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Need a crown? - 4 year follow up
From: Marino Sutedjo
To: ROOTS
Sent: Tuesday, July 01, 2008 8:05 AM
Subject: [roots] 4 years follow up
This 13 yrs old boy came to my clinic on 2004 regarding treatment on his first lower right molar.
4 years after I've met again and follow up his treatment. Do you think this tooth need a crown ??
- Marino Sutedjo
Statistically, 5 year survival rate for an endo tooth without a crown is less than 50% .
personally, I would crown that tooth - gary
I would crown that tooth. I think that you've made too much progress to leave it to chance and
end up with a fracture which would more than likely lead to an extraction. - Bettie
Hey Gary Where did u get that stat from....is it from your observation or is it evidence based
Dont get me wrong...I do crown my endo's if indicated but that number seemed
a little too high for my liking. - Regards YASH
I just make this stuff up to entertain folks. There are several studies discussing this,
especially on posterior teeth. Here is one I found quickly.- gary
Hi, The only thing is that this study did not differentiate between direct restoration with or
without cuspal coverage and they did mention this in their discussion too. Unfortunately,
as far as I am aware, there are no papers comparing survival of endodontically treated teeth
with full coverage crowns and cuspal overlay restorations. Although one might be able to
extrapolate from lab studies such as Reeh and Messer 1989 which found that the stiffness/load
to fracture of endodontically treated teeth with a gold onlay was significantly higher than
that of an unaltered tooth.
A crown would certainly be the reasonable restorative option for this tooth, but I wonder
in some cases due to the severely compromised amount of remaining tooth structure if it
would not be better to conserve tooth structure by placing an onlay of some sort -
whether direct or indirect rather than removing more tooth structure for the crown preparation.
What are people's thoughts on this? Regards, - Vivian
As long as you hood the cusps the results will be the same. - gary
"hood" the cusps? down here we were taught to "shoe" 'em. --grin - Kendel
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