This emergency patient presented with a subgingival ( under the gum ) fractured tooth segment on this upper first bicuspid. This tooth had been treated with endodontics and restored with a large composite restoration. Root canal treated teeth generally need to be restored with a post/core and crown. Composite restorations may work if there is adequate tooth structure remaining after the root canal therapy and if the occlusion is not traumatic. In this case the large composite restoration was a liability and the fracture occurred due to an unsupported lingual cusp.

Today’s therapy involved the administration of local anesthesia ( topical plus Xylocaine 1:50,00 epinephrine, to control bleeding ). The fractured segment was removed and a composite restoration was placed. The patient was advised that this tooth needed a post/core and crown.
This patient could have avoided the time and expense of an emergency dental visit had the tooth been properly restored after the root canal therapy.