Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Charité - University Medical Center Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Berlin, and Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany.
Clin Oral Investig. 2022 Apr;26(4):3679-3685. doi: 10.1007/s00784-021-04338-0. Epub 2021 Dec 10.
The aim of this study was to evaluate the effectiveness of different fiber post removal techniques and to correlate dentinal loss with microcrack formation.
Forty-five extracted single-rooted teeth were root canal treated and fiber posts were adhesively luted. Specimens were divided into three groups (n = 15) according to the removal technique: long-shaft round bur (EndoTracer #08, Komet, Lemgo, Germany), SonicFlex Endo (KaVo, Biberach, Germany), DT Post Removal Kit (VDW, Munich, Germany). Roots were scanned before post cementation and after post removal using micro-computed tomography. Dentin loss, residual luting material, working time, and the induction of microcracks were assessed. Statistical analysis was performed by using multiple contrast tests (max-t tests, α = 0.05). Correlations between parameters dentin loss/new microcracks and dentin loss/residual material were calculated using Kendall's tau.
Post removal with SonicFlex Endo resulted in the highest amount of removed dentin with significant differences to the round bur and the DT Post Removal Kit. No technique was found to completely remove the post and luting material. All techniques induced microcracks with the DT Post Removal Kit presenting the highest number of new defects. No correlation between dentin loss and new microcracks was observed. Deviations from the original root canal occurred in all groups, but no perforation was observed.
All techniques resulted in dentin loss, residual luting material, and the formation of microcracks. However, no correlation between dentin loss and the induction of microcracks was observed.
As all techniques resulted in microcrack formation and dentin loss, this study emphasizes the risk of iatrogenic damage due to post removal procedures.
本研究旨在评估不同纤维桩取出技术的有效性，并将牙本质损耗与微裂纹形成相关联。
45 颗根管治疗后的单根牙被黏固纤维桩。根据取出技术将标本分为三组（n=15）：长柄圆钻（EndoTracer #08，Komet，Lemgo，德国）、SonicFlex Endo（KaVo，Biberach，德国）、DT 桩取出套件（VDW，慕尼黑，德国）。在黏固纤维桩前后，使用微计算机断层扫描对牙根进行扫描。评估牙本质损耗、残留黏固材料、工作时间和微裂纹的诱导情况。使用多重对比检验（max-t 检验，α=0.05）进行统计分析。使用 Kendall's tau 计算牙本质损耗/新微裂纹和牙本质损耗/残留材料之间的参数相关性。
SonicFlex Endo 取出纤维桩后，牙本质损耗量最大，与圆钻和 DT 桩取出套件相比差异有统计学意义。没有一种技术能完全去除桩和黏固材料。所有技术都诱导了微裂纹，DT 桩取出套件诱导的新缺陷最多。未观察到牙本质损耗与新微裂纹之间存在相关性。所有组均发生偏离原始根管的情况，但未观察到穿孔。
所有技术均导致牙本质损耗、残留黏固材料和微裂纹形成。然而，未观察到牙本质损耗与微裂纹诱导之间存在相关性。
由于所有技术均导致微裂纹形成和牙本质损耗，因此本研究强调了由于纤维桩取出操作导致医源性损伤的风险。
