Patient: Hello, Dr. Hou! My left lower molar cracked its crown two days ago after eating something hard, and I felt pain when biting. Yesterday, I had the fractured part removed at a clinic, and this tooth was filled 6 years ago. Yesterday, the filling was removed and medication was applied. Now the tooth doesn’t hurt anymore. I would like to ask if I have to do root canal treatment for this tooth, and if I have to have a pile and crown after the root canal treatment. How much will it cost in total? I am self-paying. I am concerned about this issue and whether there are other options besides root canal treatment, such as a light filling. Thank you very much for your reply in your busy schedule. Hou Benxiang, Department of Endodontics, Beijing Stomatological Hospital Hou Benxiang, Department of Endodontics, Beijing Stomatological Hospital: First of all, we have to determine whether the tooth is fractured or the filling material is fractured, and secondly, we have to look at the extent of the tooth fracture, i.e. whether the fracture lobe is below the gum and whether there is root fracture. If it is a fracture of the filling material, then it may be possible to fill it. If the tooth is fractured to 2-3mm below the gum, it can be restored by root canal treatment followed by a pile crown, and if it is deeper below the gum, a gum surgery may be required in addition to root canal treatment. If the tooth is fractured to the root, or if the crown is completely cracked from the center, the affected tooth can only be extracted. The price of root canal treatment and crown piling is not easy to calculate, as root canal treatment is generally based on the number of root canals and the instruments used in the treatment, while crown piling is based on the type of material used. In specialist hospitals, the former is done in the endodontics department and the latter in the restorative dentistry department. Patient: Hello, Director Hou! First of all, thank you very much for your last reply. Today, I went to Peking University Dental Hospital for a dental visit. I really don’t want to pull it out either. I’m sending you the medical records and dental films. You can take a look at it for me. Thank you again! Have a good day at work! Patient: My medical history Hou Benxiang, Department of Endodontics, Beijing Stomatological Hospital: Since the dental film is not clear, I can’t judge the situation of the root of the tooth. From the medical records, it seems that the root is not a big problem, but because the crown is damaged and the original root canal treatment is not perfect, the following problems exist: 1, the root canal treatment needs to be redone, but the root canal treatment may still not be complete, because it is difficult to remove or expand the filling in the original root canal. 2, The affected tooth belongs to root canal retreatment, and the cost is higher than the general root canal treatment. 3. After root canal treatment, the tooth can only be restored by resin filling because it cannot be restored by crown, and the tooth and the material may be fractured or lost again after filling. In short, if there are medical risks in keeping the affected tooth, i.e. high cost and poor prognosis of the tooth, you can consider it according to your condition (most of the cost of root canal retreatment is not covered by medical insurance).