Root canals become complicated due to factors like severe curvature (>30°), calcification, narrow canals, complex anatomy (C-shaped canals, isthmuses), resorption, perforations, or previous treatment challenges (separated instruments, underfilled canals). These cases require specialized equipment and expertise.

While we can successfully treat most complex cases, some teeth may have poor prognosis due to factors like non-restorable structure, severe periodontal involvement, or vertical fractures. We provide honest assessments and discuss all options, including alternatives like implants when appropriate.

Prosthodontists bring unique expertise in tooth preservation and restoration. We consider the final restoration from the beginning - ensuring adequate tooth structure remains, optimal access preparation, and proper occlusal reduction. This integrated approach leads to better long-term outcomes.

With modern techniques, even complex cases have success rates of 85-90% when properly treated and restored. Success depends on factors like tooth condition, patient health, and quality of final restoration. We discuss individual prognosis during consultation.

Nearly all posterior teeth and most anterior teeth that undergo complex root canal therapy require crowns. The extensive decay and access preparations often compromise tooth structure. We may recommend posts, cores, or other foundations before final crowns to optimize longevity.