Excuse the gore picture... Did it scare you yet? Just kidding.
But this is an actual scene where the tooth and old dental filling fractured because it stayed without a crown for a while.
The major reason why we recommend a crown after a root canal treatment (RCT), most especially if there is not enough natural tooth structure left, is because of the possibility of a fracture. Imagine just sticking a humongous piece of a hard material using glue without other mechanical retention. It is bound to come off and may even push thin tooth parts that are left to fracture.
In the case I just posted, unfortunately, we had to cut the gums and bone already because there is a minimum requirement of tooth structure that should be present outside the gums for us to be able to successfully install a crown. If a crown was done sooner, we could have skipped the surgery part because the fractured part went all the way below the gum line.
Another reason to get a crown after RCT is the possibility of leakage. Your tooth dries up after the removal of your pulp (nerve and blood vessels), there will be no more nourishment and ideal moisture left in the tooth that usually helps with the retention or sticking of the dental filling. Without proper seal plus mechanical retention of the dental filling with the tooth, there will be micro spaces that may be present and decay bacteria may seep through and cause recurrence of the dental decay. This recurrent decay spreads faster because this decay is found in between filling and tooth where your toothbrush won't reach.
You might ask, how long can I keep a root canal-treated tooth without a crown? My answer is it really depends. We have to weigh how you bite, your diet, the number of teeth present in your mouth, and the bulk of natural structures left on that tooth, in short, we won't be able to give you an exact length of time because it really varies from one patient to another; from one case to another. We will need to live with you and monitor your habits for at least 1 whole week to be able to give you a close estimate at least. And we still cannot even promise a 100% accuracy of the estimate. The reason is that if we recommend that you get a crown, as much as possible, we recommend having it done right after your root canal treatment just so we can prevent possible disasters.
But is it worth it to get a root canal treatment and crown instead of just having it extracted? Definitely. When you have your tooth extracted, a series of problems with the remaining teeth and bone automatically arise. From shifting or moving of other teeth into the space left by the extracted tooth to resorption of the bone that causes tooth sensitivity to neighbouring teeth left. So yes, it's cheaper to have a root canal treatment in the long run.
So, now let's go to crown materials. There are tons of crown materials available now but the most popular today is a Zirconia, the same material used in the picture on this blog post. Zirconia is a metal that has high strength and is tooth-colored, the reason why it is so popular today. Even I would get this if I were to crown my back tooth. It can last more than 10 years as long as it is properly done, maintained, and your teeth are in an ideal bite.
There are also a few instances that I personally don't recommend a crown, very seldom though. Usually, if there is at least 70% tooth crown (top part of the tooth) structure left after total removal of decay. But usually, root canal treatment happens because decay is too big already that it has reached a point that an ordinary filling is not enough and decay has spread deep within to reach the pulp or the nerves and blood vessels of your tooth.
So to summarize, the crowning of the tooth is a treatment that shouts, "better safe than sorry."
I hope you learned and enjoyed this as much as I did doing the case and writing this blog. I try to make the explanation as simple as I could for the general public to be able to enjoy and understand it too, if there are certain areas that still confuse you or you want a deeper understanding, you may email me at dr.rafaelle@gmail.com. If you have questions regarding your personal case, I am more than happy to give you a consultation, just book an appointment with us via email, SMS (+639778130101), or through this link: Book an Appointment.
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