Thesis
A comparative study of fiber post removal made by traditional freehand, static surgical guides, and dynamic navigation methods
University of Iowa
Master of Science (MS), University of Iowa
Spring 2025
DOI: 10.25820/etd.007824
Abstract
Statement of Problem. The removal of fiber posts cemented within teeth is technically difficult. Novel technologies for their removal have sparsely documented evidence comparing the different methods.
Purpose. When the freehand (FH), static surgical guided (SSG), and dynamic navigation (DN) techniques for resin-fiber post removal are compared, which one provides the most accurate and conservative approach?
Material and Methods. Ninety dentate resin models with post spaces digitally fabricated in a mandibular second premolar were 3D-printed. These were divided into 3 treatment groups (N=30). After cementing a fiber post, a CBCT scan was made to facilitate planning of removal. Removal was performed by using each method: FH, SSG, and DN. A post-operative post space was then compared with pre- and post-operative scans by using CAD software to evaluate accuracy and volume change. Statistical analysis was performed by the Kruskal-Wallis (KW) rank sum test, and pairwise comparisons were investigated using Dunn’s test of multiple comparisons (α = 0.05).
Results. There were statistically significant differences were found between DN and FH, and SSG and FH with FH measurements consistently larger for apical deviation. Significant differences for volume differences were also found for DN when compared with both the SSG and FH groups, with the DN group consistently smaller in volume. Coronal and angular deviations were not statistically significant between groups.
Conclusion. Dynamic navigation and static surgical guides showed significant higher accuracy than the freehand method when removing fiber posts. In terms of volume change, dynamic navigation is the most conservative method of fiber post removal in comparison with static surgical guided and freehand methods.
Clinical significance. Guided fiber post removal can be recommended over the freehand removal method but is dependent on the materials available to the clinician.
Details
- Title: Subtitle
- A comparative study of fiber post removal made by traditional freehand, static surgical guides, and dynamic navigation methods
- Creators
- Nicholas Ehmann
- Contributors
- Seok-Hwan Cho (Advisor)Tarek El-Kerdani (Committee Member)Shareef Dabdoub (Committee Member)Abhishek Parolia (Committee Member)Trishul Allareddy (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Oral Science
- Date degree season
- Spring 2025
- DOI
- 10.25820/etd.007824
- Publisher
- University of Iowa
- Number of pages
- x, 67 pages
- Copyright
- Copyright 2025 Nicholas Ehmann
- Language
- English
- Date submitted
- 04/28/2025
- Description illustrations
- illustrations (chiefly color), tables
- Description bibliographic
- Includes bibliographical references (pages 62-67).
- Public Abstract (ETD)
- Dental fiber posts are frequently employed to restore teeth with significant damage, providing a stable foundation for dental restorations. However, circumstances may arise where these posts must be removed, a procedure that can pose challenges and potentially compromise the integrity of the tooth. This study aims to evaluate and compare three distinct methods for fiber post removal: the conventional freehand technique, and two digitally-assisted approaches, namely static surgical guides and dynamic navigation systems. We utilized 3D-printed models that replicated a fractured mandibular premolar. A fiber post was then cemented into each model and each of the three removal techniques were performed. We compared the exact location of the post before removal, and the space remaining after removal, and compared them using the software Geomagic Control X. Statistical analysis found significant differences between all three groups, with the FH measurements being consistently larger for some of the measurements of accuracy, but not all. Volume difference was statistically significant between dynamic navigation and both of the other groups, with consistently smaller dynamic navigation volume measurements. We concluded that dynamic navigation and static surgical guides were more accurate than the freehand method when removing fiber posts, while dynamic navigation was the most conservative method of fiber post removal, when compared to static surgical guided and freehand methods.
- Academic Unit
- Oral Pathology, Radiology and Medicine
- Record Identifier
- 9984831229602771
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