Can a tooth be so heavily filled that it cannot have a successful root canal and crown?

[ToothPatient]

Dentist I attended seemed to think so much of the tooth was filled that a root canal and crown probably wouldn't last too long.

I was under the impression a post and core would support a crown, but perhaps some residual tooth structure is necessary to do so?

This tooth has been worked on heavily.

Inspecting dentist said it's more filling that tooth at this point, most of the front of the tooth is filling.

Tooth 7, so the one that's clearly heavily filled.

I understand whether to get a RCT or extraction is ultimately my own decision in perspective of what my dentist has explained based on an inspection, but perhaps just getting some additional perspective here?

A very heavily filled or damaged tooth, may not in fact be suitable for a root canal and requires extraction?

And presumably an implant thereafter.

 

[ToothPatient]

For perspective, this was the tooth prior to getting it filled a couple months ago:

 

[Dr M]

Based on the x-ray, a root canal, post core and crown is still possible. Get a second opinion from another dentist. Perhaps your dentist is not experienced enough to perform the root canal and do the crown.

 

[dentistgreatneck]

Yes, a tooth can sometimes be so heavily filled or damaged that a successful root canal and crown may not be feasible. When a tooth is extensively filled, it may have insufficient healthy structure left to support a crown or withstand the pressures of daily function. If the remaining tooth structure is too weak, prone to fracture, or has recurrent decay, alternative treatments, such as extraction and replacement options (like implants or bridges), might be recommended. An evaluation by a dentist is essential to determine the best of action.

 

[Dr M]

The extraction of this tooth might also prove difficult. It has long roots, that extend into your sinus. This sometimes leads to additional procedures, such as sinus lift surgery and/or bone augmentation, when you think about replacing it with an implant. Additional procedures = additional costs.
When you design the crown, it can be designed in such a way, that it is taken out of the occlusion or that the load on the crown is minimal at best. This increases longevity.
The main success factor for me here would be the quality of the root canal. Poor root canal treatment would lead to future infection and ultimately tooth loss.

 

[ToothPatient]

Thing with this tooth is, it's hasn't had an infection (no signs of an infection, and I went on anti-biotics for five days with no change).

It just initially developed acute temperature sensitivity after a large cavity was filled two months ago.

A correction was made and that became less severe, more temporary (initially it lingered, I believe as illustrated here, due to a lesion on the buccal side of the tooth that was filled later).

However, like an absolute dumb ass, I went into a different dentist to reduce the height of the filling, and instead of reducing it by the 0.5 mm it was high, he took a massive lump out of the tooth and I needed to get it refilled again cause it weakened it so badly; resulting in pain now upon biting down, as well as the initial heat/cold sensitivity.

SUBSEQUENT to getting it refilled, it seems to have developed a "shadow" on the buccal face........ I have no idea what that represents. Some kind of black'ish shadow line underneath the exterior.
On dental inspection, this apparently exists on the occlusive surface also, this "shadow".

In any case, I said I'll wait as long as I can tolerate to see if the pain/sensitivity diminishes or resolves before committing to the next procedure.

..........

The dentist who suggested an extraction typically refers out for root canals to endodontists, then does the crown himself. But absolutely I'll seek a 2nd and 3rd opinion if necessary to come to the most informed decision possible before deciding on a root canal or extraction.

 

[dental_care]

A heavily filled or damaged tooth might not be suitable for a root canal and crown. Extraction and replacement might be necessary.