When a crown can’t be fitted

[Islandhopper]

Hi, I have three molars which are root filled (but not crowned). I was recently referred to an endodontist by my new dentist, as two of the root filled teeth showed signs of infection (dark areas around root tip on x-ray) and one in particular (LR6) had recently given me some bother (tenderness under the jaw). The other one (LL7) we agreed to take out, as there is doubt as to the restorability of it , as the filling extends below the level of the gum (also, having a root filling re-done is very expensive).

As LR6 also has a rather large filling on it, there is question mark on the restorability of it as well but also, the roots have some calcification-though I guess the benefit of visiting an endodontist is that they are highly specialised & have the appropriate tools & jigs.

My question is, do I have to have a crown fitted ? I understand the benefits and that they strengthen the tooth, but it seems it’s not always possible to fit one.

The original filling I have on this tooth is 23years old. Couldn’t i just have another filling fitted after the tooth has been re-root filled ?

Currently, I have a large metal filling, which is the top part of the tooth, and none of the original tooth is visible.

My regular dentists has mentioned about lowering the gum level (which I’ve never heard off or am keen on) in order to fit a crown, but on my recent visit, he cleaned and polished the tooth and said there was some of the tooth and they might be able to do something (ie fit a crown)

I’m a bit confused. If I can’t have a crown, can’t I just have a big filling (like I have currently) which has previously served me well.

Thanks,
Islandhopper

 

[Dr M]

Good day

Once a tooth has been root canal treated, it becomes brittle over time due to a lack of blood vessels etc. A large filling is also never as strong as normal tooth structure, and once a tooth has been re-treated, it might be a good idea to crown the tooth, to prevent any fracture.
That being said-because this tooth has a history of a failed RCT first time round, I would consider delaying crown treatment until the re-treatment has shown some signs of success. A crown is very expensive.
If the access cavity is small enough, a new filling can be done at the end, and if the occlusion is adjusted so that the filling is not " in the bite ", it might last you a long while. As long as you remember to not chew something that is too hard on that side, since this could result in fracture.