The perfect fiber post removal
The fiber post removal is always a challenge and the clinician should be as conservative as possible. Different techniques have been suggested, but two of them are the most common: Ultrasonics and counter-angle burs.
The removal of posts from endodontically treated teeth can be a major obstacle in the retreatment of teeth. The goal for a correct fiber post removal during a retreatment is a complete consumption of the fiber post and luting composite. In a previous article (http://endodontics.styleitaliano.org/fiber-post-removal-dont-miss-the-post/) it was been described how to identify a fiber post and below it will be described how to perfectly remove it.
For a correct fiber post removal the following material is required:
- Stropko syringe for dental assistant in order to reduce the temperature and for the removal of all the produced powder.
- Ultrasonic tip made in stainless steel with a pointed tip for composite removal.
- A sequence of 2 burs with a long neck and a small rounded active head.
- A micropipette for placing a drop of solvent in order to distinguish fiber post and composite from dentine structure.
First step is represented by removing the buildup and by detaching with an ultrasonic tip all the composite placed inside of the pulp chamber
The ideal sequence is obtained alternating micro burs at 300 RPM for fiber post removal and Ultrasounds for removing the composite from the canal walls. Ultrasounds are useful when there is lot of composite inside the canal, but sometimes the burs are efficient also for the disassembling of composite remnants.
Using a solvent is always suggested when the fiber post or composite are not visible anymore during their removal
This videos shows how to use correctly burs at 300 RPM
This is another video showing how to use correctly burs at 300 RPM
Fiber post removal can represent always a challenge for the operator, but magnification and a correct protocol can solve in a predictable way this delicate procedure.
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J Endod. 2005 Jul;31(7):520-2. doi: 10.1097/01.don.0000167397.60943.6e.
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J Endod. 2003 Sep;29(9):580-2. doi: 10.1097/00004770-200309000-00009.
PMID: 14503831 Clinical Trial.
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Am J Dent. 2008 Jun;21(3):175-8.
PMID: 18686770 Clinical Trial.
- Efficiency and effectiveness evaluation of three glass fiber post removal techniques using dental structure wear assessment method. Abe FC, Bueno CE, De Martin AS, Davini F, Cunha RS.
Indian J Dent Res. 2014 Sep-Oct;25(5):576-9. doi: 10.4103/0970-9290.147091.
- Post-endodontic restorations with adhesively luted fiber-reinforced composite post systems: a review. Bitter K, Kielbassa AM.
Am J Dent. 2007 Dec;20(6):353-60.
PMID: 18269124 Review.