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Medical Forum / General / Dentistry / October 2007

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Lost a front tooth crown

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danwood8m@googlemail.com - 28 Oct 2007 21:51 GMT
Hey everyone,

Quick bit of advice needed. I had my front tooth crowned after losing
most of it in an accident in 2001, however, tonight I've bitten too
hard on uncooked food and broken it clean off!

I look like an extra from jerry springer now! It's sunday night in the
UK, so cannot get an out of hours dentist, I will need to call in the
morning.

I have taken tommorrow off work as I work as a radio presenter and
voice-over, which means at moment, I cannot speak properly due to a
large hole.

There was no tooth below gum level anyway, and it was a root canal.
The crown is fine and not broken (it only fell a few inches) and has a
pink post protuding from the top of it.

Will this be a simply re-attachment?  I've told my boss I'm hoping to
be back at work on tuesday, I'm praying it is simply a case of
cemeting or replacing the post and nothing more complex that may take
weeks.

When I originally had the crown fitted I had an ugly temporary one for
two weeks, and am so hoping that's not going to have to be the case
again.
George - 28 Oct 2007 22:06 GMT
It could be a simple recementing or a more complex issue. No way to
know which from my desk :)
Not being able to see any pieces of broken tooth is always positive,
but your dentist will be able to help you better.

Regards,
George
danwood8m@googlemail.com - 28 Oct 2007 22:57 GMT
> It could be a simple recementing or a more complex issue. No way to
> know which from my desk :)
[quoted text clipped - 3 lines]
> Regards,
> George

Thanks George,

On closer inspection there appears to be very small bits of what look
like tooth around the top of it, I did try and take pictures, but my
phone has a crappy camera so you probably couldn't make much out, but:

http://img44.imagevenue.com/aAfkjfp01fo1i-22584/loc875/08585_photo2_122_875lo.jpg
Steven Bornfeld - 29 Oct 2007 02:34 GMT
>> It could be a simple recementing or a more complex issue. No way to
>> know which from my desk :)
[quoted text clipped - 11 lines]
>
> http://img44.imagevenue.com/aAfkjfp01fo1i-22584/loc875/08585_photo2_122_875lo.jpg

    Your link isn't working for me.

Steve
danwood8m@googlemail.com - 29 Oct 2007 04:08 GMT
On 29 Oct, 01:34, Steven Bornfeld <dentaltwinm...@earthlink.net>
wrote:
> danwoo...@googlemail.com wrote:
> >> It could be a simple recementing or a more complex issue. No way to
[quoted text clipped - 16 lines]
>
> Steve

No they appear to have taken it down!

http://pichostonline.com/u/071029/4a5064c915.jpg

I hosted it there now, its really bad quality, but bad news it seems,
the crown isnt hollow it is full to the top, and looking at my gum
there is no visible tooth, I know the root of the tooth is still there
but i can't see any of it, it appears the tooth has broken away too.
What are the chances of repairing this?

My dentist still doesn't open for another 7 hours and i'm very upset
about this.
danwood8m@googlemail.com - 29 Oct 2007 04:10 GMT
On 29 Oct, 03:08, danwoo...@googlemail.com wrote:
> On 29 Oct, 01:34, Steven Bornfeld <dentaltwinm...@earthlink.net>
> wrote:
[quoted text clipped - 32 lines]
> My dentist still doesn't open for another 7 hours and i'm very upset
> about this.

http://pichostonline.com/u/071029/9e855401c9.jpg

Another very bad pic, sorry
Zzzdentist@dentalminds.com - 29 Oct 2007 09:21 GMT
On Oct 28, 9:10 pm, danwoo...@googlemail.com wrote:

> > What are the chances of repairing this?

>From what I can see, it appears that the core (supporting portion of
the crown) has broken off the root and is still inside the crown along
with a post.  I think those two dark spots might be cavities that
weakened the neck of the tooth eventually leading to the crown
breaking off.

There usually will be a corresponding root portion with decay found in
the gum.  Unfortunately, it doesn't look too good for this tooth as
far as I can see without examining you and viewing that blurry
cellphone photo.  You probably can fit it back into the root, but it
will likely be wobbly.

In a pinch, your dentist might be able to do something temporarily
depending on how much root is left.  If there is enough root left and
an intact root canal, he might be able to clean a bit out of the canal
for a post space and remove the decay, remove the core portion inside
the old crown, pop a post into the root to be picked up in the crown,
reline the inside of the crown with temporary acrylic, seat it until
it sets up a bit, remove it, clean it up, and temporarily cement the
works in.  It might fall off with a sneeze considering the compromised
support, but maybe it could get you through until a permanent solution
can be provided.

In any case, I would say that most likely a new crown, post, pins and
core or an extraction plus either an implant or bridge would be
indicated.  The old crown probably isn't salvageable.

Zzzdentist
www.dentalminds.com
Mark & Steven Bornfeld - 29 Oct 2007 14:52 GMT
> On 29 Oct, 03:08, danwoo...@googlemail.com wrote:
>> On 29 Oct, 01:34, Steven Bornfeld <dentaltwinm...@earthlink.net>
[quoted text clipped - 30 lines]
>
> Another very bad pic, sorry

    It would be useful to see the root stump, but the photography would
probably be harder.
    Afraid anything I say will be speculation.  Your dentist will be able
to tell you if the tooth is worth saving.

Steve

Signature

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

danwood8m@googlemail.com - 31 Oct 2007 00:45 GMT
On 29 Oct, 13:52, Mark & Steven Bornfeld
<bornfeldm...@dentaltwins.com> wrote:
> danwoo...@googlemail.com wrote:
> > On 29 Oct, 03:08, danwoo...@googlemail.com wrote:
[quoted text clipped - 43 lines]
> Brooklyn, NY
> 718-258-5001

Thanks for the replies.  He did an ex-ray and told me he would have to
wait for the results to be certain.  But he did manage to re-fit the
current crown, he said my root was cracked pretty deep and he doubts
its salvageable :-(

It is my front left tooth (9 i think) but teeth 8 and 10 are also
crowns.  He advised the removal of the other two crowns and a 3-unit
bridge.  I am now wondering if its possible to do a one unit bridge
between two existing crowns?  Can someone tell me if its possible?  I
had the crowns fitted only 6 years ago and was expecting a bit longer
from them, although the fact that one failed leads him to believe the
others may soon as well.
Steven Bornfeld - 31 Oct 2007 03:36 GMT
> On 29 Oct, 13:52, Mark & Steven Bornfeld
> <bornfeldm...@dentaltwins.com> wrote:
[quoted text clipped - 51 lines]
> from them, although the fact that one failed leads him to believe the
> others may soon as well.

    The adjacent teeth must be evaluated to be sure they are strong enough
to serve as abutment (holding) teeth.  I can't imagine why the crowns on
#8 and 10 would fail simply because that on #9 failed.  If they do, what
is he going to do to make them strong enough not only to support their
own biting load, but that of the (missing) tooth #9?
    Realistically, your fixed options for replacing #9 are a 3-unit bridge
from 8 to 10, or an implant-supported crown on #9.

Steve
danwood8m@googlemail.com - 31 Oct 2007 00:46 GMT
On 29 Oct, 13:52, Mark & Steven Bornfeld
<bornfeldm...@dentaltwins.com> wrote:
> danwoo...@googlemail.com wrote:
> > On 29 Oct, 03:08, danwoo...@googlemail.com wrote:
[quoted text clipped - 43 lines]
> Brooklyn, NY
> 718-258-5001

Bizarelly he said the gum had healed over (in less than 12 hours) and
he has to cut with a scalpel quite deeply to reveal the root stump!!
danwood8m@googlemail.com - 31 Oct 2007 00:50 GMT
On 30 Oct, 23:46, danwoo...@googlemail.com wrote:
> On 29 Oct, 13:52, Mark & Steven Bornfeld
>
[quoted text clipped - 49 lines]
> Bizarelly he said the gum had healed over (in less than 12 hours) and
> he has to cut with a scalpel quite deeply to reveal the root stump!!

I posted this but don't think it worked:

He did manage to re-fit my old crown but only temporary, he said
(can't be sure until xrays come back for certain) but it appears the
root is cracked pretty deep.  This is tooth 9 we are talking about,
but teeth 8 and 10 are also crowns, he advises the removal of 9 and 10
and a 3 unit bridge... I'm wondering if there is a possibility of
putting a bridge between two existing crowns?  He said the others will
probably fail too if this one has... which is a shame I've only had
them 6 years and was expecting a bit longer from them.
Steven Fawks - 31 Oct 2007 02:42 GMT
> He did manage to re-fit my old crown but only temporary, he said
> (can't be sure until xrays come back for certain) but it appears the
[quoted text clipped - 4 lines]
> probably fail too if this one has... which is a shame I've only had
> them 6 years and was expecting a bit longer from them.

Can't really say anything for sure from here.  If 8 and 10 are decent
abutments, the advice is probably sound.  Other option would be an
implant (or 'flipper' partial if finances are a major concern).

Splinting between existing crowns isn't very likely to work.

Steve
Steven Bornfeld - 31 Oct 2007 03:37 GMT
> Bizarelly he said the gum had healed over (in less than 12 hours) and
> he has to cut with a scalpel quite deeply to reveal the root stump!!

    Not bizarre at all.  I assume the fracture extended under the gum--the
gum didn't need to jump up to cover the root stump! ;-)

Steve
 
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