Question:
I've recently had a root canal performed. I am scheduled for an appointment
with my dentist to get a crown done.
I was told by the dentist that a "post" would be put in for support. Now,
based on the literature that I got from the Endodontist, it says that a post
is required only if there was structural damage to the tooth. There was no
major damage to the tooth or root as displayed by the XRays prior to the RC.
My dentist also says that a crown can be put in without the post.
I'm confused with this conflicting information. What are the
benefits/disadvantages of the post. The endodontist did not put in a "post
base" as part of the procedure so this will have to be perfrmed by the
dentist presumably. I'd like to avoid this extra procedure and cost unless
its really required.
Answer:
There are differing schools of thought on this. At one time it was pretty
automatic that a post was placed following root canal. I still see cases
where someone has root canal, and the dentist will cut away sound tooth to
force in a post. My opinion at present, and what I do, is place a post when
I need it to help hold the crown on. If a tooth is badly broken down, and is
relatively flat, a post is needed to allow for retention of a build up that
will in turn help retain the crown. If the tooth is largely intact, I don't
necessarily place a post.
If you are uncertain why or if a post should be placed, ask your dentist to
explain his rationale.
The only major loss of tooth in my case was through the RC procedure itself
since there was only some decay at the root base - no fractured tooth etc.
The dentist indicated that the root canal process itself causes some
breakdown and that requires the post. Is there a serious risk of tooth
fracture without the post?
There is some loss of tooth structure during the process of gaining access
to the nerve chamber, as well as some minimal loss of tooth during the
preparation of the canal space.
Once again, with regard to your last question, there are differing schools
of thought. Some contend the post does add strength to a tooth weakened by
it's loss of blood supply and the instrumentation that is part of the root
canal treatment. Others will say that the loss of tooth strength due to the
fact the nerve and accompanying blood supply are removed during root canal
treatment causes little or no weakening of the tooth and the tooth is
therefore no more likely to fracture than it was before the procedure was
completed. I tend to fall into the latter line of thinking, and as I said in
my first post, tend to use posts for retentive rather than fracture
resistance purposes.
I would simply ask your dentist, who has actually seen the tooth and the
extent of breakdown, and would be best able to judge if a post is or is not
called for.
I might add that dentists are also using many more "fiber posts" when
posts are indicated instead of Titianium or stainless steel. They are
supposed to have a little more flex and be less likely to cause a root fracture.
