dentist will assess the condition of the root and recommend the most suitable solution in terms of both function and aesthetics.

In terms of cost, zirconia dental posts are the most expensive, followed by fibreglass posts and metal posts.

The higher price of zirconium posts is justified by the quality of the material and the precision of the manufacturing technology. Zirconium is chosen particularly for the front teeth, where aesthetics must be perfect — it mimics the natural colour and translucency of the tooth very well.

What makes this material so highly regarded? In addition to its excellent mechanical strength, zirconium possesses a natural translucency that allows light to reflect in a similar way to tooth enamel, delivering a flawless aesthetic result.

Furthermore, zirconia is biocompatible and does not irritate gum tissue, maintaining gum health without causing discolouration or inflammation (Frontiers in Dental Medicine, 2021).

Each post is custom-made in the dental laboratory to match the exact shape of the patient’s root canal, ensuring a perfect fit and long-lasting durability. 

The most important advantage is that the natural root of the tooth is preserved with the help of the post.  

The post is fixed at the level of the tooth root, whereas with an implant, the root must be extracted and the implant then inserted into the bone.  

Furthermore, the treatment procedure for posts is shorter and simpler; no surgery is required and there is no recovery time.  

Another point worth mentioning is that, although the tooth becomes devitalised (without nerve supply), pressure receptors from the periodontium are still present at the root level – sensors that detect masticatory forces – so the tooth will continue to feel ‘natural’, and the patient will not notice any difference.  

Thus, the pivot is a far more conservative solution, preserving the natural tooth root, and is more accessible both financially and in terms of the time required to carry out the treatment.  

1. Wang X, Shu X, Zhang Y, Yang B, Jian Y, Zhao K. Evaluation of fibre posts versus metal posts for restoring severely damaged endodontically treated teeth: a systematic review and meta-analysis. Quintessence Int. 2019;50(1):8–20. doi: 10.3290/j.qi.a41499. PMID: 30600326.
2. Joshi S, Shah P, Gandhage D, Mopagar V, Malge RK, Pendyala G. Comparative evaluation of the fracture resistance of carbon fibre posts and glass fibre posts in permanent anterior teeth: an in vitro study. Cureus. 20 May 2024;16(5):e60647. doi: 10.7759/cureus.60647. PMID: 38903272; PMCID: PMC11187463.  
3. Lin Hua, Yin Cuilan, Mo Anchun, ‘Zirconia-Based Dental Biomaterials: Structure, Mechanical Properties, Biocompatibility, Surface Modification, and Applications as Implants’, Frontiers in Dental Medicine, Volume 2 – 202, DOI 10.3389/fdmed.2021.689198, ISSN=2673-4915