Medical Forum / General / Dentistry / July 2006
metal line across top surface of crown??
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dakotacaster@yahoo.com - 24 Jul 2006 17:46 GMT Is this normal or did part of the crown crack or fall off? What I mean by top surface (of this upper rear molar) is the biting surface of the tooth--the "main" surface, which I suppose is the top of the tooth (or maybe it's "bottom surface" because it's an UPPER molar).
I just don't remember how it looked when the crown was put on about 2 months ago, since its not easy to see. But today I put a mirror in my mouth to look (up), and I see a metal (indented) line running from front to back on that surface, covering about the middle 50% of the surface (so, about 25% of the surface is white (porcelain?) on the left, and same on the right.
The crown specialist put this (i believe porcelain crown , maybe fused with...) on about 2 months ago, with a fiber post. He also said something about using a gold base, i THINK for the post. Immediately before that, it had root canal treatment by an endodontist (who noticed a crack along the bottom of the tooth when taking out the old filling).
What prompted me to look at the tooth is that for the past few weeks, when I touch the tooth with a hard object (like, the back or underside of a toothbrush), I feel some pain (not enough to really bother me, but....i just thought I shouldn't feel anything). Chewing is no problem...no temperature sensitivity....just sensitive to touch. I wish I would have "touched" it right after the RCT and/or while the temp crown was on, but I never thought of it. (By the way, before the RCT, i had lots of pain symptoms (spontaneous, temp. sensitive, etc.). but never sensitive to touch like this....it just feels like the tooth is one big nerve (and it's not coming from the gums). But its fine if i don't go out of my way to touch it with a hard object...and again, chewing is never a problem.
Anyway, my main question is about that "metal line", though any other comments about "post-RCT sensitivity" would be interesting to. (I did lots of searching on this topic, but found nothing on my crown line question). thanks much.
Mark & Steven Bornfeld - 24 Jul 2006 19:10 GMT > Is this normal or did part of the crown crack or fall off? What I mean > by top surface (of this upper rear molar) is the biting surface of the [quoted text clipped - 31 lines] > lots of searching on this topic, but found nothing on my crown line > question). thanks much. If the line is straight and you feel no roughness to your tongue, that was probably the way the dentist and/ or the lab designed the crown. Sometimes you want the lingual (or palatal) surface in metal--generally less abrasive than most porcelains, and you'll never see the metal anyway (unless you're puttin' mirrors into your mouth!).
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
dakotacaster@yahoo.com - 24 Jul 2006 21:33 GMT Thanks much. This is my third crown with this particular dentist/lab....but only the first crown with this metal line (and also the first crown of theirs with a post). I think I have 2 other crowns as well (one with a post), but none with this line. But it sounds like i shouldn't worry about it...., unless the previous sentence changes your mind? I wish i would have looked at it (or remembered) what it looked like right after it was done. (BTW, The dentists are in another country, 12 hour time difference, a bit hard to call unless i buy an international phone card then stay up all night trying to catch him). p.s. I asked the endodontist what could be causing that "touching" pain, and, to sum it up, he had no idea (i.e., could be dozens of causes). My only hypothesis is that part of a nerve wasn't removed (or a "5th" canal was never seen). But right after he finished the crown (and several weeks before I noticed this touching pain), he said I need to (a dentist needs to) monitor the pocket size (gum) to observe possible infection.
> If the line is straight and you feel no roughness to your tongue, that > was probably the way the dentist and/ or the lab designed the crown. [quoted text clipped - 9 lines] > Brooklyn, NY > 718-258-5001 Mark & Steven Bornfeld - 24 Jul 2006 21:40 GMT > Thanks much. This is my third crown with this particular > dentist/lab....but only the first crown with this metal line (and also [quoted text clipped - 13 lines] > I need to (a dentist needs to) monitor the pocket size (gum) to observe > possible infection. Well, anything I said would be just a guess. My suggestion is to have a dentist locally who can just take a look at it.
Steve
>> If the line is straight and you feel no roughness to your tongue, that >>was probably the way the dentist and/ or the lab designed the crown. [quoted text clipped - 9 lines] >>Brooklyn, NY >>718-258-5001
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
dakotacaster@yahoo.com - 24 Jul 2006 22:48 GMT I actually don't have a local dentist, so I'd first have to locate/choose one, then make an appointment as a new patient (and it could take a long time to see one in that case). I would assume an in-person dentist can now tell whether the metal line is "normal" or not, but he's not going to be able to say any more than my overseas dentists (who i have alot of confidence in) regarding the pain question, since (I would assume) my tooth and xrays still look the same as they did 2 months ago, i.e., "fine" (unless of course the "metal line" is NOT supposed to be there!). So, in that case, let me just ask: Is it fair to say that you're still pretty sure the indented metal line is "supposed to be there? (I'm only asking this because i'm not sure whether my first response to you might have changed your initial "probably the way it was designed" answer). p.s. I have my overseas endodontists cell phone number, and i'm wondering whether I should call him late tonight and ask him about the metal line. However, he did not do the crown. But he works in the same "dental center" as the crown doc (who would be much harder to reach without a cell phone number).
> > Thanks much. This is my third crown with this particular > > dentist/lab....but only the first crown with this metal line (and also [quoted text clipped - 38 lines] > Brooklyn, NY > 718-258-5001 Mark & Steven Bornfeld - 24 Jul 2006 23:45 GMT > I actually don't have a local dentist, so I'd first have to > locate/choose one, then [quoted text clipped - 10 lines] > response to you might have changed your initial "probably the way it > was designed" answer). I'm not sure at all. I was surmising based on what you said. If you could take a photo and post it, it would be much easier to say.
Steve
> p.s. I have my overseas endodontists cell phone number, and i'm > wondering whether I should call him late tonight and ask him about the [quoted text clipped - 44 lines] >>Brooklyn, NY >>718-258-5001
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
dakotacaster@yahoo.com - 27 Jul 2006 21:42 GMT Thanks....I ended up calling my overseas dentists and actually reached them without much trouble. First I talked to the endo-doc, who said "highly probable that it was designed that way" (but he had never seen the crown so he couldn't be 100% sure)....and i realized at that point that I'm in good shape. I then confirmed it with my crown doc...and he reminded me that we had discussed the fact that he was making the metal surface, which I had forgotten. I have to remember next time to pay attention to what a restored tooth looks like right after its done!
One unrelated question:
OK, thanks. After having all of my perio. cleanings (about 4-month intervals) (and perio consultations) done overseas, I'm now back in the USA for good and am starting to look for a periodontist (which is horrible because I'm in one of the most expensive areas of the USA and the cost will be about 10 times more than what i was paying overseas, and all my overseas dentists went to good US dental schools....anyway back to my question). Since there's a good chance I'll need gum (flap?, maybe bone?) surgery at some point (some 6 mm pockets, and at least one 7), how would most periodontists react if, after a year or two with them, I decided to try to save alot of money and get the surgery done at a dental school. What I mean is, I assume my new perio. doc is going to want to continue with 3-month cleanings for a while to observe the pockets.....then after a year or so he'll probably say "surgery time!". At that point, I may want to try to use a dental school (I really can't afford it otherwise). But I don't want to STOP using my perio doc....I would just want to get the surgery done at the school. Then go back to using my doc. I would expect the following problems, but what else?: (1) most perio docs probably would say "up to you, but not ideal because the same doc who did the surgery should be involved in post-surgery care and observation (2) the dental school probably wouldn't like it because they want me to keep returning for observation??? But I would think I would potentially save thousands by using a dental school. Unfortunately, the closest one is about 80 miles away (and in BAD traffic)....
Also, can you give me a rough idea what perio-docs charge for: (1) hour-long perio cleanings (I"m used to paying $35-$40 max overseas, and its done by the periodontist himself. (2) surgery of various kinds (flap, graft, etc.). I realize there are huge variations in cost between cities and within cities, though.
> > I actually don't have a local dentist, so I'd first have to > > locate/choose one, then [quoted text clipped - 70 lines] > Brooklyn, NY > 718-258-5001 Mark & Steven Bornfeld - 27 Jul 2006 21:52 GMT > Thanks....I ended up calling my overseas dentists and actually reached > them without much trouble. First I talked to the endo-doc, who said [quoted text clipped - 39 lines] > I realize there are huge variations in cost between cities and within > cities, though. Sorry, I can't help with fees--I have a hard enough time keeping track of my own. Generally speaking, you are better with continuity of care, rather than jumping back and forth for pre surgical, surgical and post surgical care. OTOH, depending on the periodontist, he/she will certainly understand it if you are under financial constraints. My recommendation, if you have a periodontist now, is to have a frank discussion and see if they are amenable to following you after you have surgery done at a dental school. Some may be OK with this, and my impression is they are more likely to be OK with this if they find out about it BEFORE you go to the dental school for treatment. Thanks for the update about your crown.
Steve
 Signature Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
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