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Medical Forum / General / Dentistry / November 2006

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Crown reset after 10 years - Old tooth disintegrating and tooth now too proud/high

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DT - 30 Oct 2006 16:04 GMT
I wonder whether anyone out there has any comment on this one for me:

The crown in question has replaced the vast majority of my upper left
eye tooth. It was put in position around 10 years ago, but this weekend
it got loose and finally fell out. The dentist I saw today has scraped
away some of the old tooth as it is (quote!) "Mushy". It looks brown
and crumbly to me, but I'm no expert! He mentioned that because the old
tooth which serves as the crown's base is coming to the end of its life
we might have to consider other options. He mentioned three options,
but didn't go in to detail and he was in a hurry to attend to his next
client. One option was definately a denture (no thankyou - I'm not
ready for polygrip just yet!), another I think might have been a bridge
with something or other and I can't remember the other one at all
(perhaps he scraped away part of my grey-matter too!). Does anyone know
what the three options are likely to be and what they consist of?

The second thing is that when the crown was first put in place I
remember not being quite able to bite and locate all of my upper and
lower teeth together. This is the case again - it doesn't feel quite
right. Last time the doctor didn't cement it in place until he had
taken some mesaurements using some kind of paper that I had to bite
down on in order to assess the crown's placement in it's hole and he
got it sitting perfectly.The crown is now definately sat a little too
high and when I told the dentist this today he said that it would
"normalise" with time. Is this so, why do I remember the dentist 10
years ago taking so much time to get the bite perfect before setting
it? I am also worried as I have seen a few posts with people
experiencing pain with this raised crown business and it's just
starting to feel a bit tender. Any constructive comments would be
welcome.
Mark & Steven Bornfeld - 30 Oct 2006 17:57 GMT
> I wonder whether anyone out there has any comment on this one for me:
>
[quoted text clipped - 26 lines]
> starting to feel a bit tender. Any constructive comments would be
> welcome.

    It will not "normalize" in time.  I assume the crown was recemented as
a temporary expedient.  If you hit this tooth first, there's a good
chance the crown will crack right off again.  And if it doesn't it will
make the tooth sore.
    The viable options for this tooth depend on the condition of the tooth,
the condition of the adjacent teeth, and your willingness to undergo
dental treatment.
    If there is enough sound tooth structure left, it may be possible to
remake the crown.  If the tooth has not had a root canal treatment
before, it is possible it may need one now.
    If the tooth is not salvageable, it can be replaced by a fixed bridge,
a removable appliance, or an implant.  The decision as to which is the
most appropriate is based on the condition of the adjacent teeth, the
amount and quality of the bone remaining when the tooth is removed, and
your tolerance for lengthy treatment.  Implants usually take a long time
from beginning to end--the fixture (anchor into the jaw) needs a few
months to heal before it can be restored (in most cases).  You may need
a temporary removable appliance in the meantime.  OTOH, with an implant
it is not necessary to touch the adjacent teeth.  If your adjacent teeth
are heavily filled or already crowned, this isn't a major issue.  But if
the adjacent teeth are not restored, the implant will make this unnecessary.
    As far as expense, the trend is that a 3-unit fixed bridge is pretty
close in fee to a single implant-retained crown.

Steve

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Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

DT - 03 Nov 2006 16:41 GMT
It's a crown and in very good condition. The adjacent teeth are in good
condition.  It's just the base of the original tooth that is rotten.
It's been a few days now and I have to say that it feels like it has
normalised, but I'm sure it's probably that I've just got used to its
projection. Thankyou for your information on the different options that
might be available to me. Fortunately my future dental treatment will
be free as I am in the armed forces. I have a checkup in a few weeks so
hopefully I will have some idea as to what is likely to be done then.
 
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