Incidence of root fractures and methods used for post removal

This study was undertaken to determine the incidence of root fractures during post removal, as well as the methods used and the success rates achieved with various post removal devices and techniques.

Patient records from a specialist endodontic practice were examined. A total of 1600 teeth from which posts were removed were identified. These teeth had no preoperative signs or symptoms to suggest root fractures. The incidence of root fractures was determined and a subset of 234 patient records were examined in detail to determine the methods used to remove different types of posts.

Only one tooth fractured during post removal (0.06%) and all posts were successfully removed, typically in about 3 min. Most cast posts were removed with an Eggler post remover but some dislodged when the crown was removed; ultrasonics was used occasionally. Most parallel-sided posts were removed with ultrasonics and threaded posts were unscrewed. The Masserann kit and ultrasonics were combined to remove fractured cast posts and some parallel-sided posts.

This study indicates that, with good case selection, post removal is a predictable procedure. If appropriate techniques and devices are used for the particular type of post being removed, then root fracture is a rare occurrence.