Help Bryanna!
 

Hi Bryanna,

I don't know where to start... I've read some of your threads and I value your professional opinions greatly. Please let me know what would you advise on this matter.

I had a ceramic with metal interior crown done on my front tooth for nearly 13+ years ago... all was good until the stains on my teeth could easily identify the crown. So I went to a dentist and she suggested bleaching and changing my crown to all-ceramic. Long story short, the first all-ceramic crown cracked and broke after a month, and had to replace with the second one. This ceramic crown has been working for 3 years... until I bite into a something hard when I was eating. The central incisor now broke and the crown came off with part of the incisor attached to the crown, which leaves the other part of the incisor somewhat hollow.

Please see attached pics for reference. Do you think this can be re-bonded back together. I understand I will not be able to use force when eating as it is no longer as strong as it used to be. I have not yet seen a dentist because I don't know who to trust anymore. I'd like to consult with you first prior to seeing any dentist.

For now, I temporarily placed the crown back and somehow, it fits very well and tight. In fact, when I tried to take it back out when brushing teeth at night, I had difficult time getting it out since it fit well between the other 2 teeth.

Please get back to me at your earliest convenience. Thanks, AJ.

Hi AJ,

Thanks for posting the pictures!

Unfortunately, there are several un-restorable issues with this tooth and crown.

1)A large portion of the tooth has fractured off with the crown.

2) The tooth has a horizontal fracture on the palatal portion which most likely is a lot deeper into the root of tooth than is visible on this photo.

3) The crown is also fractured along the back portion and not repairable.

Numbers 1 and 2 mean the tooth is not salvageable because there is not enough tooth structure remaining to hold another crown. Anything that is cemented onto this tiny stub of a tooth will not last very long.

Some dentists will suggest to root canal the tooth (it may already be root canaled, you didn't say) and then put a post in the tooth and make a new crown. To be honest.... the root canal only serves to create further problems and a post would cause the tooth to fracture even further. Extraction of this tooth is unfortunately inevitable :(

My suggestion would be to consult with an oral surgeon about the removal of this tooth, discuss placing a bone graft at the same time providing the bone is healthy and then 4-6 months later have the surgeon put in a dental implant. Your general dentist can have a temporary partial denture (called a flipper) made for you to wear after the extraction and during the healing phase of the implant. The implant can be restored with a new crown about 6 months after the implant is placed.

I'm sorry to give you this news. I know you were hoping to hear something different. Think twice before allowing the dentist to talk you into doing the root canal and/or a new crown as there is no longevity associated with either of those things in your particular case.

Also..... it is best to have the oral surgeon remove this tooth and do the bone graft rather than your general dentist because he will be better equipped to take this root out.

Please keep us posted!
Bryanna