We’ve all done it. You can wander for literally hours looking at ‘nothing’ on the internet. Well, PC World posted the 15 Best Places to waste time on the Internet….take a look. If you have time!!
I’ve said that a dental implant is the best possible treatment for this situation, but some would ask why not a bridge?
A few brief reasons. Although an implant is more work (eg: a few surgery appointments, and other visits to make a crown), the ultimate product, the tooth, is LESS maintenance than a bridge. There’s also less chance of trouble or problems with an implant. The tooth behind has a perfect-fitting crown which does NOT need to be replaced. A bridge would require the destruction of this crown and the fabrication of a new one that is part of a bridge. Also, the tooth in front of the fractured area would need a crown, and it is not in need of any work at this time.
Finally, the patient did NOT want a bridge…under ANY circumstances. So the decision in this case was easy!
Gum surgery or an implant…how to decide? For this tooth it’s pretty easy. Look how far under the gum the tooth broke off:
Without getting into too many details, the crack is SO deep that gum surgery would not be possible. For this situation, a dental implant is the best possible solution. We’ll talk about the dental implant process later.
One last thing. Why not a bridge instead of the implant?
Here’s a picture of what the tooth looked like:
Not a pretty site. You can see how well the crown fit the existing tooth, but a large portion of the root surface (the tooth UNDER the gum) simply broke off. There are only two options here: Gum surgery to lengthen and expose the fractured area (which we discussed here), or removal of the tooth and placement of a dental implant.
So this tooth probably had an ‘original’ crack that continued, slowly, until it needed a root canal. Later it completely fractured.
But here’s another reason the tooth under this crown may have fractured. This patient has eaten very hard, crunchy cereal for many years. She was trying to be ‘good’ and eat healthy food, but the trauma of this hard food over the years may also have contributed to the tooth’s demise.
So what happened here?
The tooth was originally crowned due to fractures/cracking that started because of a large silver filling, which we’ve examined in other posts like this one. The cracks may have continued, slowly, inside the tooth (similar to a crack in a car’s windshield).
When they got to the nerve, the tooth became symptomatic and needed the root canal. But the cracks kept going, and the tooth completely fracture off inside the crown.
How’s this for a situation? This tooth had a very nice crown that had been in place for over 5 years. Suddenly it becomes very bite and thermal sensitive (hot and cold bothered it alot!). A root canal was completed, and that relieved the symptoms. Then, a few weeks later, this happened:
