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Posts – when it all goes wrong! part 2: post removal techniques

From Volume 40, Issue 3, April 2013 | Pages 166-178

Authors

Sam Rollings

BDS(Hons), MFDS RCS(Ed), MFGDP(UK)

SpR in Restorative Dentistry, Department of Restorative Dentistry, University of Aberdeen Dental School and Hospital, Cornhill Road, Aberdeen

Articles by Sam Rollings

Brian Stevenson

BDS, PhD, MFDS FHEA

Clinical Lecturer in Restorative Dentistry, Dundee Dental Hospital, University of Dundee, Park Place, Dundee, DD1 4HN, UK

Articles by Brian Stevenson

David Ricketts

Dundee Dental School

Articles by David Ricketts

Abstract

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.

Article

The previous article in this series discussed the variety of post systems that are available on the dental market and the incidence and reasons for failure of teeth that have been restored with posts. It also discussed the treatment options available for the management of such failures and highlighted the importance of carrying out a thorough assessment to aid with treatment planning. Post removal is often indicated, and this article will describe the various techniques and systems available and their indications.

The preparation required prior to post removal will vary depending on what type of post is present and what technique for removal is going to be used. The tooth should be isolated (preferably with rubber dam) to prevent the inhalation or ingestion of post fragments or instruments during the procedure and to maintain an aseptic working environment.

Informed consent must be obtained from the patient and other possible treatment options discussed. In cases of endodontic failure, these may include peri-radicular surgery, extraction, or monitoring of a radiographic lesion, and the advantages and disadvantages of each approach must be discussed. If post removal is necessary because of a fractured post, the alternatives are limited to keeping the root as an overdenture abutment, retaining a core with dentine pins (a compromise with a poor long term outcome) or extraction.

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