Post and Crown or Dental Implant? Which is More Suitable for Root-Canalled Teeth?

According to the Australian Dental Association (ADA), 65 percent of Australians have not been to the dentist in over 2 years. Australians are also more likely to visit their dentist when a specific dental issue arises rather than for a dental checkup. Because of this, minor dental issues such as early decay, tartar build-up, and slight wear and tear worsen until teeth decline to the point of needing root canal therapy.

Once a tooth becomes infected, the only cure is the removal (root canal therapy) of the infected tissue, effectively rendering a tooth lifeless. However, lifeless does not mean lost. The tooth can still be restored. However, while keeping natural teeth should always be a priority, when a tooth is severely damaged, replacement with a dental implant becomes the obvious solution.

But as a patient, you might wonder if it wouldn't be better to simply restore the tooth with a post and crown. It depends on the situation.

The More Natural Tooth, the Stronger the Crown

Severely decayed or broken teeth that have very little remaining structure above the gum line can be crowned, however, the risk of failure is greater than that in teeth with more natural structure remaining. Failure can occur for several reasons:

  • Damaged root canal: If the root canal treatment weakened the root canal the post is placed in, the root could fracture leading to failure of the post and crown.
  • Decay under crown: Bacteria can find their way under a crown and cause tooth decay. This is especially true is the crown extends below the gum line.
  • Lack of support: If all surfaces of a tooth, mesial, lingual, buccal, and distal have decayed leaving only tooth structure below the gum line, the crown will only be supported by composite resin and the thin post. The chance of failure is increased.
  • Cleaning difficulty: If the crown extends below the gum line, cleaning that area will be difficult. This may lead to a build-up of tartar, which contains bacteria that erode teeth, and cause the crown to fail.

However, as already mentioned, the more remaining tooth structure, the more reliable the post and crown. If all 4 sides of the tooth are intact, and only the occlusal (chewing) surface is severely decayed, then a post and crown will stand a much higher chance of success. In this case, as long as the gum tissue is healthy, a post and crown may be the better option.

A Dental Implant is Better if Little Tooth Remains

In terms of life expectancy, a well-placed, well-taken care of dental crown and post can last up to 15 years. However, when little tooth structure remains, a crown can fail in 1-3 years should it be on a tooth that comes under regular chewing pressure. A dental implant is clearly the best option when a tooth is so severely damaged that no tooth structure remains above the gum line.

Not only does a dental implant lock into the bone, and even promote bone growth, but there is also no chance of decay occurring on or around it. Even if the dental crown that is part of a dental implant fails through wear and tear, it can easily be replaced with another. If a patient practices good oral hygiene, a dental implant can last many years, even a lifetime.

Although dental implants are not indestructible, they are more reliable than posts and crowns--if all or most of a natural tooth is gone. However, whatever you and your dentist decide, you must do your part to ensure the longevity of the restoration or replacement by cleaning and caring for your teeth. Otherwise, you increase the risk of failure, and the need for more dental treatment