Can a Zirconia Crown with a Live Tooth Have a Root Canal Without Needing to Replace the Crown?

Root canal procedures are done through a zirconia crown usually without any complications. 

 

Sometimes the crown might de-bond or fracture, but it doesn't happen often, and if it does you will need a new crown.

 

After the root canal is completed, make sure it is sealed up properly.

It is definitely possible to drill through a Zirconia Crown in order to accomplish a root canal treatment.  If done correctly, you would not need to replace the crown.  However, after drilling through a Zirconia crown, it is difficult to make the crown look as it did before making a hole in it.  Some patients opt for having a new crown placed because they don't like the appearance afterwards.  If the crown fractures while drilling through it, it will become compromised and will need to be replaced.

Yes. A root canal can be done under a Zirconium crown. You have to drill a small whole (called access opening) thru the chewing surface of the crown. Very difficult to drill thru zirconia. There are some some special drill bits on the market just for zirconia. If you use a lot of water in the process, the integrity of the crown is not markedly compromised and you can put a filling to cover the hole without having to redo the crown.

But if for any reasons in the process of doing the root canal you need a large access opening, then I would recommend having thd crown redone.