Nonmetal Post Removal - Unicore Option: Maxillary Anterior: Advanced Endodontics Dr. Cliff Ruddle

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Once straightline access into the pulp chamber has been accomplished, all core materials eliminated and the post has been fully exposed, then a variety of techniques have been advocated to potentially remove a post.
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Endodontics just got a lot more exciting in the advent of adhesion dentistry in the emphasis internationally on aesthetic dentistry we're seeing a lot more bonded nonmetallic post notice this maxillary right central incisor the patients been referred in because the patients sustained trauma and it's a restorative problem but in carefully evaluating the preoperative film you can see that the post has been exposed due to the traumatic episode but also the tooth is in Adana CLE failing notice the apical and lateral root lesion in this show I'm going to demonstrate how to remove nonmetallic post using the eunuchor drill system evaluating the isolated tooth clinically reveals the ball shaped head of that nonmetallic post this needs to be removed so simply use a surgical length tapered diamond or a comparable instrument and simply remove the ball and make a platform so the tooth is nice and flat now that you've exposed the post recognize that some post materials have colors that are very close to surrounding dentin so at times it's useful to use a die like methylene blue or Chinese red to stain this and oftentimes this will better map the circumferential dimensions of that post we can use ultrasonics or a little small round bur to make a small divot in the head of the post this will create a pilot hole for our subsequent instruments to follow the unicore drill has an asymmetrical tip which means when you turn this at high rpms and a slow speed handpiece the tip tends to keep centered there are four drills in the unicore kit and we're starting with the small one always use the small one to reduce surface area it will take some inward pressure to pilot down through that hard nonmetallic material and we'll work our way down until we see pink got a purcha notice that we're using a small cannula to blow air deep in the prep so we're perfectly focused many many millimeters away from the incisal edge that's been modified through two-three duction the red UNICOR drill number two comes in it can follow that pilot hole quite nicely and what's really neat about this your first drill or two might shift a little bit off-center and it may in fact look like the prep is drifting a little bit more towards dentin but what you'll notice with the subsequent larger instruments they will recenter and because the material you're removing is softer in its Bernal hardness number than the surrounding dentin you'll Center back up after using the instrument with the red stripe on the handle that gets us to the blue and we can quite easily just remove some of the residual flashing of that nonmetallic post again keep your rpms up at 15,000 rpms preferably using a high torque handpiece if we rack focus down on the more apical work you can see the little divot in the gutta-percha from the tip of that UNICOR drill well now through a little bit of effort we remove the gutta-percha reshape the canal with emphasis on disinfection cleaning fit a cone using heat and pressure and vertical condensation we can carry a wave of warm rubber through the master cone and quark the apical 1/3 notice the lateral canals have been filled on the way down the canal has been back packed and you're looking at the provisionalization and if you look out at about two years you can see excellent apical and lateral healing and the results of the restorative effort let's review how to remove the new generation of nonmetallic post first plan your removal method carefully by evaluating multiple different horizontally angled preoperative films establish the coronal platform you can use various dyes to further map the post dentin interface it is helpful to start a pilot hole with either an ultrasonic instrument or a very small round bird use the eunich or drills small too big at AI rpms and a high torque handpiece carefully and progressively remove all the nonmetallic material until you see gutta-percha in this instance apical to the post well I bring you good news there are many ways to remove posts historically but the new challenge in recent years with the explosion and emphasis on aesthetic dentistry is the more translucent nonmetallic post we've looked at a method to remove these in a very predictable way you