Posts and Cores for Dental Crowns

If you have had a dental crown recently placed (particularly on a root canal treated tooth) you may have been surprised to learn that you needed a post or core placed in addition to the crown. These procedures allow us to maximize the strength of the natural enamel and add structure back to broken down teeth. In every instance, they are an integral part of the long term success of a crown. 

When teeth have root canals placed or deep cavities removed, they are left with a large hole in the center of the tooth or a missing wall of enamel. For a crown to be successfully cemented, the tooth has to have a fairly regular "teepee" shape. Any large holes or divots in the tooth prevent the lab from making a successful restoration.  A core is a bulk of material added to the tooth to provide strength and structure prior to finishing the crown. They are made from a variety of material, depending on the specific needs of the tooth and the plan for the final crown. Many times the endodontist will place the buildup themselves once the root canal is finished. 

When a tooth is missing multiple walls of enamel or lacks enough structure above the gumline (as is common with fractured teeth), a post may need to be placed in addition to a core. Posts are solid metal or composite rods that are cemented in the roots of root canal treated teeth. They extend upward and act as an anchor for the core buildup. Without a post, large cores are prone to failure and fracture. This causes huge headaches, particularly after the root canal and crown are completed. An important point to note is that posts can only be placed on root canal treated teeth, as it needs to be placed within the root system. In rare instances, a root canal may be performed on a healthy tooth so that a post can be placed.

We always try our best to notify patients of the potential need for a post and/or core prior to starting crown treatment. These procedures are not optional steps, but rather necessary precautions for the long term stability of the tooth. If you would like to know more about posts, cores, dental crowns or root canals, please give our office a call!

Recent changes to our Root Canal Policies

Our office recently changed our protocols on finishing root canal procedures done by endodontic specialists. These changes reflect the safest and most effective dental practices known today. As with all procedures carried out at Thousand Oaks Family Dentistry, we put your treatment, comfort and convenience first!

When a root canal is finished, you are essentially left with a tooth sans nerve tissue and a small opening at the top. This opening is a necessary part of the root canal procedure that allows the endodontist to reach the nerve tissue and roots. Unfortunately, it is also a major deterrent to the long term structural integrity of the tooth. In order to restore strength to the tooth, the opening needs to be sealed with a special filling material called a core and finished off with a dental crown. This core material chemically bonds to the enamel and protects against fractures and cracks. Many times, a device called a post will be added to the core to provide more rigidity when necessary. Posts extend partially down one root and create an additional structural anchor for the core to adhere to. 

Historically, the endodontists we work with would complete the root canal procedure and place a temporary filling into the opening (a "temporary core). This material does not actually bond to dental enamel and only serves to keep bacteria and food out of the inner tooth. It is very easy to remove, allowing for the quick re-access of a tooth if the first root canal was unsuccessful. Patients then had to return to our office, have the temporary filling removed and have a permanent restoration placed. Not only did this create a new opportunity for bacteria to invade the tooth, it caused our patients to spend days to weeks functioning with a severely weakened tooth. 

Currently, our endodontic specialists are placing permanent posts and cores at the time of root canal completion. This ensures the tooth is continuously sealed and structurally reinforced prior to crown placement. While immediately placing a permanent core can make re-accessing the tooth more difficult, the positives largely outweigh any negatives. Very few teeth end up needing immediate re-access, and the continued structural support of the tooth is a far more important factor in long term root canal success. 

If you would like to know more about root canals, posts, cores or any other dental procedures, please call our office. We are always happy and excited to walk you through any part of your dental treatment!