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.
