**Background:** Early childhood caries is a common problem in children under three years, often leading to severe destruction of primary anterior teeth. Restoring these teeth is challenging due to small crown size, wide pulp chambers, and behavioral management issues. Intracanal posts are used to provide retention for coronal restorations. While glass fiber posts offer good aesthetics and mechanical properties, they are not absorbable. Dentin posts, made from permanent tooth dentin, theoretically can be resorbed during physiological exfoliation, making them attractive for pediatric use. This study aimed to compare the pull-out resistance of dentin posts versus glass fiber posts in restoring severely decayed primary anterior teeth.
**Methods:** The study was conducted at the Department of Pediatric Dentistry, Damascus University. Sample size was calculated using G*Power 3.1.9.7 (95% power, effect size 0.8, α=0.05), requiring a minimum of 10 per group; 30 primary anterior teeth were collected. Teeth were included if they had at least two-thirds root length, intact roots free of caries/fractures, and were extracted due to trauma, caries with crown destruction, or orthodontic reasons. Exclusion criteria were prior endodontic treatment or radiographic signs of resorption. Crowns were cut 1 mm above the cementoenamel junction. Root canals were prepared with Hedstrom files up to size 40, irrigated with 5.25% sodium hypochlorite, dried, and filled with Metapex. Teeth were divided into two groups of 15: dentin posts and glass fiber posts. Seven posts of 1.4 mm diameter and eight of 1.2 mm diameter were used per group. Glass fiber posts (DenMat) required no pretreatment. Dentin posts were fabricated from single-rooted permanent teeth using a CAD-CAM milling machine (DWX-52, Roland, Japan) to match dimensions, then sterilized in 10% formalin for two weeks. Post spaces were prepared with Gates-Glidden drills (1.1 mm for 1.2 mm posts, 1.3 mm for 1.4 mm posts) to a depth of 4 mm (3 mm post extension below CEJ). Both groups used the same cementation protocol: etching with 37% phosphoric acid (15 s for dentin/post space, 30 s for enamel), bonding agent (Tetric N-Bond, light-cured 20 s), and dual-cure resin cement (Variolink II, light-cured 40 s). Posts were cut to 3 mm above CEJ, and cores were built with Tetric N-Ceram composite to 4 mm above CEJ. Samples underwent 500 thermal cycles (5°C–55°C, 30 s each, 5 s transfer). Pull-out testing was performed using a Testometric machine at 0.5 mm/min, recording force at failure in Newtons. Failure patterns were classified macroscopically. Statistical analysis used Kolmogorov-Smirnov, Student's t-test, and chi-square test (SPSS v24).
**Key Results:** Mean pull-out resistance was 153.2 ± 39.12 N for glass fiber posts and 156.7 ± 39.78 N for dentin posts. Data were normally distributed (Kolmogorov-Smirnov p > 0.05). Student's t-test showed no statistically significant difference between groups (p = 0.811, 95% confidence). Failure patterns: post-cement separation occurred in 66.7% (10/15) of glass fiber and 80% (12/15) of dentin posts; cement-canal wall separation in 26.7% (4/15) of glass fiber and 20% (3/15) of dentin posts; restoration-post separation in 6.7% (1/15) of glass fiber and 0% of dentin posts. Chi-square test showed no significant difference in failure patterns (p = 0.516).
**Clinical Implications:** Dentin posts demonstrate pull-out resistance comparable to glass fiber posts when used to restore severely decayed primary anterior teeth. Given their theoretical advantage of natural absorbability during exfoliation, dentin posts may be a preferred option in pediatric dentistry. However, the authors note limitations including small sample size, difficulty obtaining suitable teeth, and inability to fully replicate intraoral conditions despite thermocycling. They emphasize the need for future clinical studies with larger samples to confirm these in vitro findings.