You probably already noticed it is common to have local treatment plans include a CDT code D2950 on the same tooth number as a crown. This is the code for the core buildup. This is a procedure that generally raises several questions as to what it is and why it is always quoted as a separate cost alongside a dental crown.
Sometimes, when a tooth is severely fractured or missing a large portion of its surface due to a large cavity or a failed filling, a crown will be recommended to restore function and appearance. However, there are times when the remaining tooth structure is so little that it is necessary to restore some surface area for adequate crown support.
The core buildup is part of the preparation of a tooth prior to a crown. It is an essential part of the process of getting a successful crown, because it is the procedure in which the tooth structure that will then serve as support to the crown is restored. Example of actual procedure on tooth with large, failed filling, such as yours:
There are cases in which large decay, fracture, or severe grinding leave the restorative dentist little tooth surface to work with. Due to mechanical factors a successful crown, porcelain or otherwise, requires a
certain amount of height, taper, and width of structural integrity for the proper retention of the prosthetic. A large percentage of the success of the crown depends on the core buildup.
What is the core buildup made up of?
Traditionally, the buildup was made up of amalgam or other metal-based materials. However, since these act mechanically, not with adhesion, they require a more invasive preparation of the tooth enamel. In other words, they require large portions of grinding for the retention of the metal. Only more recently, dentists use composites in order to create the core buildup because they act through adhesion and require a less invasive preparation. This helps save tooth structure and results in better crown retention.
