Search

Failed root canal treatment is best addressed primarily with the provision of repeat endodontic treatment with thorough irrigation under isolation. If a post is present in the root of the tooth it needs to be removed first. This paper is the second in a series of two which provide an overview of techniques for post removal. Specifically designed post removal devices and the removal of fibre posts are described. Post removal device techniques are illustrated with a series of clinical case figures. Clinical Relevance: Endodontic re-treatment has a more successful long-term outcome than surgical treatment for failed root canal treatment. This approach may involve the removal of existing post restorations.

Posts have been used for many years to retain restorations or cores for extra-coronal restorations in endodontically treated teeth. This article discusses the variety of post systems that are available and the incidence and reasons for failure of teeth that have been restored with posts. The treatment options available for the management of such failures are considered, in addition to the indications for both non-surgical and surgical management of endodontic failures. The attitudes of dentists and the perceived complications of attempting post removal are reviewed, along with the evidence to support the prevalence of complications. Clinical Relevance: Failure of post-retained restorations is a relatively frequent finding due to failure of the restoration itself or the endodontic treatment. It is therefore important to understand and be aware of the various treatment options available, their indications and associated risks.

This paper describes an evidence-based clinical procedure that is suitable for the removal of fractured metal post fragments using ultrasonic vibration in general dental practice, particularly when non-resin-based cements have been used. Fragments of posts cemented with resin-based cements are likely to be extremely difficult to remove. The use of non-resin-based cements is recommended for luting posts, as fragment or total post removal is much easier with these materials.

Dismantling restorations from teeth which require endodontic re-treatment can be difficult. Many dentists are reluctant to remove posts through fear of weakening, perforating or fracturing the remaining root structure. A variety of techniques have been described and developed for post removal. This is the first in a series of two papers which provide an overview of these techniques. The rationale for endodontic re-treatment, pre-operative assessment and factors affecting post removal are discussed. Techniques are illustrated with clinical case reports. The second paper describes the use of specific post removal devices and the removal of fibre posts. Clinical Relevance: Endodontic re-treatment has a more successful long-term outcome than surgical treatment for failed root canal treatment. This may involve the removal of existing post restorations or portions thereof.

Many different techniques for the removal of posts have been proposed over the years, including the development of a number of different instruments and systems. This article discusses a number of the more common techniques, systems and their indications. Clinical Relevance: Dentists should be aware of the techniques available for the removal of posts and understand which techniques are appropriate for individual cases.