Digital Glide Path© for Fibre Post Retrieval Through Guided Endodontics in a Patient With Factor VIII Deficiency

Fibre posts are used in restorative dentistry to reinforce structurally weakened endodontically treated teeth that require additional retention to support the core. However, in cases of endodontic failure, retrieving posts is challenging with conventional endodontic retreatment procedures because the post adapts closely to the root canal walls and visibility is limited. Traditional freehand methods carry a risk of excessive dentin loss, root perforation and unpredictability. Guided endodontics, which utilises cone-beam computed tomography (CBCT) and a 3D-printed guide, offers a precise and minimally invasive alternative for post removal. This case report illustrates the use of static guided endodontics utilising a Digital Glide Path^© for removal of a fibre post during nonsurgical endodontic retreatment of a maxillary lateral incisor (tooth 12) diagnosed with asymptomatic apical periodontitis in a 27-year-old patient with factor VIII deficiency. An intraoral periapical radiograph of 12 showed a fibre post, inadequate obturation of the apical third, and an associated periapical radiolucency. The patient's blood report showed a 12% FVIII, 2BU/ml inhibitor and a prolonged APTT value, suggesting that an elective periapical surgery should not be undertaken without perioperative haemostatic control / Factor VIII replacement. Hence, a non-surgical guided endodontic approach was planned after obtaining written informed consent from the patient. A DICOM file was acquired to visualize the spatial orientation of the fibre post within the root canal system. A surface scan of 12 was performed to generate an STL file, and planning software integrated both files to generate a Digital Glide Path^© for fibre post removal. A 3D resin template was fabricated to precisely guide a specialised bur to the apical extent of the fibre post, thereby facilitating its precise removal. Thus, Digital Glide Path^© minimised procedural errors in fibre post removal while serving as a predictable alternative to surgical retreatment in a hemophilic patient.