Removal of passive prefabricated metal posts cemented with resin cement using two ultrasonic application protocols: an ex vivo study
DOI:
https://doi.org/10.64668/rccss.v3i186107Keywords:
endodontic retreatment, post removal, resin cements, ultrasonic therapy, dental pinsAbstract
Introduction: The removal of intraradicular posts is frequent in endodontic retreatment, but its efficacy varies depending on the cement, post design, and ultrasound protocol. Objective: To evaluate the efficacy of two ultrasound protocols (alone and with a stopper) compared to a control group in the removal of prefabricated passive metallic posts fixed with self-curing resin cement, analyzing the removal rate and the required tensile strength. Material and method: An ex vivo, experimental study with 45 single-rooted mandibular premolars randomly distributed into three groups (n=15): Protocol 1 (ultrasound alone + traction), Protocol 2 (ultrasound with stopper + traction), and Protocol 3 (control, traction alone). The posts were fixed with resin cement (Multilink) and subjected to traction in a universal testing machine. Results: No post was removed by the application of ultrasound in Protocols 1 and 2 (0% removal). The mean tensile strength required was 12.77 kg (SD 6.12) for Protocol 1, 11.55 kg (SD 6.76) for Protocol 2, and 13.92 kg (SD 6.50) for Protocol 3, with no statistically significant differences recorded among the three groups (ANOVA, p=0.618). Conclusion: Under the conditions of this study, neither of the ultrasound protocols was able to remove the passive metallic posts fixed with resin cement. Furthermore, the use of ultrasonic vibration did not significantly reduce the subsequent tensile strength required for their dislodgement.
References
1. Zanza A, Reda R, Testarelli L. Endodontic orthograde retreatments: challenges and solutions. Clin Cosmet Investig Dent. 2023;15:245-265. Disponible en: DOI: 10.2147/CCIDE.S397835.
2. Ajina M, Shah PK, Chong BS. Critical analysis of research methods and experimental models to study removal of root filling materials. Int Endod J. 2022;55(Suppl 1):119-152. Disponible en: DOI: 10.1111/iej.13650.
3. Alves FRF, Rôças IN, Provenzano JC, Siqueira JF Jr. Removal of the previous root canal filling material for retreatment: implications and techniques. Appl Sci. 2022;12(20):10217. Disponible en: DOI: 10.3390/app122010217.
4. Habib SR, et al. Push-out bond strength of endodontic posts cemented to extracted teeth: an in-vitro evaluation. Materials (Basel). 2022;15(19):6792. Disponible en: DOI: 10.3390/ma15196792.
5. Giok KC, Veettil SK, Menon RK. Comparative effectiveness of fiber and metal posts in the restoration of endodontically treated teeth: a systematic review with network meta-analysis. J Prosthet Dent. 2025;134(3):597-615. Disponible en: DOI: 10.1016/j.prosdent.2023.08.022.
6. Van Landuyt KL, Wouters E, Zicari F, Debels E, Naert I, Van Meerbeek B, Peumans M. Randomized controlled trial comparing glass-fiber versus metal posts in single-crowned teeth: 15-year follow-up. J Dent. 2025;156:105694. Disponible en: DOI: 10.1016/j.jdent.2025.105694.
7. Al-Dabbagh RA, Sindi MA, Sanari MA, Manna AI, Al-Dabbagh MA. Effect of a circumferential ferrule on the survival and success of endodontically treated teeth restored with fiber posts: a systematic review and meta-analysis. J Prosthet Dent. 2024;132(6):1251-1259. Disponible en: DOI: 10.1016/j.prosdent.2023.12.002.
8. Cui Z, Zhang G, Lv B, Jiang Z, Liu Y, Qu L. Fibre post removal using dynamic navigation system and autonomous robotic system: an in vitro study. Int Endod J. 2026. Disponible en: DOI: 10.1111/iej.70173.
9. Kulvitit S, Eamtanaporn T, Sinpitaksakul P, Promoppatum P, Khrueaduangkham S, Porntaveetus T. The effects of combined dynamic navigation system and dental operating microscope on the accuracy and efficiency of fiber post removal: an in vitro study. BMC Oral Health. 2025;25(1):482. Disponible en: DOI: 10.1186/s12903-025-05887-6.
10. Krug R, Schwarz F, Dullin C, Leontiev W, Connert T, Krastl G, Haupt F. Removal of fiber posts using conventional versus guided endodontics: a comparative study of dentin loss and complications. Clin Oral Investig. 2024;28(3):190. Disponible en: DOI: 10.1007/s00784-024-05577-7.
11. Ito R, Watanabe S, Satake K, Saito R, Okiji T. Accuracy and efficiency of the surgical-guide-assisted fiber post removal technique for anterior teeth: an ex vivo study. Dent J (Basel). 2024;12(10):333. Disponible en: DOI: 10.3390/dj12100333.
12. Honda R, Pelepenko LE, Monteiro MF, Marciano MA, Gomes BPFA, de Jesus Soares A, Ferraz CR, Almeida JFA. Fibre post removal using ultrasonic tips: a comparative in vitro study using different protocols. Aust Endod J. 2025;51(1):47-54. Disponible en: DOI: 10.1111/aej.12898.
13. Fenigstein M, Askar M, Maalhagh-Fard A, Paurazas S. Comparison of two fiber post removal techniques evaluating dentin removal, efficiency, and heat production. Dent J (Basel). 2025;13(6):234. Disponible en: DOI: 10.3390/dj13060234.
14. Josic U, Mazzitelli C, Maravic T, Comba A, Mayer-Santos E, Florenzano F, Breschi L, Mazzoni A. Evaluation of fiber post adhesion to root dentin achieved with different composite cements: 1-year in vitro results. J Adhes Dent. 2022;24:95-104. Disponible en: DOI: 10.3290/j.jad.b2838131.
15. Mazzitelli C, Maravic T, Josic U, Mancuso E, Generali L, Checchi V, Breschi L, Mazzoni A. Effect of adhesive strategy on resin cement bonding to dentin. J Esthet Restor Dent. 2023;35(3):501-507. Disponible en: DOI: 10.1111/jerd.12978.
16. Baena E, Escribano N, Fuentes MV, Reche C, Ceballos L. Aging effect on push-out bond strength of six resin cements: an in vitro study. Materials (Basel). 2025;18(6):1371. Disponible en: DOI: 10.3390/ma18061371.
17. Martins MD, Junqueira RB, de Carvalho RF, Lacerda MFLS, Faé DS, Lemos CAA. Is a fiber post better than a metal post for the restoration of endodontically treated teeth? A systematic review and meta-analysis. J Dent. 2021;112:103750. Disponible en: DOI: 10.1016/j.jdent.2021.103750.
18. Stueland H, Ørstavik D, Handal T. Treatment outcome of surgical and non-surgical endodontic retreatment of teeth with apical periodontitis. Int Endod J. 2023;56(6):686-696. Disponible en: DOI: 10.1111/iej.13914.
19. Hesarkhani A, Fotovat F, Saneian F, Akbari H, Allahbakhshi H. Retention of cast posts cemented with two commonly used conventional and two resin cements and the mode of root fracture following their removal. Front Dent. 2021;18:37. Disponible en: DOI: 10.18502/fid.v18i37.7562.
20. Bhatt M, Seth T, Chaudhary S, Rajguru K, Khalane CS, Chib AS, Gupta S. Nonsurgical retreatment of endodontically treated teeth: a prospective cohort study on success rates and quality of life. Cureus. 2025;17(7):e88886. Disponible en: DOI: 10.7759/cureus.88886.
