Is a crown really needed for a root canalled molar (which did not have any cavities) ?

[augmentin123]

Is a crown really needed for a root canalled molar (which did not have any cavities) ?

Hi - I got a RCT done on number 47 (second right mandibular molar) around 6 months back .. it has a permanent composite filling on the access opening since then. Now I am planning to get it crowned.

My question is that whether a crown is mandatory if the nerve had been infected due to a perio problem and not due to a cavity in the tooth? (there were never any cavities on the tooth in question here)

Also, for molars, is Zirconia the best option for crown?

Many thanks .. awaiting a quick response from the expert dentists here

 

[rob wain]

Re: Is a crown really needed for a root canalled molar (which did not have any cavities) ?

If it were my tooth I would hope not to crown it and certainly not with zirconia
An onlay would be better and if the access cavity was small then a filling may be fine

 

[augmentin123]

Re: Is a crown really needed for a root canalled molar (which did not have any cavities) ?

If it were my tooth I would hope not to crown it and certainly not with zirconia
An onlay would be better and if the access cavity was small then a filling may be fine

Thanks for the response Dr Rob

I spoke to two prosthodontists here ( I am in India) .. and both say that onlay may work but can be risky in the long run. Here somehow most dentists follow the conservative approach and say that for a second molar ,crown is the recommended option regardless of how much tooth structure is still left

My main concern is that I dont want good tooth structure to be removed in order to accommodate the crown (since there were no cavities originally on this tooth and the RCT was done due to a primary perio and secondary endo problem I was told)

What would you suggest.. should I insist for an onlay ?

 

[rob wain]

Re: Is a crown really needed for a root canalled molar (which did not have any cavities) ?

the conservative traditional approach would be a gold onlay. i would prefer this rather than a crown if possible

 

[Dr. Daniel]

Re: Is a crown really needed for a root canalled molar (which did not have any cavities) ?

Hi,

It is difficult to advise without knowing more about the tooth's clinical situation.
The question is how much healthy tooth structure is remained after the root canal treatment.
Max scenario: the tooth was intact (not even a filling in it), so after the RCT a filling should be enough.
Min scenario: hardly any enamel is left after the RCT, than has to come a build up and a crown.
medium scenario: the tooth had a filling before the RCT and then an onlay is very reasonable.