What causes an endodontically treated tooth to need additional treatment?
A tooth that has required endodontic treatment or a root canal is a more likely candidate for additional treatment. The tooth may become brittle after the root canal treatment, causing it to develop a crack at any point in the future. In a normal tooth, the dental pulp tends to hydrate the inner layers of the tooth, allowing it to be more resilient to the mouth's biting forces. However, once this root canal tissue has been removed, the tooth tends to become dry and loses its natural resilience. This makes it more prone to breakages and cracks.

In many cases, the endodontically treated tooth may have history of a large filling due to extensive decay or breakage. Such a tooth may be structurally unsound. Therefore, an endodontically treated tooth may need additional build-up. In the front or anterior teeth, the build-up may be as simple as sealing the access point to the pulp chamber to prevent re-infection. The build-up material for the anterior teeth may be a composite tooth-like material that is more aesthetically acceptable than gold metal.

For the back teeth or the posterior teeth, a dental crown becomes mandatory in order to provide additional protection to the tooth structure. The dental crown may also be used in combination with a dental post, depending on the condition of the tooth. A post is placed when the natural tooth structure has suffered extensive damage. In such a situation, the dentist needs to "build up" the height of the tooth structure to an appropriate level.

Gold is an excellent build-up material for the posterior teeth that require crowns. Gold is resistant to bacterial seepage, is highly biocompatible by nature and has thermal expansion and contraction properties almost similar to natural teeth. Its resistance to biting forces is also very high.

An endodontically treated tooth requires periodic dental examinations to monitor any adverse changes or damage that can be controlled with timely intervention.
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