A crown buildup is essentially a large filling that is used to replace enough missing tooth structure to retain a crown (or cap). Most teeth that require a crown (or cap) are broken down due to a large cavity or fractured cusp. Depending on the amount of missing tooth structure, there are times that there is not enough tooth remaining above the gums to allow a crown to grab hold of. Even though a crown is glued on, there must still be enough tooth structure present to provide a friction fit since the glue is not strong enough to bear the brunt of one’s bite.
Teeth that have undergone root canal treatment usually need crown buildups. This is because by the time the inner surface is removed to provide access to the root canal space and the outer surface is removed to provide space for the porcelain, there is not much tooth structure left to retain a crown.

Broken tooth with a buildup

There are different materials available for crown buildups: composite (tooth-colored filling material), amalgam, and glass ionomer. I prefer the glass ionomer because it leaches fluoride into the surrounding tooth structure. This makes the tooth more resistant to decay. This is an important feature since decay sneaking up under a crown can be its achilles heel. A crown that is placed on a properly constructed crown buildup should give a person decades of service.