How often are traditional crowns replaced with a post crown? Are dental implants a recommended alternative at that point?
When is a Post Crown Needed over a Traditional Crown?
Doctor Answers 7
Post and Core Under A Dental Corwn
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.
Post Crown vs. Traditional Crown
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.
Post and Core vs. Traditional Crown
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.
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When is an implant recommended over a post and crown?
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.
Post Crown Guidelines
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.
Posts are sometimes used in root canal treated teeth
Traditional crowns are used to protect teeth that are at risk of fracturing under normal function in the mouth. A traditional crown preparation reduces the size of the tooth 360 degrees around the circumference of the tooth and also shortens the tooth . This way there is room for the crown to cover the entire tooth and rebuild it to its original shape, strength and function.
A post / crown is done only on root canal treated teeth. The post is placed into the root canal to help retain the crown. It is used when there is not enough tooth structure left to retain the crown on its own. A small percentage of teeth that are prepared for crowns require root canal treatment at a later date (probably about 5 to 7 %) This means that 93 to 95% of the time a post crown won't be needed.
Dental implants are used to replace missing teeth. Unless the remaining tooth structure is severely compromised I would still opt to place a post and crown to restore the tooth.
Post and crowns vs. crowns without posts
After removal of decay, old fillings, old crowns, often a root canal is needed to remove the nerve and allow the tooth doc to place a "post and core" to rebuild create an adequate stump for the new crown to be cementetd upon.
This is not always needed. It all depends on how much healthy toot structure is left ABOVE the gum line.
The current policy is that if even if you have had the root canal and the post and core, BUT you do not have about 4mm of tooth left above the gumline, it is best to pull the tooth and replace it with an implant, abutment and crown which will last forever. Otherwise, you post, core and crown mayn no last more than 5 years (or less!!)