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Medical Forum / General / Dentistry / June 2007Root canal & crown
After root canal, does tooth has to be crowned? Are onlays also recommended? Thanks On Jun 4, 7:20 am, yeh_li...@yahoo.com wrote: > After root canal, does tooth has to be crowned? Are onlays also > recommended? > Thanks It depends on the tooth that underwent the root canal treatment and how badly damaged it is. Anterior teeth (incisors and canines) do not always need a crown after root canal, although a crown would be needed if the tooth is badly damaged (missing a lot of tooth structure). Usually a crown on anterior teeth after root canal should be accompanied by a post inside the root. Posterior teeth (molars and premolars) will usually require a crown after root canal to reduce the chance of suffering a catastrophic structure, since root canal treatment on these tends to take away a lot of internal structure due to their morphology. Premolars usually require a post inside the root, whereas molars usually don't. An onlay is a viable alternative to having a crown; the choice of an onlay over a crown will usually depend on how much tooth is left for the dentist to work with. If the outcome of the root canal treatment is uncertain for any reason (eg a shortfill in a calcified canal or chronic infection with a large lesion seen on the xray) and the tooth is not severely broken down, the dentist may choose to use a provisional restoration, usually a bonded composite restoration, until good healing is evident. The tooth should be placed out of occlusion so that the patient can't exercise a lot of biting pressure on it to reduce the chance of a fracture. Regards, George I vote for an onlay instead of a crown (unless the tooth was already destroyed for a full crown. Most teeth need some sort of restoration after RCT. 20 years ago, we were all taught to always place a post and crown after RCT. Now we know that the post does not help, and many times causes fracture of the root. There is current debate over whether or not the entire biting surface of the tooth needs to be cut back prior to restoration. Many of us are beginning to leave that way of thinking as well--since bonding strengths are getting better. I say restore the tooth however it would have been restored if a RCT had not been done. (assuming an indirect bonded restoration).  Signature/ Amatus / > On Jun 4, 7:20 am, yeh_li...@yahoo.com wrote: >> After root canal, does tooth has to be crowned? Are onlays also [quoted text clipped - 25 lines] > Regards, > George I agree Steve. I have been doing quite a few onlays on RCted molars and usually prfer them over a crown, assuming the tooth can take them. Regards, George > I agree Steve. I have been doing quite a few onlays on RCted molars > and usually prfer them over a crown, assuming the tooth can take them. > > Regards, > George How much molar is considered to be sufficient for a onlay? Depends >> I agree Steve. I have been doing quite a few onlays on RCted molars >> and usually prfer them over a crown, assuming the tooth can take them. [quoted text clipped - 3 lines] > > How much molar is considered to be sufficient for a onlay? >> I agree Steve. I have been doing quite a few onlays on RCted molars >> and usually prfer them over a crown, assuming the tooth can take them. [quoted text clipped - 3 lines] > >How much molar is considered to be sufficient for a onlay? Enough If I might add a tag to this discussion, I have a question about RCT. I have a premolar that had a very deep cavity 18 years ago, and the dentist opted to do a crown. Unfortunately, a month ago the crown came loose and broke, taking a portion of the wall of the tooth with it. My current dentist says there is no longer enough tooth material to anchor a new crown without RCT and a post. I am reluctant to do this, because the roots and nerve are healthy. Moreover, I have absolute fear and loathing of RCT, having had it done seven times over the years (I'm 59). I'm wondering if there are any options other than RCT for an otherwise healthy tooth that needs sufficient material to support and anchor a crown. Any opinions about this would be welcome. I had the nerve of a back tooth removed in other country by the dentist who was my friend. He did not do any root canal & crown but just a large filling. After 10 years, it is still fine. No infection, no fracture. I am sure no dentist in here want to do it this way. But the RC and crown I had in US really cause a lot problem in my life. I still have uncomfortable biting until now. Theoretically root canal & crown are to save teeth. But I do think they also weaken tooth too much. If the teeth are well cared, I would like to run a little risk to reduce heavy treatment in my mouth. > I had the nerve of a back tooth removed in other country by the > dentist who was my friend. He did not do any root canal & crown but [quoted text clipped - 6 lines] > they also weaken tooth too much. If the teeth are well cared, I would > like to run a little risk to reduce heavy treatment in my mouth. You are correct that it will be difficult to find a dentist to restore a tooth permanently that has not had a completed root canal. My perspective is a little different--most teeth needing root canal have already been greatly weakened by decay and previous restorations. However, proper restoration of teeth following successful root canal treatment can lead to long-term success. If you have pain long after a root canal something is wrong and it should be looked into. We may not agree on what constitutes "well cared" for. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 I had the nerve of a back tooth removed in other country by the dentist who was my friend. He did not do any root canal & crown but just a large filling. After 10 years, it is still fine. No infection, no fracture. I am sure no dentist in here want to do it this way. But the RC and crown I had in US really caused a lot problems in my life. I still have uncomfortable biting until now. Theoretically root canal & crown are to save teeth. But I do think they also damage tooth very much. If the teeth are well cared, I would like to run a little risk to reduce heavy treatment in my mouth. |
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