Fiber Post Removal Using a Conservative Fully Guided Approach: A Dental Technique

Abstract

This report describes the usefulness of an endodontic template for the removal of a fiber post. A 40-year-old man presented with discomfort in the maxillary left canine. Clinical and radiographic examinations showed tooth #23 with a permanent core material retained with fiber post along with a persistent apical radiolucency. Among the various treatment modalities, nonsurgical root canal retreatment with fiber post removal using a conservative fully guided approach was proposed. After obtaining both the cone-beam computed tomographic images and the cast surface scan, their data were merged using implant planning software (ImplaStation for Windows x64 Bit Beta Version, ProDigiDent, Miami, Florida, USA) and superimposed. The drilling space was planned based on the location, diameter, and apical extent of the fiber post and was virtually overlapped and transferred clinically using a resin template to drill through the fiber post. With guides in position over the rubber dam, drilling was made with increments of 2 mm using a size 4 long-shank round bur (Thomas, Bourges, France) until it exposed the coronal gutta-percha. As soon as the canal was located, K3 rotary files (Sybron Endo, Orange, USA) were used along with chloroform to remove the old obturating materials. Then, additional shaping and cleaning were done with ProTaper Next rotary files (Dentsply Sirona, Ballaigues, Switzerland), sizes X2 and X3, and 5.25% NaOCl irrigation, respectively. The root canal was then dried with paper points and obturated with gutta-percha and AH Plus sealer (Dentsply Sirona, Ballaigues, Switzerland) using the continuous-wave compaction technique. Finally, the tooth was temporarily restored using the double seal technique with zinc oxide and zinc sulfate-based temporary material (Cavit W; 3M ESPE, St. Paul, MN, USA) and resin-modified glass ionomer material (Photac Fil; ESPE, Norristown, PA, USA) filling materials and referred for the final restoration.

A three‐dimensional printed assembled sleeveless guide system for fiber‐post removal

“…The technical workflow of the data acquisition, CAD-CAM, and clinical application of this guide system is similar to that of a traditional post removal guide. [11][12][13][14][15] However, major differences exist in the data processing steps to develop the special configurations of this guide system, as described in this technique report. There are several advantages of this design compared with the traditional one.…”

“…Guided implantology and endodontics have emerged to provide high levels of accuracy, safety, and efficiency 9,10 . Recently, a guided technique has also been used to remove fiber‐posts 11–15 . These guide systems reported for fiber‐post removal apply the traditional design with a sleeve to guide the rotary instrument.…”

“…9,10 Recently, a guided technique has also been used to remove fiber-posts. [11][12][13][14][15] These guide systems reported for fiber-post removal apply the traditional design with a sleeve to guide the rotary instrument. This design has several disadvantages.…”

Application of an Endodontic Static Guide in Fiber Post Removal from a Compromised Tooth

“…The guided endodontic technique can accurately remove the fiber post, and this approach is predictable. Previous studies reported successful case management of infected root canals with fiber post using endodontic static guides [20,21]. Perez et al indicated that the mean deviation between the virtual design and actual dimensions after removing the fiber post was 0 39 ± 0 14 mm coronally and 0 40 ± 19 mm apically [7].…”

Post Removal Using Guided Endodontics: A Systematic Review of the Literature

“…Using the snowball technique one more publication was identified. Finally, 9 studies were included in this review [22]- [30]. Inter-reviewer reliability was calculated using Cohen's kappa (0.92 for the first round, 1 for the second round).…”