Re: Crowned tooth needs root canal?

On Fri, 15 Jul 2005 14:29:28 -0700, "Blocks To Books"
<blocks2books@xxxxxxx> wrote:

>
>----- Original Message -----
>From: "Steven Bornfeld" <dentaltwinnonsense@xxxxxxxxxxxxx>
>Newsgroups: sci.med.dentistry
>Sent: Friday, July 15, 2005 12:55 PM
>Subject: Re: Crowned tooth needs root canal?
>
>
>> It is certainly possible that a crack can progress despite the presence of
>> a crown. In this case however it's unlikely that a root canal is going to
>> be able to save the tooth. In a situation like this there is often a
>> vertical root fracture, and if a crown does not prevent its spread the
>> tooth will sometimes be lost.
>> The first thing to do is to confirm that the crowned tooth is actually the
>> tooth responsible for your pain. If it is (and before progressing to root
>> canal treatment) I would remove the crown and any underlying restorative
>> material if at all possible and examine the tooth carefully--preferably
>> with magnification.
>>
>> Steve
>
>Thanks again. I was just now able to determine the crowned tooth is for
>sure the one that is the source of the pain by biting on a q-tip - using it
>almost like a home-made tooth sleuth - which I learned from an original
>cracked molar where a dentist used a tooth sleuth to diagnose it. I learned
>about using a q-tip as a type of tooth sleuth from lurking on smd on and off
>over the years. I tried biting on all the upper molars with the q-tip and
>the only one that hurt when I bit on the q-tip was the crowned molar but it
>hurt on the cheek side instead of the tongue side where I thought the pain
>was originating from. Don't now if a sprained tooth can cause this same
>type of pain. The bite has been adjusted because it was high in places. I
>rested the tooth from all chewing for a week but as soon as I began chewing
>hard foods on that side again, the pain resumed as it was before the bite
>adjustment on the crown.
>
>My dentist - who is a second opinion dentist - thinks there is a possibility
>the crown might be loose or leaking and the pain could be caused by decay
>getting inside. I didn't want to destroy the crown or damage my tooth
>further drilling the crown off only to learn the tooth was actually cracked
>into the nerve and could be fixed by a root canal and then have to buy a
>second crown. I thought if it needed a root canal - then I should do that
>first and then, if the crown survived, see if that solved the problem. If
>not, get the old crown drilled off the root canalled tooth and replace the
>crown and pay the big bucks in that order.
>
>Unfortunately the crown is fairly new - only three years old. I don't know
>if that might make it harder to get off without destroying it. It was
>placed by a prosthodontist who is retired. It's actually the nicest and
>appears to be the most high quality restoration I have in my mouth. It has
>a composite build up underneath the crown. I wonder if my endodontist could
>drill into the biting surface of the crown like he was preparing to do a
>root canal, remove the build up and get a look at the tooth that way with
>his microscope.
>
>Another thing that really concerns me is that this tooth is an upper first
>molar with roots almost inside my sinus. The roots have always been that
>way. I've been told that about the closeness of the roots my entire life
>when I get x-rays but it's never caused me any pain problems the tooth in
>the past. Because of the close proximity to the sinus cavity, I don't know
>if I could have an extraction without causing damage to my sinus bones and I
>don't think there is even enough bone and space for a replacement tooth
>implant to ever be screwed in. As far as a sinus lift goes; I don't know if
>everyone is a candidate or only those people whose sinuses have sagged. I
>have very small bones and I think the closeness is just part of my body make
>up. It's compact and everything is close together. Unfortunately the teeth
>on either side of my molar have no restorations; which makes a bridge a more
>invasive situation. I've been concerned about anything happening to this
>particular tooth for all those reasons.
>
>I was/am a heavy clencher and they didn't know how to prevent the damage
>like they do now with NTI's. Because of that, over the years, my teeth have
>been damaged by abfraction lesions, cracked molars, and gum recession even
>though I have almost perfect home care and am in good health. I will talk
>to the endodontist about what you suggested when I go in on Tuesday for his
>evaluation. Unfortunately from having more than one cracked molar, I pretty
>much remember what the feelings are with a cracked tooth and that is what
>this feels like. I truly hope and pray I'm wrong on this. I didn't know it
>could be a hopeless case that couldn't be salvaged by a root canal. I
>thought only teeth with root canals were subject to root fracture and
>couldn't be saved.
>
>Thank you very much for responding. The help and education people can get
>here is vital. Thank you again for trying to help me understand my options
>and what might be possibly going on. If you get any more ideas on my
>situation, I would appreciate it. The help you have already given is
>appreciated very much.
>
>> --
>> Cut the nonsense to reply
>
>>
>

IMO the only way to safely remove a crown is by cutting it off.
Sometimes a 'Richwill crown remover' can be used sucessfully.
Those reverse dent puller thingies should remain in the auto
body shop.

If the crown cannot be removed safely, then have the RCT done
through the crown and have Fuji 9 placed in the access.

You can get a new crown later after your symptoms subside.

You do have an appointment with the endodontist right ?



--
W_B

wubbabubbazG@xxxxxxxxxxxxxx
Take out the G'RBAGE
.

Relevant Pages

  • Re: Crowned tooth needs root canal?
    ... Subject: Re: Crowned tooth needs root canal? ... and if a crown does not prevent its spread the ... cracked molar where a dentist used a tooth sleuth to diagnose it. ... thought only teeth with root canals were subject to root fracture and ...
    (sci.med.dentistry)
  • Re: should I sue the dental clinic
    ... In a dental clinic I had root canal and porcelain crown done for my ... there is a big fracture in my tooth and it is not worth to do ... The general public knows not about the dangers/risks of root canals. ... Mercury amalgams are said to be the caskets of the body. ...
    (sci.med.dentistry)
  • Debating Crown, Conflicted
    ... trouble since a dentist put a truly massive filling in it when I was a ... to do a root canal as he went quite deep, but a crown turned out to be ... The molar feels and looks wonderful and solid. ... tooth as indicative of what's going on in this other one. ...
    (sci.med.dentistry)
  • Two Cases...
    ... put a medium AutoMatrix around the second molar, ... the floor of the mesial box of the composite filling, ... crown on the Endo-treated left upper incisor. ... he had a strange feeling in that tooth after the ...
    (sci.med.dentistry)
  • Re: Crowned tooth needs root canal?
    ... >> Three years ago I had a cracked upper molar repaired with a crown. ... the tooth has been symptom ... >> pain when I would chew hard foods such as raw carrots. ...
    (sci.med.dentistry)