Comparing Techniques for Removing Fiber Endodontic Posts: A Systematic Review.

AIM: This systematic review aimed to establish the available techniques for fiber post removal, pointing out where each method stands out evaluating its advantages, and where they fall short indicating the possible harmful effects. MATERIALS AND METHODS: This systematic review was registered in PROSPERO (CRD42020193799). A broad search of the electronic databases PubMed, Web of Science, Scopus, and Virtual Health Library was carried out before April 27, 2020, for in vitro studies about techniques for removing fiber posts luted with resin cements of endodontically treated teeth. The methodological quality of included studies was evaluated based on the critical assessment tool for in vitro studies. RESULTS: Thirteen articles were selected and included after applying the inclusion and exclusion criteria. All included studies received an assessment of methodological quality between high and moderate. Most studies used ultrasonic inserts as a strategy to remove fiber posts, manufactured removal kits and drills were also widely used, only one study evaluated the removal capacity of the Er:YAG laser. Ultrasonic inserts seem to lead to a greater working time for removal of the fiber post, tend to generate significant volume changes in the root structure and increase the temperature on the root canal and clean the root canal walls further. CONCLUSION: Although the results tend to show greater agility in removing fiber posts with manufactured removal kits and the ultrasonic inserts seem to work better in removing fiber remains and luting agent, there is still no consensus in the literature as to which technique is the best. CLINICAL SIGNIFICANCE: In some cases, clinicians may be faced with the need to remove fiber posts in order to regain access to the root canal due to the need for endodontic retreatment which directly implies the search for the most appropriate removal technique. How to cite this article: Purger LO, Tavares SJO, Martinez RLCH, et al. Comparing Techniques for Removing Fiber Endodontic Posts: A Systematic Review. J Contemp Dent Pract 2021;22(5):587-595.

Minimally invasive intervention in external cervical resorption: a case report with six-year follow-up.

Root resorption consists of the loss of mineralized tissue (enamel, dentin, and cementum) of the inner or outer surface of the tooth due to the action of clastic cells. The correct diagnosis, the location, degree of tissue destruction, and the type of treatment are obstacles to the resolution of these lesions. The external cervical resorption is initiated in the amelocemental region progressively resorbing cementum, dentin, and enamel, constituting multiples ducts of resorption in an apical direction. This study reports a clinical case of treatment of a tooth affected by external cervical resorption with six-year clinical and radiographic follow-up. A 28-year-old male patient attended the clinic reporting a stain in the element 11. On clinical examination, there was a pinkish stain in the cervical lingual region, small cavitation in the enamel cervical region, and gingival bleeding with no insertion loss. Radiographically was observed a change at the root in the right central incisor, which was diagnosed as external root resorption. The negative response to the pulp sensitivity test confirmed the condition of pulp necrosis, indicating the need for endodontic treatment. To the treatment, it was opted for a minimally invasive approach, with endodontic access, instrumentation, and monthly exchanges of calcium hydroxide, for three months. After this period, the root canal has been filled with gutta-percha and sealer 26, in the apical third. The cervical and medium third were filled with MTA (mineral trioxide aggregate) leaving a central space for later fiberglass posts placing. The fiberglass post has been cemented with resinous cement and the tooth restored with resin composite. After six years of a radiographic control semiannual and annual, noticed normality in the periradicular tissues and disruption of the resorption process, was observed. The clinical management minimally invasive adopted reported in this case presents a viable treatment for external root resorption of the cervical third, especially in anterior teeth.