Evaluation of Crown removal using Two devices Manual Back Action vs spring loaded press type crown removers - A randomized clinical trial

Abstract

Objectives: While manual back‑action devices rely on tactile feedback and controlled force, automated spring‑loaded press‑type removers offer ease of operation but may exert less predictable forces. This study aimed to compare the success rate, efficiency, and incidence of unexpected events between manual back‑action and spring‑loaded press‑type crown removers.
Materials and Methods: In this randomized clinical trial, 140 crowns and bridges (70 per group) requiring removal were assigned to either a manual back‑action remover (Group 1) or a spring‑loaded press‑type remover (Group 2). All procedures were performed by a single experienced endodontist under local anesthesia. Primary outcome was successful intact removal; secondary outcomes included procedure time and adverse events (catastrophic vs. non‑catastrophic failures). Statistical comparisons were made using chi‑square tests and independent t‑tests.
Results: Overall success was high in both groups (Group 1: 87% [61/70]; Group 2: 91% [64/70]; p > 0.05) . Mean removal time did not differ significantly (Group 1: 6 ± 5 min; Group 2: 5 ± 3 min; p > 0.05) . However, the manual back‑action group experienced significantly fewer unexpected events (20% vs. 47%; p = 0.046), including lower rates of coronal tooth fractures (4% vs. 11%) and crown chipping (4% vs. 24%) . Reuse of restorations was higher after manual removal (80% vs. 56%; p = 0.002).
Conclusion: Both devices are effective for crown and bridge removal, achieving comparable success rates and procedure times. The manual back‑action remover, however, yields a significantly lower incidence of adverse events and greater preservation of restorations. Clinicians should consider manual removal when conservation of tooth structure and prosthesis reuse are priorities.