A survey of methods used for post removal in specialist endodontic practice

 Materials and methods.

A survey of members of the Australian and New Zealand Academy of Endodontists (ANZAE) was conducted in April 1999. The survey was mailed to all 74 members of the ANZAE with an explanatory letter and a stamped pre-addressed return envelope. The survey was divided into three parts to obtain the following information:

1. Details of previous undergraduate and postgraduate training, number of years in specialist endodontic practice, number of h per week treating patients, and the practice location. 
2. An analysis of cases treated by the endodontists to determine the percentage of teeth that require root canal retreatment, the number of orthograde retreatment cases and the number of surgical cases treated each month. The attitudes toward the risk of root fracture during post removal were determined, as well as the treatment options considered for post removal and reasons for not removing a post. Each respondent was also asked to indicate whether they had ever fractured a root during post removal and to provide details of the case(s), if possible. 
3. Data were obtained about the post removal devices that were available in their practices and which ones they commonly used.

Periapical radiographs of four clinical examples (Figs 1–4) were provided to determine the methods used to remove posts in the following specific situations: a maxillary anterior tooth with a cast post and core, a maxillary anterior tooth with a parallel-sided preformed post, a mandibular molar with a parallel serrated preformed post, and a maxillary anterior tooth with a fractured parallel-sided preformed post.

Figures 1. A cast post and core in a maxillary incisor tooth. Respondents were asked to indicate the instruments they would use to remove this post or any other treatment that they would recommend.

The survey participants were advised to assume that root canal treatment was indicated because of the presence of symptoms and that there were no other complicating factors. They were asked to indicate their first and second choices for removing each post, and if post removal was not their preferred treatment, then they were asked to indicate what other treatment they would provide.

Figures 2. A parallel preformed post in a maxillary incisor tooth. Respondents were asked to indicate the instruments they would use to remove this post or any other treatment that they would recommend.

Figures 4. A fractured post in a maxillary incisor tooth root. Respondents were asked to indicate the instruments they would use to remove this post or any other treatment that they would recommend.

Statistical analysis.
Data from the returned surveys were entered into a database statistical software program ( SPSS for Windows 6.1.31995, SPSS Inc, Chicago, IL, USA) for analysis. Chi-squared ( 2 ) tests were conducted from contingency tables of different variables where the sample was large. When the sample was not large and the expected value was less than five, the Fisher’s exact test was used. Statistical analysis was performed at the 95% level of confidence.