Fiber post removal: don't miss the post
Fiber post removal is a first necessary step in order to gain the access to the root canals and retreat them. Many techniques have been suggested, but in this article we will consider the first analytical considerations in order to avoid procedural iatrogenic errors.
The removal of fiber posts from endodontically treated teeth can be one of the mayor obstacles during the retretatment and it can lead the clinician into wrong paths, as perforations or other iatrogenic errors. The first steps that every clinician must do before starting the retreatment are:
- Xray analysis for highlighting the presence or not of a Fiber post
- Fiber post orientation: analysis of the cutting cross section
- Fiber Post orientation: take 2 spatial references
- Composition of a the fiber post (Carbon or Glass fibers)
X ray Analysis
Radiopacity of an esthetic fiber post is important to the extent that it allows the post to be clearly identified on an x-ray when surrounded by tooth and bone tissue and core material. Unfortunately this detection is not always possible and a GP can face the problem when it is too late.
Voids, bubbles or white lines on the wall of the canal are the main signs of a presence of o fiber post not perfectly visible
Orientation: cross section analysis
Before the removal of the build up and the part of the fiber post luted inside, it is always better to flatten the occlusal part of the tooth. Then, it is advised to observe if the cross section of the fiber post is round or ovoidal. If it’s perfectly round we can deduce that the fiber post is straight, on the other hand, the more the section is ovoidal the more the fiber post is placed angulated.
Orientation: Take two references
Before the removal of the fiber post it is always better to measure with a probe the distance between the head of the fiber post and a reference point on the wall of the crown.
The second measurement must be done when the fiber post has been removed at the orifice level. If we consider the two measures together, we can deduce the orientation of the post and consequently we can place the US tip accordingly to the reference points
Fiber post composition
It’s evident that a Black carbon fiber post is easier to remove if compared with a fiber glass one. The black color is more visible into the deepest part of the canal and instead a white fiber post can be confused with luting composite or dentin.
Even if you are an expert or if you feel like a an Endo pro, when you have to remove a fiber post is always better do a previous analysis in order to avoid iatrogenic errors.
Comparison of the efficiency and effectiveness of various techniques for removal of fiber posts. Lindemann M, Yaman P, Dennison JB, Herrero AA. J Endod. 2005 Jul;31(7):520-2. doi: 10.1097/01.don.0000167397.60943.6e.
Comparison of two techniques for removing fiber posts. Gesi A, Magnolfi S, Goracci C, Ferrari M. J Endod. 2003 Sep;29(9):580-2. doi: 10.1097/00004770-200309000-00009.
Removal time of fiber posts versus titanium posts. Frazer RQ, Kovarik RE, Chance KB, Mitchell RJ. Am J Dent. 2008 Jun;21(3):175-8.
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.