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Even if removing a post core is less frequent
than in the past
the frequency of this operation still
depends on the kind of patients you have.
While fiber posts can easily be removed
with an appropriate drill,
removing a metal post can be a real difficulty.
I said that we removed less and less metal posts
which is not completely true.
Indeed more and more metal posts
are removed in order to be replaced
with more aesthetic posts
i.e. fiber or zirconia.
But it is essential to understand that the presence itself of a post
weaken the root and can cause its fracture.
And if you use an inappropriate technique such as a "pulling" crown remover,
you face substantial risks of fracture.
1 or 2 riskfree devices for removing posts
are available on the market,
but most dentists agree to say that
their implementation is complex and long.
And if ultrasonics allow to remove some posts in a lot of cases,
this operation is so long that it can cause a lot of frustration
to the patient and to the dentist.
This is why we designed teh instrument I'm about to show you.
If you already use the WAMkey on a routine basis to remove crowns and bridges,
you will quickly understand why this device is so efficient
and how it works because
it actually uses the same mechanical principles
as our famous crown remover.
WAM'X is a pair of forceps with 2 little orifices
in which you insert a pair of prongs.
As you can see, these prongs can freely rotate
but can't fall
thanks to little retentions in the back of each cylinder.
The process is quite simple.
First, you create a groove on both sides of the crown,
on, the mesial and distal sides of the post.
It is essential to dril back to the occlusal side of the root
so the prong will only push on the root during the post removal.
Once this preparation finished, you select the 2 most appropriate prongs
between 3 sizes, depending on the space you have just created.
You set them now in the orifices of the forceps
and introduce them into the space
you have created between the root and the core.
And now, all you have to do is to squeeze the handles
in order to remove the post along its axis.
The intro kit also contains 3 pairs of little silicon rings
that you will place this way, on the occlusal side of the root,
in order to spread the forces o a greater number of contact points.
I know that some of you wonder how many roots they would fracture this way !
So let's try to reassure them and try
to explain why WAM'X is so efficient and why risks are so limited.
As I mentioned it, WAM'X is totally inspired wy the WAMkey.
So it pushes on the root which induces
no more feeling to the patient than bitting a hard toffee.
Secondly, we are between the rro and the core,
so there's no loss of energy into the ligament.
Same as with the WAMkey.
So we need far less energy here than if we were pulling the post
with a plyer or with a crown remover.
Now remember... I told you that the prongs
could freely rotate in the orifices.
So they will let the post choose the way of least resistance.
And the combination of all these factors
result in an easy and painless
post removal along the best trajectory.
This is also why the risk of fracturing the root
is so limited.
So if I had to summarize all this, I would say that
WAM'X is a simple and quick way to solve tricky cases.
In general, depending on the context,
4 to 6 minutes are usually enough to remove anterior posts
while 7 to 10 minutes can be necessary for posterior posts,
especially if you have adjacent teeth.
As stated previously, this solution is extremely
predictable and gentle, and finally, it allows to remove posts
from the whole denture, even from posterior teeth
Restorations with dowel pins are of course
are slightly longer to remove, but not really harder.
You'll have to seperate the core in 2 pieces,
and in most cases, the vibrations induced by the drilling will release
the secondary pin which is usually shorter than the main post.
Then you'll remove the main post as usual with the WAM'X.
Let's now view some clinical cases.
We first met this patient 2 or 3 years ago.
We had then recemented her richmond crown
that was loose.
We have recently decided with the patient
to build an anterior structure that is cosmeticly more appropriate,
and rather than cutting the richmond-crown into a post-core
that would not be 100% reliable
we prefered to remove it and create a brand new build-up.
We start now by eliminating the cervical area of the crown (colored in black).
In general, I strongly recommend you to start drilling frankly in the crown
rather than at the marginal junction.
This will prevent your bur from ripping into the root.
The preparation work is now finished.
We select the most appropriate prongs
between the 3 available sizes and
insert them in the forceps.
We then place them between the root and the core
around the post...
Et voilĂ !
It's removed !
Here is now a post & core
that has a quite special story.
It's the 1st post that was removed in vivo
with a prototype of WAM'X.
As usual, we start drilling grooves on each side of the core
We then apply 1 or 2 minutes of ultrasonics to weaken the cement...
We insert the prongs
You probably noticed that at that time, we didn't have any silicone rings
which didn't prevent us from succeeding!
And look at the size of this post !!!
Actually we couldn't see it very well on the Xray,
but htis post was really huge,
and as you can hear it
and in spite of ultrasonics, the cement was still very resistant.
And here, the Xray confirms us that the root is absolutely intact!
One last case for pleasure!
Another richmond crown to remove
in order to do a root canal retreatment.
We drill the grooves as usual...
Of course, the preparation is longer than
for removing crowns with the WAMkey.
There it is...but here,
we face a little difficulty.
We can't find any appropriate prong between the 3 available sizes.
So we just modify one prong
The prongs are now perfectly adapted
They even slightly float which is ideal
to let the post free to go in any direction
during its removal.
We can now proceed
The dentist: "Vous allez sentir que j'appuie sur votre dent, OK ?"
The patient: "OK".
Et voilĂ again !!!
The dentist: "How are you?"
The patient: "great!"
There we are! I think you now know the essential about WAM'X
but in case I haven't answered all your questions
you can still send us some inquiries or visit our website
for more videos and clinical cases.
Thnaks a lot for your attention,
and stay tuned for more dental innovations !!!