A fractured molar restored without root canal treatment or a crown in Jeju

Decay beneath an amalgam filling was treated with MTA vital pulp therapy, fibre reinforcement, and resin build-up.

Published September 13, 2026·Dr. Soohyun Ko

KEY POINT

Part of a molar fractured as decay spread beneath an old amalgam filling. The pulp became exposed during decay removal. MTA vital pulp therapy preserved the pulp, and fibre reinforcement and resin build-up restored the tooth without a crown.

Decay beneath an amalgam filling

The patient visited after a molar previously treated with amalgam had broken. Part of the tooth beside the filling had fractured, and decay was visible inside.

The initial X-ray

An X-ray documented the tooth before treatment.

Removing the amalgam and decay

We removed the old amalgam and treated the decay with the tooth isolated under a rubber dam.

Decay removal under rubber-dam isolation

The pulp became exposed during decay removal

The pulp became exposed and bleeding was visible while the decay was being removed.

Protecting the exposed pulp with MTA

We performed vital pulp therapy using MTA. The white area in the photograph is the MTA placed at the exposure site. In this case, we proceeded with resin build-up while preserving the pulp.

Reinforcing the remaining tooth

After treating the decay, we assessed the amount and condition of sound tooth remaining. Fibre reinforcement was used before rebuilding the broken area and chewing surface with resin.

Fibre reinforcement during resin build-up

Restoring the tooth without a crown

Resin restored the tooth’s shape under rubber-dam isolation. This avoided the additional preparation needed for a full crown and preserved as much of the remaining tooth as possible.

Resin build-up completed under the rubber dam

The completed resin restoration

The molar fractured by decay beneath the amalgam filling was restored without root canal treatment or a crown.

The restored molar after rubber-dam removal

Checking the pulp and restoration over time

Regular examinations monitor pulp health and the restoration. Other teeth may require a crown or root canal treatment depending on their condition. Fibre reinforcement does not completely prevent fractures, and follow-up remains necessary.