On the pre operative X Ray, this asymptomatic tooth looks badly worn and its root canal is calcified, still, this tooth periodontal status is good and its crown to root ratio would still be acceptable even after having performed a potential crown lengthening procedure. Casted post bevelled margin preparation will include 2mm of preparation length on solid tooth to ensure an adequate length of parallel wall to achieve an effective ferrule.
In this case overall outcome success mostly relied on an intricate root canal procedure outcome. Dental operating microscope has been most helpful when attempting to locate this narrow root canal entry and thus, played a key role in helping preserving this natural tooth. Being able to perform a root canal in this case allowed the patient to preserve its tooth instead of extracting it and replacing it with a dental implant.
Root canal instrumentation has been performed with Mani stainless K files and ProTaper Universal (Dentsply). Chelator: RC Prep. PUI Irrigation: NaOCl 5%. Ultrasonic tip: BUC One from Spartan. P5 (Dentsply) Sealer used: Pulp Canal Sealer. Obturation technique WVC.
Good evening
I will be worry that its not ferule ( dentine) available on that root
What is your experience and what is the evidence in these type of cases?
Kindest wishes from England
Thank you for your comment Dr Stanley
According to my experience, I would state that is not true that the lack of ferrule alone does condemn a tooth. If this was the case how could we explain that the premolar next to this one, which I treated in 2005 and was also presenting with the same clinical condition (meaning no ferrule and no crown lengthening to get one ) is still 100% functional after 10 years?
Maybe a part of the answer lies somewhere between those lines:
“Bonding between the post and the cement appeared to be the most important parameter to achieve optimal mechanical behavior of the tooth-prosthesis combination.”
http://www.ncbi.nlm.nih.gov/pubmed/6343442