Endodontia guiada na remoção de um pino de fibra de vidro – relato de caso

Abstract

This case report aims to describe the optimization of a guided endodontic protocol for the removal of a fiberglass post, using digital technology for planning and procedure execution. A 29-year-old male patient sought treatment due to discomfort in tooth 22. The tooth had undergone endodontic treatment and contained a fiberglass post. Cone-beam computed tomography (CBCT) revealed apical periodontitis associated with the apex, root inclination towards the palatal region, and the presence of a fiberglass post extending to the middle third of the root. Two treatment plans were proposed to the patient: removal of the fiberglass post with the assistance of an endodontic guide (Endo Guide) followed by endodontic retreatment, or parendodontic surgery. The patient, experiencing significant anxiety regarding a surgical procedure, opted for the endodontic guide. This treatment protocol was implemented to establish a precise and controlled access path to the obturation material within the root canal. Initially, the fiberglass post was carefully removed using a combined approach with ultrasonic tips, which proved effective for fragmenting and removing the post while minimizing the risk of damage to the remaining tooth structure. This procedure was optimized with the use of an operating microscope, which provided magnification and detailed visualization, allowing greater precision and safety throughout each step of the treatment. After complete post removal, calcium hydroxide was applied within the canal as intracanal medication for 14 days. This choice aimed to disinfect the canal, eliminating any remaining microorganisms and promoting an environment conducive to periapical tissue healing. At the second appointment, the patient was asymptomatic, indicating the success of the preliminary treatment. With a favorable clinical condition and no signs of infection or inflammation, the root canal was definitively obturated, ensuring a hermetic seal and the conclusion of the endodontic treatment. The endodontic guide proved to be a predictable and accurate method for accessing the obturation material in teeth rehabilitated with a fiberglass intraradicular post.