Necessity of endodontic therapy for vital but small tooth needing crown (#7)?

Aug 16, 2017
19 years ago I broke #7. I received a crown, seemingly a mirror image of #10, which resumed being a heavy usage, well stressed workhorse, gnawing fingernails and beef jerky without any delicate restraint. Then after 19 years the crown split and broke off (only the crown broke, leaving the nub).

The initial break was far down; I would estimate that the native enamel nub is about 10% of the normal #7 height. To my recollection the nub was in a similar state 19 years ago when initially receiving the crown (to my knowledge has not shrunk or deteriorated).

Yesterday a dentist told me that the crown lab refused to make a new crown from the newly submitted impression, and requires me to get a root canal and post and build up.

Is that proper? Killing a tooth that has nerve and blood function (no pain or infection or bone atrophy evident)? When another practitioner was able to build a rock-solid crown with neither a post -- or even a buildup? The earlier dentist felt that there was just enough existing to put the crown on. This one doesn't.

Is this a judgment call such that I should just forfeit my crown prepayment and shop around? I can almost pay for a new crown elsewhere for the cost that I'm being dragged into from a root canal and buildup.

And not just the root canal bothers me. Why even require a buildup?


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