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Medical Forum / General / Dentistry / September 2008Decapitated tooth
My RHS upper pre-molar (I think previously crowned) has broken off at the gum line, leaving the full root in situ. I think it must have been route-canalled too - as there's no pain, just a gap. I'll be going to my dentist just as soon as I've saved the bucksheesh. In the meantime, I was wondering what options he's likely to offer me. And wondering how the hell he's gunna get the root out - if that's what he's likely to do. The tooth had been filled many times and was now undersized due to loss of tooth-wall. > My RHS upper pre-molar (I think previously crowned) has broken off at the > gum line, leaving the full root in situ. [quoted text clipped - 10 lines] > The tooth had been filled many times and was now undersized due to loss of > tooth-wall. Getting it out is generally not a problem. Saving it depends on the condition and bulk of the remaining root. Sometimes if the tooth is to be saved it is necessary to do what we call a "crown lengthening" procedure--removing some gum and occasionally some bone surrounding the root to expose enough root structure to replace a crown without burying the edge of the crown too far under the gumline. OTOH, these days we are more likely to remove questionable teeth if implant placement is an option. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 On Sep 25, 8:46 am, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: > > My RHS upper pre-molar (I think previously crowned) has broken off at the > > gum line, leaving the full root in situ. [quoted text clipped - 27 lines] > Brooklyn, NY > 718-258-5001 >> My RHS upper pre-molar (I think previously crowned) has broken off at the >> gum line, leaving the full root in situ. [quoted text clipped - 19 lines] > OTOH, these days we are more likely to remove questionable teeth if > implant placement is an option. Thanks for that, Steve. If it's removed and the hole left empty, does it create problems for the adjacent (or even opposite) teeth ? Is leaving a hole even an option ? And if so, is it filled with anything ? And if not, does bone and stuff grow into it ? And if so, is inserting a peg replacement tooth possible at a later (more affluent) point ? > Steve >>> My RHS upper pre-molar (I think previously crowned) has broken off at the >>> gum line, leaving the full root in situ. [quoted text clipped - 24 lines] >If it's removed and the hole left empty, does it create problems for the >adjacent (or even opposite) teeth ? Most times but not always. >Is leaving a hole even an option ? Sure. >And if so, is it filled with anything ? Do you mean a space where the tooth was ? >And if not, does bone and stuff grow into it ? Bone fills in where the root used to be. Gingiva grows over bone. >And if so, is inserting a peg replacement tooth possible at a later (more >affluent) point ? Implant later ? Possible if teeth haven't shifted too far. >> Steve >>>> My RHS upper pre-molar (I think previously crowned) has broken off at >>>> the [quoted text clipped - 45 lines] >> >>> Steve >>>> My RHS upper pre-molar (I think previously crowned) has broken off at >>>> the [quoted text clipped - 28 lines] >>adjacent (or even opposite) teeth ? > Most times but not always. So if I'm gunna get a pegtooth fitted, I really need to do it when the root's removed. Would leaving just the unrecrowned root in situ be likely to create any problems for later pegtoothing - either WRT to creating problems for adjacent teeth or the tooth itself ? >>Is leaving a hole even an option ? > Sure. [quoted text clipped - 12 lines] >> >>> Steve >>>>> My RHS upper pre-molar (I think previously crowned) has broken off at >>>>> the [quoted text clipped - 30 lines] > So if I'm gunna get a pegtooth fitted, I really need to do it when the > root's removed. I generally agree with what newbie's said. The teeth don't always drift, but do frequently. What will happen definitely is that the bone in which the root sits will resorb, possibly requiring a bone graft at the time you decide to place the implant. > Would leaving just the unrecrowned root in situ be likely to create any > problems for later pegtoothing - either WRT to creating problems for > adjacent teeth or the tooth itself ? If the root canal in the root is intact, the opening can be sealed and the root retained. This will minimize loss of bone, but may not prevent movement of the adjacent teeth. Steve >>> Is leaving a hole even an option ? >> Sure. [quoted text clipped - 10 lines] >> Implant later ? Possible if teeth haven't shifted too far. >>>> Steve >>>>>> My RHS upper pre-molar (I think previously crowned) has broken off at >>>>>> the [quoted text clipped - 48 lines] > root retained. This will minimize loss of bone, but may not prevent > movement of the adjacent teeth. As I feared. Although, it should at least, only be the tops that cause the teeth to angle. Would chewing have a tendency to limit the degree of movement ? Or is chewing likely to be destablising the adjacent teeth as we speak ? > Steve > [quoted text clipped - 13 lines] >>> Implant later ? Possible if teeth haven't shifted too far. >>>>> Steve > As I feared. > Although, it should at least, only be the tops that cause the teeth to > angle. > Would chewing have a tendency to limit the degree of movement ? > Or is chewing likely to be destablising the adjacent teeth as we speak ? If the teeth adjacent to the space are in a stable biting relationship with their opposing teeth it generally would tend to limit movement. Steve This all began about a month ago, when I noticed I could rock the tooth in-situ. There was mild, dull pain. Three weeks later, it was decapitated by a piece of nougat - but the pain had subsided altogether. At the time the tooth first became 'rockable', I also noticed I had mild problems with unclearable Eustachian tubes. In the week that's passed since the decapitation, I've had ear pain like an ear infection. And since I first noticed the unclearable Eustachian issue, I've felt kind of rough - like a non-fullblown cold with fatigue in the evenings, bloating and atypical food appetite. Could it be that the tooth has an infection that's somehow spread up the Eustachian tubes ? If so, would my dentist be able to detect such an infection - by X-ray or other means ? I'd like to find out if the tooth is in some way causal, as I'm getting well hacked off with feeling sub-par ATM. >> As I feared. >> Although, it should at least, only be the tops that cause the teeth to [quoted text clipped - 6 lines] > > Steve > This all began about a month ago, when I noticed I could rock the tooth > in-situ. [quoted text clipped - 12 lines] > Could it be that the tooth has an infection that's somehow spread up the > Eustachian tubes ? The chances of any relation are very remote, except to the extent that an infected tooth may lower your body's general resistance to other (eg: upper respiratory) infection. In the dark days of ancient dentistry when I was in school, we were taught that a "bad bite" could cause "occlusion of the eustachian tubes. You may wish to google "Costen's syndrome". Unless the breaking of this tooth caused your bite to collapse, I see the chances of this being very unlikely. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> This all began about a month ago, when I noticed I could rock the tooth >> in-situ. [quoted text clipped - 16 lines] > infected tooth may lower your body's general resistance to other (eg: > upper respiratory) infection. OK. I guess a dental infection = an abscess, which I understand I would most definitely be aware of. Just coincidental timing then. > In the dark days of ancient dentistry when I was in school, we were taught > that a "bad bite" could cause "occlusion of the eustachian tubes. You may [quoted text clipped - 3 lines] > > Steve |
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