How long do root canals with crowns last?

Root canals with crowns can last many years if properly cared for. The success and longevity of a root canal with a crown depends on several factors including the health of the tooth and surrounding bone, the quality of the root canal treatment, the type of crown placed, and the patient’s oral hygiene.

Quick answers

  • With proper care, a root canal and crown can last 10-15 years or longer.
  • Factors that influence longevity include tooth and bone health, root canal quality, crown type, and oral hygiene.
  • Porcelain fused to metal crowns tend to have greater longevity than all-ceramic crowns.
  • Proper brushing, flossing, regular dental cleanings and checkups help maintain the tooth and crown.
  • Crowns may need to be replaced if they become damaged or decay forms under the crown.

What is a root canal?

A root canal is a treatment for an infected or severely damaged tooth. During a root canal, the pulp tissue inside the tooth is removed and the root canals are cleaned, shaped, and sealed. A crown is then placed over the tooth to protect and restore it.

The pulp contains nerves, blood vessels, and connective tissue. It can become infected, often due to deep decay, cracks or chips in the tooth, or trauma. Without treatment, the infection can spread to the bone around the tooth and cause a dental abscess. A root canal removes the infected pulp, cleans the canals, and seals the tooth to prevent further infection.

Why is a crown needed after a root canal?

A crown is recommended after a root canal because the procedure removes tooth structure and weakens the remaining tooth. The crown covers and protects the tooth, helping prevent fracture or cracking. It restores the tooth’s natural shape, size, and function.

A root canal treated tooth is more brittle and prone to fracture without a crown. The crown distributes chewing forces evenly over the tooth and protects it from fracture. It also improves the tooth’s appearance, covering any discoloration or damage.

How long do root canal treated teeth with crowns last?

With proper oral hygiene and regular dental care, a root canal treated tooth with a crown can last 10-15 years or longer. Some can last a lifetime. However, there are many factors that affect the longevity.

Factors affecting longevity

Some key factors that influence how long a root canal and crown will last include:

  • Health of tooth and bone: Teeth with extensive decay or fractures or those with decreased bone support are less likely to benefit long-term from root canal treatment. The success rate is higher in teeth with relatively good bone support.
  • Quality of root canal: The skill of the dentist performing the root canal and the sealing of the canal affect prognosis. Complete cleaning and sealing provides better results.
  • Type of crown: Crowns made of porcelain fused to metal generally have greater longevity than all-ceramic crowns.
  • Oral hygiene: Poor oral hygiene increases the risk of new decay or infection around the root canal treated tooth and crown, decreasing longevity.
  • Regular dental visits:Regular cleanings, exams, and x-rays help detect problems early to maintain the tooth and crown.
  • Occlusion: Issues with bite alignment or forces can lead to fracture or damage. This may require adjustment or orthodontic treatment.
  • Parafunctional habits: Clenching, grinding, chewing on hard objects, or other habits can increase wear or breakage.

Success rates

The reported success rates for root canal treated teeth lasting at least 5 years range from 86% to 97%. However, many can last 10-15 years or longer with the right conditions. Here are some general estimates on how long root canals with crowns can last:

  • With poor bone support, complex root canal, poor oral hygiene: 5-7 years
  • With good bone support, straightforward root canal, fair oral hygiene: 7-10 years
  • With excellent bone support, high quality root canal, very good oral hygiene: 10-15+ years

These are general estimates only. Some teeth may exceed or fall short of these time frames based on individual factors.

Signs a root canal and crown may need replacement

Some signs that a root canal treated tooth with a crown may require intervention include:

  • Tooth fracture – Cracks or fractures indicate the tooth structure is failing.
  • Loose crown – This suggests poor integrity of the underlying tooth or bonding failure.
  • Tooth pain or sensitivity – This can signal a new infection or inflammation at the root tip.
  • Gum swelling or abscess – Infection may be present at the root.
  • Darkening discoloration – This can occur from leakage or internal bleeding.
  • New decay – Decay around the crown margins may require repair or replacement.
  • Worn crown – Excessive wear, chipping, or poor margins may necessitate a new crown.

At regular dental exams, the dentist will check the root canal treated tooth and crown for any concerning signs. X-rays may also be taken periodically to assess bone levels and the condition at the root.

Improving longevity of root canal treated teeth

To help a root canal and crown last as long as possible, it is essential to maintain excellent oral hygiene and follow your dentist’s recommendations. Key tips include:

  • Brush twice daily – Thoroughly brushing helps prevent decay around the crown margins.
  • Floss daily – Flossing removes plaque from below the gumline near the crown.
  • Use antibacterial rinse – Rinsing with an antibacterial mouthwash helps reduce bacteria.
  • Avoid hard foods – Limit very hard, sticky, or chewy foods to prevent crown damage or tooth fracture.
  • Wear a nightguard if needed – If you grind your teeth, wear a nightguard to prevent excess stress on the tooth.
  • Get regular dental exams – Regular cleanings, x-rays, and exams detect problems early.
  • Don’t delay needed treatment – Address any new decay, pain, or other issues promptly.

Following your dentist’s home care instructions and being vigilant with oral hygiene is key for getting the maximum longevity from your root canal and crown.

Types of crowns

There are several types of crowns that may be placed on a root canal treated tooth. The most common options include:

  • Porcelain fused to metal: A metal core fused to a porcelain outer layer. Very strong and durable.
  • All-ceramic: Made entirely of ceramic materials. Appearance is very natural.
  • Gold: Made from gold alloy. Less common but very durable.
  • Porcelain fused to zirconia: Zirconia inner core with porcelain outer layer. Strong and natural looking.
  • Stainless steel: Made from stainless steel. Used for front primary teeth.
  • Temporary acrylic: Short term crown placed during crown fabrication.

Porcelain fused to metal and all-ceramic crowns are the most common options placed on root canal treated back teeth. Your dentist will recommend the best type of crown based on factors like location, aesthetics, and cost.

Porcelain fused to metal crowns

This type fuses a metal core to an outer porcelain layer that mimics natural tooth color. The metal provides strength, while the porcelain gives a natural appearance. This combination offers excellent durability and survival rates.

Studies show porcelain fused to metal crowns have a 94% 8-year survival probability when placed on root canal treated molars. With proper home care, they may last 10-15 years or longer.

All-ceramic crowns

These crowns are fabricated entirely from ceramic materials like zirconia or lithium disilicate. They offer exceptional aesthetics with a natural tooth appearance. However, they have less longevity than metal-ceramic crowns.

The 10-year survival rate may be lower, with more fractures over time. However, newer stronger ceramics continue to improve longevity. With proper care, all-ceramic crowns can still last 10-15 years.

Gold crowns

Gold crowns are made from a gold alloy. While not as common today, they are extremely durable and fracture-resistant. The 10-year survival rate is comparable to porcelain-fused-to-metal crowns.

The main disadvantage is aesthetics – they show as a silver/gold color. However, they remain one of the longest lasting crown options for posterior root canal treated teeth.

When replacement is needed

There are several reasons why a new crown may be needed on a root canal treated tooth:

  • The crown becomes damaged or fractured.
  • Decay forms under the crown margins.
  • The crown becomes loose, de-cemented, or unattached from the tooth.
  • There are recurrent infections or pain indicating root canal failure.
  • The bite alignment changes (due to grinding or shifting teeth).
  • There is excessive wear, chipping, or poor marginal integrity.
  • For aesthetic reasons – to improve appearance.

During exams, your dentist will check the condition of your root canal crowned tooth, looking for any signs a new crown is needed. If decay, fracture, or failure occurs, a new crown can often be placed without having to redo the root canal. An x-ray may be taken to check bone levels and the roots.

Root canal retreatment considerations

If a root canal fails and becomes reinfected, nonsurgical retreatment may be done to clean and re-seal the canals. However, the long-term prognosis is lower compared to initial treatment. Factors like extensive decay, fractures, or decreased bone support may indicate extraction vs retreatment.

The reported tooth survival rates after nonsurgical root canal retreatment range from 68% to 89% at 5-10 years. Many teeth will require extraction or apicoectomy later. With retreatment, a new crown is typically placed after the procedure is complete.

Apicoectomy considerations

If retreatment is not feasible or fails, an apicoectomy may be considered. This is a microsurgery that removes the root tip and seals the end of the tooth. Success rates range from 59% to 89% at 1-4 years.

Long-term data over 10+ years is limited. An apicoectomy allows the root canal treated tooth to be retained and used longer but is not a permanent solution. A new crown is usually placed after the apicoectomy heals.

Extraction considerations

If a root canal fails or fracture occurs, extraction may be inevitable. Extensive decay, severe bone loss, fractured roots, or failed previous treatment may indicate that attempting retreatment or apicoectomy will not have good long-term prognosis.

Extraction should not be feared. Dental implants offer an excellent option to replace the lost tooth and restore chewing function. Implant supported crowns have high success and survival rates of 95-97% at 10 years.

Final crown and bridge options

When a root canal and crown ultimately reach the end of their lifespan, there are several options to replace the lost tooth and restore your smile:

  • Dental implant: An artificial root fused to the jawbone that supports a realistic replacement crown.
  • Bridge: Adjacent teeth are crowned and an artificial tooth is fixed between them.
  • Removable partial denture: A removable appliance with artificial teeth.
  • No replacement: If posterior with minimal aesthetic concerns.

Dental implants offer the best long-term solution for replacing a failed root canal treated tooth. While more invasive and costly upfront, their longevity and maintenance are superior to bridges.

Root canal and crown FAQs

Can a crown be placed without a root canal?

It depends. If the tooth pulp is healthy, a crown can be placed for protection without needing a root canal first. However, if the pulp is inflamed, infected, or necrotic, a root canal is required before placing a permanent crown.

Is a root canal without a crown ok?

A root canal without a crown is ill-advised. The tooth becomes brittle and prone to fracture. A temporary filling also leaves the tooth vulnerable to reinfection. Placing a crown protects the tooth from further damage.

Can a crown be placed right after a root canal?

It is preferable to wait until the root canal is fully healed before placing a permanent crown, usually a couple weeks. A temporary crown can be placed in the meantime. Placing a permanent crown too soon risks failure if an infection flares up.

Is a root canal necessary with a crown?

It depends on the health of the tooth pulp. If the pulp is healthy, a crown can be cemented without a root canal. However, if the pulp is inflamed, infected, or shows irreversible damage, a root canal is required for long-term success.

Summary

  • With good oral hygiene and regular care, root canals with crowns can last 10-15 years or longer.
  • Tooth and bone health, root canal quality, crown type, and hygiene affect longevity.
  • Signs a new crown may be needed include fracture, decay, loosening, or damage.
  • Implants are an excellent option to replace failed root canal treated teeth.
  • Maintaining the tooth and crown with proper hygiene and care gives the best prognosis.

Root canals and crowns can provide many years of continued use for a tooth that would otherwise require extraction. With diligent home care and checkups, you can maximize the lifespan of your restored tooth.

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