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Root Canals

Root canal filling or crown?

08/22/2006

Question:

I need a root canal, because my dentist drilled through my tooth when replacing a filling. This dentist told me I needed a crown since it`s a back tooth and will be weakened by the procedure and could break or crumble. It was upsetting to me to lose an entire tooth because of a small hole. When I got a second opinion, I was told that I could just get a filling- with this material called "Cerec". When I asked dentist #2 about dentist #1`s opinion that my tooth would break because it was weakened, he said, "regular teeth can break, too". Who should I believe????? Also, if I don`t get a crown, will my tooth become discolored over time?

Answer:

If you read some of the previous postings, you will see that crowns are recommended for posterior teeth that have had root canal treatment. There is indeed a larger risk of having the tooth crack if a crown is not placed. The Cerec system is used to make crowns as well as onlays (semi-crowns). These restorations are bonded to the tooth and are supposed to help strengthen the tooth. Unfortunately, I do not have the experience with these types of restorations to say whether or not they are as good as or superior to traditional crowns.
 
Discoloration of the back tooth could occur, but is less at risk than an anterior (front) tooth. Also the cosmetic impact is much less since very few people smile wide enough for someone to see if the back tooth is discolored. The greater concern is the potential for the tooth to fracture if it is not properly restored after the root canal treatment.

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University