Hi Kelly,
Yes, I have lots of experience with this type of dental case.
I am going to re post some of your post and reply in bold type. This will help to clarify some things...
<<About ten years ago, I SWEAR my front tooth (crowned) moved forward and I pushed it back. I then had braces and had the crowns replaced two years ago. One front tooth has always felt "twingy" and I kept asking the dentist if the root was fractured. He kept saying no; he saw nothing. Last April, the pain was HORRIBLE and i had an emergency root canal. The endontist said that the tooth had a little side canal and treatment was "questionable." When he got into the tooth, though, he said that the nerve/tissue was dead and he was confident that my problems were ending.>>
THE ORIGINAL SYMPTOMS THAT YOU HAD ON THIS FRONT TOOTH INDICATE THAT THE NERVES WERE DYING AND THE PROBLEM WAS NOT PICKED UP ON THE XRAYS OVER THOSE 10 YEARS. THE ORTHODONTIA AND RESTORATIVE WORK THAT YOU HAD DONE ON THIS TOOTH HAVE EXACERBATED THE ORIGINAL PROBLEM THAT WAS CAUSING THE NERVES TO DIE. IF YOU HAVE ANY HISTORY OF TRAUMA TO THIS TOOTH, EVEN BITING INTO SOMETHING REALLY HARD WHEN YOU WERE YOUNGER COULD HAVE TRAUMATIZED THE TOOTH ENOUGH TO CAUSE THE NERVES TO DIE. FRACTURES IN TEETH ARE NOT ALWAYS VISIBLE CLINICALLY OR RADIO-GRAPHICALLY. SO IT IS VERY POSSIBLE THAT THE TOOTH IS FRACTURED.
AS FAR AS THE ENDO STATING HIS CONFIDENCE IN THAT THE "PROBLEMS" WITH THIS TOOTH WERE GOING TO IMPROVE AFTER THE ROOT CANAL WAS DONE IS A BIT MISLEADING IN THAT THE RC PROCEDURE DOES NOT MAKE AN UNHEALTHY TOOTH HEALTHY AGAIN. THE PROCEDURE IS DONE TO RETAIN, NOT CURE, A NON VITAL AND UNHEALTHY TOOTH FOR AN UNCERTAIN AMOUNT OF TIME. THERE ARE MANY BIOLOGICAL CHANGES THAT OCCUR IN A NON VITAL RC TOOTH AS WELL AS IN THE BONE SURROUNDING THAT TOOTH THAT CAN CAUSE OR CONTRIBUTE TO A MORE WIDESPREAD SYSTEMIC PROBLEM.
<<I had pain again after (not terribly severe) and went back to him and my regular dentist. I said that I must be crazy but I really felt the root was somehow fractured. They both said that the xray showed it was healing and that it wouldn't heal if the root was fractured. Is this true? It still twinges in pain.>>
PAIN IS NOT THE BEST INDICATOR FOR MANY DENTAL PROBLEMS AS MOST DENTAL ISSUES ARE PAIN FREE UNTIL THE PROBLEM BECOMES SEVERE OR MORE WIDESPREAD. IT IS NOT UNCOMMON TO HAVE PAIN OR DISCOMFORT WITH AN RC TOOTH FOR SEVERAL REASONS BUT ONE OBVIOUS ONE IS BECAUSE THE TOOTH IS SITTING IN A LIVE LIGAMENT AND LIVE JAW BONE. SO THE CHRONIC INFLAMMATION AND BACTERIA THAT LIVES INSIDE AND OUTSIDE OF THE RC TOOTH IS IRRITATING TO THE VITALITY THAT SURROUNDS THE TOOTH. ALSO, A FRACTURED RC TOOTH WILL BE MORE SYMPTOMATIC THAN ONE THAT IS NOT FRACTURED.
WHEN A DENTIST SAYS THAT THE RC TOOTH LOOKS LIKE IT'S "HEALING" OR APPEARS TO BE "FINE" THIS DOES NOT MEAN THE TOOTH LOOKS HEALTHY. IT JUST MEANS THAT THE TOOTH LOOKS LIKE IT SHOULD AFTER HAVING A ROOT CANAL.
<< My regular dentist says the canal is just overfilled. HELP???? Any advice?>>
AGAIN OVERFILLS OF RC TEETH ARE FREQUENTLY SEEN BUT THEY ARE NOT A BENIGN ISSUE AS THEY ARE OFTEN PASSED OFF TO BE. YOUR ENDO SHOULD HAVE INFORMED YOU THAT HE OVERFILLED THE TOOTH. THAT OVERFILL OF MATERIAL IS A CONSTANT IRRITANT AND ANOTHER AREA FOR BACTERIA TO GROW. A GOOD EXAMPLE WOULD BE.... A SPLINTER EMBEDDED IN A KNUCKLE ON YOUR FINGER. TO THINK OF THAT HAS SOMETHING ACCEPTABLE WOULD BE.... UNACCEPTABLE.
<<Also, my four front teeth are crwons so I am thinking I would opt for an implant bridge. Any experience with those?>>
DUE TO THE LONGEVITY, CHRONIC AND CURRENT PROBLEMS WITH THIS TOOTH, CHANCES ARE THE BONE IS GOING TO BE COMPROMISED EVEN AFTER THE TOOTH IS REMOVED. BONE GRAFTING AND INTEGRATION OF THE DENTAL IMPLANT WILL ONLY BE SUCCESSFUL IF THERE IS HEALTHY ADEQUATE BONE TO PUT IT INTO. ARE ANY OF THE OTHER FRONT TEETH ROOT CANALED?
Bryanna