It is to be done in cavities where pulp is exposed ether as a result cavity in tooth/ accident where tooth got fractured and the disease moves to the apex of the root. It causes severe pain and swelling which is due to inflamed tissue or pus locked in a narrow space causing the tooth to rise in the Occlusal cavity thereby producing tenderness to percussion .In such a case the tooth access is done by drilling under local anesthesia and the pus and infected pulp is removed. The root canals are cleaned of all the debris and the walls are filed so that the there are minimal bacteria in the canals. Once the root canals are disinfected by irrigants, they are dried, and then sealed with a suitable material like Gutta Percha.
The pulp chamber is filled with suitable cements and the access cavity closed with composite resins. The tooth structure is usually weakened as a result of the disease and the root canal treatment .So It MUST be covered with crown after root canal treatment. It could be a simple metal alloy or Porcelain fused to metal alloy for better aesthetics. Strength wise all crowns are good, whereas retention depends upon the skill of the dentist.
If the length of the crown is short then crown lengthening procedure might be done. The other way to enhance the retention is to put a post in the root canal after the RCT. This aids in the retention of the tooth especially where the length of the crown is compromised.
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