When to crown canine?

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rocknightmare

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hey guys,

One of my patients needed a root canal on her upper canine due to a carious lesion on the distal of the tooth, a fairly large lesion. now the root canal is completed I am trying to determine if there is a case for crowning the tooth vs not crowning.. (just putting a composite restoration). from the literature that our faculty have provided us -- it seems questionable if there is any need to crown it.. (post teeth we should crown due to high occlusal forces, anterior teeth aren't exposed to this amount of forces thus there doesn't seem to be a reason.. ))

any information would be helpful and backing up with references would be appreciated....

let the games begin ;)

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Is she in canine guidance or group function? Does she have a bruxism habit? If she is in canine guidance for excursive movements, I would say there is a great deal of force the canine must endure and I would believe a post and core would be indicated + a crown.
 
Is she in canine guidance or group function? Does she have a bruxism habit? If she is in canine guidance for excursive movements, I would say there is a great deal of force the canine must endure and I would believe a post and core would be indicated + a crown.

Im sorry to sound ignorant but I've alays thought canine guidance and group function are independent from each other, though both occlusal schemes pertains to excursive movements of the mandible.
 
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Im sorry to sound ignorant but I've alays thought canine guidance and group function are independent from each other, though both occlusal schemes pertains to excursive movements of the mandible.

Canine guidance and group function ARE independent from each other. They are two different types of occlusal schemes. That was the point I am trying to make. In canine guidance (aka "canine protected occlusion"), the canines take the posterior teeth out of occlusion on excursive movements...ie all of the forces are solely on the canines. In group function, the canines don't take the posterior teeth out of occlusion in working movements because they are too small or have been worn down by attrition. In group function, all posterior teeth on the working side, along with the canines, are in contact, thus spreading the forces over several teeth, not just the canines.
 
Is she in canine guidance or group function? Does she have a bruxism habit? If she is in canine guidance for excursive movements, I would say there is a great deal of force the canine must endure and I would believe a post and core would be indicated + a crown.

Post and core does not strengthen a tooth (go ask your restorative professor if you dont believe me). Ask yourself when you ever slide on youir canines? chewing does not involve any type of guidance, guidance is needed during parafunction. If she bruxes, make her a biteguard. Otherwise, unless there is a severe amount of unsupported enamel full coverage is likely not indicated.
 
endless summer said:
Is she in canine guidance or group function? Does she have a bruxism habit? If she is in canine guidance for excursive movements, I would say there is a great deal of force the canine must endure and I would believe a post and core would be indicated + a crown.
It's impossible to say for sure without photos +/- films, but like OceanDMD said, it may well be reasonable to restore the tooth directly, and it certainly doesn't sound to me like a post & core is indicated here. Even if the OP does elect to crown the tooth, a directly placed build-up would be preferred if the remaining tooth allows it.

Posts & cores are frequently necessary, but they do not strengthen teeth (again like Ocean said), done improperly they can significantly predispose teeth to nonrestorable fractures, and they introduce another element of complexity and potential prosthetic failure--especially in cases where, like this one, the tooth will be subjected to significant lateral forces.
 
Canine guidance and group function ARE independent from each other. They are two different types of occlusal schemes. That was the point I am trying to make. In canine guidance (aka "canine protected occlusion"), the canines take the posterior teeth out of occlusion on excursive movements...ie all of the forces are solely on the canines. In group function, the canines don't take the posterior teeth out of occlusion in working movements because they are too small or have been worn down by attrition. In group function, all posterior teeth on the working side, along with the canines, are in contact, thus spreading the forces over several teeth, not just the canines.

Uhm that was what i was thinking also, so why would identifying between the two matter, since both occlusal schemes occur. I thought you meant the patient was either in canine guidance or group function.
 
Uhm that was what i was thinking also, so why would identifying between the two matter, since both occlusal schemes occur. I thought you meant the patient was either in canine guidance or group function.

Go back and read my post. Canine guidance or group function have NOTHING TO DO WITH CROWNING A TOOTH. Go chew a piece a gum and tell me how many times you ride up the lingual surface of your maxillary canines. You don't. Its BS taught in dental school. If the patient grinds nocturnallly, then an orthotic or bite guard is indicated to treat the grinding.
 
Go back and read my post. Canine guidance or group function have NOTHING TO DO WITH CROWNING A TOOTH. Go chew a piece a gum and tell me how many times you ride up the lingual surface of your maxillary canines. You don't. Its BS taught in dental school. If the patient grinds nocturnallly, then an orthotic or bite guard is indicated to treat the grinding.

I was appalled that you would insinuate that what I was being taught in dental school wasn't gospel. So I have now obtained a stick of chewing gum and have begun chewing....Holy crap...you shaken my whole dental foundation...:scared:
 
Hey,

One of my patients is in the exact same situation-I just finished RCT on tooth #11. After caries removal, because of significant lost of tooth structure, a post/core/crown is indicated.

From my understanding, crowning vs. not crowning depends on how much tooth structure is left. In my case, basically the mesial half of the tooth is gone.
 
totally depends on remaining tooth structure. post and core only support the crown . If all you have is a small access opening, without seeing any photos, I don't see why you would need a post and core. but no one here can really say one way or another without quite a bit more information
 
well in my case even if i were to crown it.. i won't need a post and core i think i can get enough retention from remaining tooth structure to place a crown.
 
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