CASE REPORT

Richmond Crown- A Conventional Approach for Restoration of

Badly Broken Posterior Teeth
Abhinav Agarwal1, Manish Chadha2, D.R.V.Kumar3, Prakash Somani4, Preet Jain5
____________________________________________________________________________

Abstract:
Restoration of badly broken endodontically treated teeth is a common problem in restorative
dentistry. Such teeth often require additional support from the root canal by means of a post and
core restoration. In cases where tooth structure is significantly lost full coverage restorations for
posterior teeth are necessary to achieve proper tooth form and function. Badly broken teeth with
minimal or no crown structure require addition retention and support. The Richmond crown can
be a good treatment modality for restoration of such teeth. This case report shows prosthetic
restoration of badly broken posterior teeth with Richmond crown.

Key Words: Richmond crown, dowel and core, endodontically treated, badly broken teeth.
____________________________________________________________________________

Introduction
The restoration of endodontically

screwretained crown. It was later modified

treated teeth has been a concern of dentists

to eliminate the threaded tube and was

for more than 100 years.1-6 As early as 1728,

redesigned

Pierre Fauchard described the use of

crown.8 During the 1930s, the custom cast

tenons, which were metal posts screwed

post-and-core was developed to replace the

into the roots of teeth to retain bridges.7 In

one-piece post crowns.

the mid-1800s, wood replaced metal as the

Case Report

as

1-piece

dowel

and

post material, and the pivot crown, a

A 35 yr old female patient reported

wooden post fitted to an artificial crown and

in the college with endodontically treated

to the canal of the root, was popular among

badly broken/decayed tooth (Fig.1) and

dentists.7

wanted to get it restored. After treatment

The

Richmond

crown

was

introduced in 1878 and incorporated a

planning it was decided to restore the badly

broken tooth with Richmond crown.

threaded tube in the canal with a

Journal of Dental Peers, Vol.1, Issue 1, April 2013 35

CASE REPORT
For making final impression, distal
canal was coated with light body and a small
piece of orthodontic wire coated with light
body was placed in the canal. Later light
body was injected around the prepared
tooth, putty was loaded in stock tray and
final impression is made (Fig.3).
Fig.1: Pre-treatment

Treatment Procedure
First

all

the

carious

part

and

unsupported tooth structure was removed. It

was decided to place the post in distal canal.
Gutta percha was removed from distal canal
with gades glidden drill, care was taken not
to disturb the apical seal. Post space

Fig. 3: Final Impression of post space

preparation was done with peso reamer till

Impression was examined for defects

size 04. Tooth preparation was done as

in recording of post space. Impression was

conservatively as possible. Undercut areas

poured with die stone and wax pattern was

within the crown structure were blocked

fabricated. Metal try in was done before

with glass ionomer cement (Fig.2).

ceramic build up. (Fig.4) Cementation was

done with resin cement. (Fig.5, 6, 7)

Fig. 4 & 5: Metal try in & Richmond crown

Discussion
A

single-unit

post-core-crown

restoration has various advantages over its

Fig. 2: After tooth preparation and block out

multiple unit counterparts. When the post

and core are two separate entities, flexion of

Journal of Dental Peers, Vol.1, Issue 1, April 2013 36

CASE REPORT
the post under functional forces stresses the

and cause breakdown of the materials over a

post-core interface, resulting in separation of

period of time. Therefore, it is desirable to

the core due to permanent deformation of

unify the post, core, and crown in one

for

long-term

stability.10 By

post. Breakdown of the core eventually

material

results in caries or dislodgement of crown.

decreasing the number of interfaces between

components, the single unit restoration helps
to achieve a monobloc effect.11
It is generally agreed that the
successful treatment of a badly broken tooth
with pulpal disease depends not only on
good endodontic therapy, but also on good
prosthetic reconstruction of the tooth.12
Endodontically treated, molar teeth should
receive cuspal coverage, but in most cases,
do not require a post. Unless the destruction
of coronal tooth structure is extensive, the
pulp chamber and canals provide adequate
retention for a core buildup. Molars must
resist primarily vertical forces. In those
molars that do require a post, the post should
be placed in the largest, straightest canal,
which is the palatal canal in the maxillary

Fig. 6 & 7: Post-treatment and Richmond crown

in Occlusion

molars and a distal canal in the mandibular

molars. Rarely, if ever, is more than one

The different coefficients of thermal

post required in a molar.13, 14

expansion of the various components also

In this case report Richmond crown

have a deleterious effect on the bonds

was planned as it can be a better option

between the tooth-post-core-cement-crown

instead of prefabricated posts because of

complex. The combined effects of thermal

major loss of tooth structure and lack of

cycling,

occlusal clearance for conventional PFM

fatigue

loading,

and

aqueous

environment test the bond between materials

crown.

Journal of Dental Peers, Vol.1, Issue 1, April 2013 37

CASE REPORT
treatments. J Endodont 1978;4:341-

Summary and Conclusion

There

are

situations

in

which

345.

Richmond crown should or should not be

6. Sorensen

JA,

used, as well as features that should be

Clinically

considered in deciding that one is the

dowel

treatment of choice for restoring a grossly

1984;52:28-35

Martinoff

significant

design.

JT.

factors

Prosthet

in

Dent

decayed or badly broken tooth. Richmond

7. Smith CT, Schuman NJ, Wasson W.

crown can be used as a treatment option for

Biomechanical criteria for evaluating

the badly broken endodontically treated

prefabricated

tooth with less occlusal clearance but should

systems: a guide for the restorative

be used judiciously.

dentist. Quintessence

References

Int.1998;29:305-312.

1. Kantor

ME,

Pines

MS.

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Retentive properties of post and core

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8. Smith CT, Schuman N. Prefabricated

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Journal of Dental Peers, Vol.1, Issue 1, April 2013 38

of

CASE REPORT
endodontically

treated

teeth:

Restoration

of

Endodontically

literature review: Part I: Success and

Treated Teeth: A Literature Review.

failure data, treatment concepts. J

journal of endodontics Vol. 30, No.

Prosthodont. 1994;3:24350.

5, May 2004

13. Richard S. Schwartz, James W.

Robbins.Post

Placement

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Correspondence: 1Dr. Abhinav Agarwal, Senior Lecturer, Pacific Dental College and
Hospital, Debari, Udaipur- 313024.
Contact Info:
E-mail drabhi_17@yahoo.co.in,
Phone no: +91 9672020334.
2

Dr.Manish Chadha, Senior Lecturer, 3Dr. D.R.V. Kumar, Reader, 4Dr. Prakash Somani,
Senior Lecturer, 5Dr. Preet Jain, Senior Lecturer, Pacific Dental College and Hospital,
Debari, Udaipur- 313024.

Journal of Dental Peers, Vol.1, Issue 1, April 2013 39