Curtis

We don't follow your description entirely but think your situation is:

1) You had a post & core and crown placed 40 years ago.
2) Recently, related to the development of decay, that restoration work fell out.
3) A dentist removed the decay, and then recemented the original post and core.
4) But after that, that dentist stated to you that they thought extraction of the tooth and replacement of the tooth via a bridge or implant was indicated. Other dentists who have seen your tooth have stated the same thing.

One would have to assume that possibly:

1) The decay involved a substantial aspect of the tooth that lies below the gum line. This page explains why subgingival (below the gum line) issues are a problem. (The page is about broken teeth, but the same challenges would apply with tooth structure lost to decay.)

With a front tooth (and the cosmetics involved), changing the level of the gum line might not give an acceptable result.

If the gum line level was changed, possibly due to the extent of the decay the amount of root length still encased in bone would be too short to provide suitable tooth stability.

2) The dentist may feel that what's now left of the tooth offers big challenges in being able to adequately (securely, predictably) anchor a post and core to it.

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Whatever decay existed had to lie beyond the edge of the existing crown (decay can't penetrate through a crown). So now that the decay has been removed, it's edges no longer fully lie on sound tooth structure (at least one part would rest on an area of filling).

Structurally that's a weak configuration. And it also means that the existing crown no longer creates a predictable seal over your tooth (the weak link being the fit in the area of the filling). (This page explains some problems associated with dental crowns and tooth decay.)

So even if somehow your tooth is restored with a post & core and crown, all of the components will need to be new ones to do the job right.

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