Best Practices in Endodontics by Schwartz Richard S. & Canakapalli Venkat

Author:Schwartz, Richard S. & Canakapalli, Venkat
Language: eng
Format: epub
Publisher: International Quintessence Publishing Group
Published: 2015-09-15T00:00:00+00:00

Retreatment sometimes requires post removal to gain access to the root canal system. Post removal should only be considered when there is sufficient remaining tooth structure so the tooth can be restored predictably. The structural integrity of the remaining tooth structure is one of the key factors for long-term survival of the tooth.

There are several factors that influence the difficulty of post removal:

• Type of luting cement

• Post length

• Adaptation of the post to the canal wall

• Use of magnification and specific devices

• Expertise of the clinician

• Composition, shape, and surface texture of the post

Posts come in a variety of materials, designs, and shapes, and their removal requires a variety of techniques and instruments. Therefore, it is important to identify which type of post was used. Posts can be fabricated from stainless steel, gold, nickel-chromium alloy, titanium alloy, ceramic, zirconia, and fiber-reinforced composite (FRC). Metal posts can be passive or active, which may also influence the choice of the device that will be used for post removal.

Post Identification

In general, the radiographic appearance of the post can help the clinician to identify its material composition and its design (active versus passive) ( Fig 17-1 ). The most radiopaque post systems are cast post and core systems and stainless steel posts, followed by posts made out of zirconium dioxide (zirconia). Titanium posts are sometimes difficult to distinguish radiographically, because their radiopacity is similar to that of gutta-percha. Most FRC posts are relatively radiolucent and may be outlined by more radiodense luting cements.

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