When is a Post Crown Needed over a Traditional Crown?

A post is typically needed in a tooth that has had an extensive amount of tooth structure affected.  A post can only be placed on teeth that have had previous root canal treatment.  Posts have been placed in teeth for  years , but I have shifted away from placing them in recent years in favor of implants.  Posts have been shown to put the tooth at risk of root fracture, especially it teeth that take a significant amount of force when chewing.  I feel the success rate goes up when dental implants are placed in a tooth that would require a post and core to save it.  If my tooth needed a post to save it, I would opt for the implant.  Hope this helps.    

A traditional crown covers and supports the remaining tooth structure after decay, old filling material and unsupported structure has been removed. 

A post/core and crown is used when a tooth has had root canal therapy.  In this instance, the tooth has been hollowed out and the post and core is needed to build up and provide a supportive base for the crown.

Whether a root canal is necessary for a relatively healthy tooth is dependent on how much natural structure of the tooth remains and how close the prepared surface is to the nerve chamber.  The patient's symptoms, if any, and the best judgment of the treating dentist will help guide this determination.

A post can be placed into the root of a tooth to provide support for a root canal treated tooth. The post is only needed when the amount of remaining healthy tooth is unable to support the filling material (called a core build up) that is placed to prepare the tooth for the crown. Not every root canal treated tooth will require a post where enough tooth is left after the root canal to support the core build up.

A traditional crown is used to treat a tooth that does not require a root canal, after the build up the tooth is prepared for the crown. Teeth that are treated by this method are not as compromised as teeth that require root canal treatment or posts.

The trend over the past ten years has changed. I will recommend that a patient have an implant placed over the choice of post and crown. It depends on many factors such as 1. How much tooth is remaining? 2. what it the bite in the area of concern? and 3. the long term prognosis of the tooth. I find many times today that an implant is more predictable than a post and crown. I hope this helps with your decision.

Posts are used in teeth that have had root canal therapy and where inadequate tooth structure remains to do a traditional build up (using the existing tooth structure) and crown.  Posts can help rebuild a tooth and provide a foundation for a crown and long term success.  But anytime a post is placed into a root and loaded, there is a chance of future root fracture.  Prior to implants becoming very predictable and successful, we had no alternative other than extraction.  If restorting the tooth with a post is going to be an heroic effort, definitely go with the implant assuming adequate bone exists for a successful implant.  If substantial tooth structure exists, definitely do the crown.