Fracture during Crown Preparation

[sammyhkhan]

Hiyya folks,

The two pre-molars in my upper left jaw have undergone RCT. Both of the teeth have large fillings (70-80%) and have not been crowned. One RCT was done approximately 7 years ago and the tooth restored using amalgam, whereas the other RCT was done approximately 2 years ago and the tooth restored using white composite.

My dentist has recommended that both teeth be crowned as soon as possible. I agree with him… However, he has warned me of the high risk that the teeth may fracture during crown preparation and that they ultimately may have to be extracted. I am extremely worried about this outcome.

Could anyone comment upon the risk of fracture during crown preparation for root canalled teeth? How high are the risks and how are they best minimised?

Much appreciated!

Sam

 

[comfortdentist]

Risks are much higher with no treatment.

 

[sammyhkhan]

I am also curious to hear about people's (particularly dentist's) thoughts about the extent to which a dentist's experience matters when it comes to fracturing a tooth during crown preparation...

 

[rob wain]

Comfort dentist is correct that there is a high risk of fracture of the teeth if they're left alone.
The problem with a crown is that it requires drilling away more of the remaining tooth which makes it even weaker - this is why the dentist is warning of the risk of fracture during treatment.
In the past the best solution was a gold 3/4 crown which was often a very successful treatment but didnt look very good.
Nowadays I would try and use a porcelain onlay solution and try and preserve as much tooth as possible. The design depends upon the situation though.
Does experience matter? yes, it matters with most dental procedures and your treatment is technically demanding. It is reassuring though that your dentist has recognised and warned you of the risk of a breakage - that suggests they have experience