Hi Kathleen, there are several ways to set a stone with a culet.
In the Advanced DVD series, one way would be to make it into a pendant using the "Orbit" prong pendant design; another would be to use the Prong Frame pendant design. Of course, either of these can also be altered for smaller stones to create earrings, too.
If you decide to use a frame, you will either have to add pattern wire in the center, or use a lot of wires to be able to make the frame deep enough to prevent the culet from rocking on the skin (which can be irritating to wear). I do love pear shapes, though, because they are so easy to work with!
Answer contributed by Dale "Cougar" Armstrong