When a Vital Tooth Has an Old Crown

فارسی

A patient presented with crowns on all of their teeth. According to the history, the crowns had been placed by a non-dentist. Their quality was unsatisfactory, and they were to be replaced. As a result, teeth that had already been prepared would be reopened and refined for new crowns.

In this situation, we do not look only at the pulp’s current status; the tooth’s history matters too. A stressed pulp is a pulp that has repeatedly been exposed to insults such as caries, restorations, and tooth preparation and, despite remaining vital, may have a reduced capacity to respond and repair. If the earlier preparation was not conservative and did not prioritize preservation of tooth structure, the likelihood of cumulative pulpal injury may be greater. Now that the teeth are to undergo extensive prosthetic treatment again, this additional preparation may be another insult to a pulp that was already under stress.

Considering the previous treatment history and the need to revise the teeth again, I decided to perform root canal treatment before starting the new restorations. The crowns would then be made separately, as far as each tooth’s condition allows.

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