Post Removal: Screw Type

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THERE ARE many types of posts used when restoring an endodontically treated tooth. In this article, I want to discuss the removal of the screw type post. Screw type posts are actually the easiest ones to get out because you can just loosen the post using an endodontic ultrasonic tip and unscrew it counterclockwise with a wrench or thin-ended hemostat or forceps. However, what do you do when a patient presents with a post that is broken inside the root (Figure 1)? The basic principle is the same. The first step is to make a trough around the post, but remember to keep it conservative or else the root will be so thinned and weakened that successful restoration will be questionable. Then you can simply touch the post with the ultrasonic tip and sometimes the post flies out if it is short enough. If it does not, you need to go around the post counterclockwise with the ultrasonic tip. Using a drop of chloroform may help to loosen the cement also. Once the post is out, the tooth can be retreated (Figures 2 and 3) if necessary.

October - December 2012

Figure 1
FIGURE 1: Pre-op.
Figure 2
FIGURE 2: Mid-op.
Figure 3
FIGURE 3: Post-op.