Root filled teeth are usually badly decayed or broken down even before root canal treatment; however, they are unavoidably and inevitably still further weakened by root canal preparation.

Not surprisingly therefore, these teeth are extremely vulnerable to biting forces and may crack or break if left un-restored.

Conventional wisdom dictates that most of these teeth should be strengthened and reinforced by means of crowns or other forms of laboratory made restoration which covers the entire biting surface of the tooth. (See also crowns.)

Where a root treated tooth is extremely broken down, there may also be a need to provide a post and core in order to retain the restoration. The post fits into the root canal, and the core forms a foundation for the crown.

Despite all this attention, a heavily restored, root filled tooth may still fracture, and when this happens the tooth would frequently be beyond salvage despite all efforts.

This situation sometimes presents us with a dilemma. Crowning a root filled tooth may sometimes seem to be a ‘dramatic’ step to take, but then fracture of the tooth is usually such a catastrophic event that on balance the patient is usually better off with a crown than a fracture!

Despite this, there will still be occasions when a decision is made to avoid crowning a tooth, accepting that the loss of the tooth, and subsequent restoration with an implant would be a reasonable worst case treatment in the event of fracture.