Should Your Dental Crown Be Permanently Cemented? Expert Insights

The all-ceramic crown has not been permanently bonded?

Hello Dr.
Huang, a few years ago I had an upper molar that underwent root canal treatment and was fitted with a porcelain crown.
At that time, I asked the dentist several times, but the dentist decided not to permanently cement the crown, and I no longer remember the specific reason.
Recently, when I visited another dental clinic, another dentist was somewhat surprised that my crown was not permanently bonded.
Additionally, after researching online, I found that it seems most patients have their crowns permanently cemented after a trial period.
This has made me a bit anxious, even though I haven't experienced any discomfort over the years and the crown (seemingly) hasn't loosened.
However, I still worry that because the crown isn't permanently bonded, there might be gaps, and since the tooth that underwent root canal treatment won't hurt if it decays, I might only discover the issue when the crown falls off, potentially requiring an implant.
Should I seriously consider having the crown permanently cemented? Thank you very much for taking the time to answer my question, and I wish you good health.

Ms. Zhang, 20~29 year old female. Ask Date: 2020/11/23

Dr. Huang Tingfang reply Dentistry

Dear Ms.
Chang,
Hello! Typically, dental cement is used to secure restorations; otherwise, there is a risk of cavities.
Generally, dental implants do not require cement, making them easier to remove and less prone to decay.
Wishing you all the best!
Sincerely,
Dr.
Huang Ting-Fang
Director of Dentistry

Reply Date: 2020/11/23

More Info

When it comes to dental crowns, the decision of whether to permanently cement them or not can be influenced by various factors, including the specific dental situation, the type of crown, and the dentist's clinical judgment. In your case, having a dental crown placed after root canal treatment is a common practice, as it helps protect the tooth from further damage and restores its function. However, the choice of whether to cement it permanently or not can vary based on individual circumstances.

Reasons for Not Permanently Cementing a Crown
1. Monitoring and Adjustments: One reason a dentist might choose not to permanently cement a crown is to allow for future adjustments. If the crown is not cemented, it can be removed easily for any necessary modifications, such as reshaping or adjusting the bite. This can be particularly important if the patient has a history of grinding their teeth or if there are concerns about the fit of the crown.

2. Potential for Future Treatment: If there is a possibility that the tooth may require further treatment, such as retreatment of the root canal or additional restorative work, a dentist may opt for a temporary cement. This allows for easier access to the tooth if needed.

3. Patient Comfort and Preference: Some patients may express a preference for a non-permanent solution, especially if they are concerned about the longevity of the crown or potential complications.

Risks of Not Permanently Cementing a Crown
1. Microleakage: One of the main concerns with a non-permanently cemented crown is the potential for microleakage. This occurs when bacteria and fluids can seep between the crown and the tooth, leading to decay underneath the crown. Since you mentioned that your tooth has undergone root canal treatment, it is crucial to ensure that no new decay develops, as the tooth may not exhibit pain until significant damage has occurred.

2. Crown Displacement: Although you have not experienced any discomfort or looseness, there is always a risk that a non-permanently cemented crown could become dislodged, especially if subjected to significant forces from chewing or grinding. If the crown were to come off, it could expose the underlying tooth structure to bacteria and food particles, increasing the risk of decay.

3. Long-term Stability: Permanent cementing provides a more stable and secure fit, which can enhance the longevity of the crown. Over time, the bond created by permanent cement can help prevent movement and maintain the integrity of the restoration.

Recommendations
Given your concerns, it may be wise to consult with your current dentist about the possibility of permanently cementing the crown. Here are some considerations to discuss:
1. Assessment of the Crown Fit: Have your dentist evaluate the fit of the crown and check for any signs of microleakage or decay. If everything looks good, they may recommend permanent cementing as a precaution.

2. Future Treatment Plans: Discuss any potential future treatments that may be necessary for the tooth or surrounding teeth. If there are no foreseeable issues, permanent cementing may be the best option.

3. Personal Comfort: Share your concerns about the crown not being permanently cemented. A good dentist will take your worries seriously and work with you to find a solution that ensures both your comfort and the health of your tooth.

In conclusion, while there are valid reasons for not permanently cementing a crown, the potential risks associated with this decision should not be overlooked. It is essential to have an open dialogue with your dentist about your specific situation, and together, you can make an informed decision that prioritizes the health and longevity of your dental restoration.

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