Why (or-is) putting crowns on teeth which almost require root canal, is no longer done?

Discussion in 'Endodontics' started by babyag, Jun 11, 2018.

  1. babyag


    Jun 11, 2018
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    I would like to ask about a technique that was practiced in the past and why was it dismissed in the present.

    Once upon a time (20 years ago) it was popular (at least in my country) that in borderline cases where the tooth is almost in a need of a root canal (the pulp was not infected, yet, but a filling was unfeasible for some reason) the dentist would glue a crown on the tooth and leave it as such. Usually it would hold for 10-20 years before the tooth would actually require a root canal.

    Nowadays my dentist says that this technique is obsolete and in borderline cases you just perform a root canal (his reasoning on the matter was "Because that's what we do now").

    If someone could explain as to why is it so it would be be truly a tremendous help.

    Thank you very much!
    babyag, Jun 11, 2018
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  2. babyag

    MattKW Verified Dentist

    Mar 18, 2018
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    If molar teeth start cracking cusps, there comes a point where more fillings won't have anything to hold onto. Personally, I draw the line at 2 broken cusps. Then, it is recommended to do a crown while there is still some natural tooth to encircle. If you wait for all the cusps to fracture, then a crown is of doubtful usefulness. Which is similar to what you are saying for "borderline cases". This hasn't change. All procedures cause damage to the tooth, so although a crown can physically strengthen the tooth, it also causes damage to the nerve and in ~10% of cases the nerve will die. Now you have to do an RCT through the crown - a pain in many ways, and patients don't always understand this risk.
    Unfortunately i have heard of some dentists who simply do the RCT before a crown. There are various reasons you could speculate as to why, but one might be that it avoids the risk of post-op crown pain, and an RCT for a patient who doesn't like a hole drilled through their crown.
    MattKW, Jun 12, 2018
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