Fiber Post Removal Using a Conservative Fully Guided Approach: A Dental Technique

This report describes the usefulness of an endodontic template for the removal of a fiber post. A 40-year-old man presented with discomfort in the maxillary left canine. Clinical and radiographic examinations showed tooth #23 with a permanent core material retained with fiber post along with a persistent apical radiolucency. Among the various treatment modalities, nonsurgical root canal retreatment with fiber post removal using a conservative fully guided approach was proposed. After obtaining both the cone-beam computed tomographic images and the cast surface scan, their data were merged using implant planning software (ImplaStation for Windows x64 Bit Beta Version, ProDigiDent, Miami, Florida, USA) and superimposed. The drilling space was planned based on the location, diameter, and apical extent of the fiber post and was virtually overlapped and transferred clinically using a resin template to drill through the fiber post. With guides in position over the rubber dam, drilling was made with increments of 2 mm using a size 4 long-shank round bur (Thomas, Bourges, France) until it exposed the coronal gutta-percha. As soon as the canal was located, K3 rotary files (Sybron Endo, Orange, USA) were used along with chloroform to remove the old obturating materials. Then, additional shaping and cleaning were done with ProTaper Next rotary files (Dentsply Sirona, Ballaigues, Switzerland), sizes X2 and X3, and 5.25% NaOCl irrigation, respectively. The root canal was then dried with paper points and obturated with gutta-percha and AH Plus sealer (Dentsply Sirona, Ballaigues, Switzerland) using the continuous-wave compaction technique. Finally, the tooth was temporarily restored using the double seal technique with zinc oxide and zinc sulfate-based temporary material (Cavit W; 3M ESPE, St. Paul, MN, USA) and resin-modified glass ionomer material (Photac Fil; ESPE, Norristown, PA, USA) filling materials and referred for the final restoration.