Re: Getting #31 Root Canaled Next To Impacted Wisdom

Newbie@xxxxxxx wrote:
On Thu, 20 Dec 2007 23:17:04 -0500, frankieinpeace@xxxxxxxxx (Frank L)
wrote:

I have to have #31 crowned and possibly root canaled because it hurts
when I bite hard food. There is a small crack but it doesn't extend to
the gumline. My question though is this: will the crown interfere (bump
into) the horizontally impacted wisdom tooth? There is a small space
between the 2 teeth on the x-ray.

The problem with any 'crack' or 'fracture' of any tooth is that the extent cannot be determined just by looking from the outside.
Radiographs rarely reveal fractures unless they are non-restorable.

Depending on age, position, difficulty in restoration, etc...
generally my approach is to treat the RCT and place a good
fuji9 build-up, surgically remove the impacted wisdom tooth,
then prepare/place the crown on the RCT'd molar after WT
surgery healing is acceptable.

Question two: If it gets a root canal and ever developed an abscess, can
that spread to the wisdom tooth when it's in that position? What would
the dentist then do? Would they be able to treat it with antibiotics or
would they have to get the wisdom tooth extracted?

Hey dude ! That's more than just a one question #2 !!!

OK, on a second molar RCT with an impacted WT <of any angle>
it is extremely unlikely for a periapical abcess to spread from one
tooth to another. This is also true of any other teeth, say from a 1st bicuspid to the 2nd bicuspid. There are situations that this can
occur and it is called anachoresis. There is almost always a
periodontal component in those type of cases. IOW kinda rare.

Wherein lies the rub is the impacted lower WT that has periodontal
problems up against a 2nd molar that has distal decay into the pulp.
Getting a good clean margin for a crown on the distally decayed 2nd
molar that has RCT is very often dependant on removing the impacted
3rd molar <WT>. If the "horizontally impacted" WT is *not* removed it
is unlikely that a long term stable solution can be achieved.

If you can post or send some radiographs will be able to advise you
further.


Agree entirely. And we've all seen that final scenario played out again and again.

Steve

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

Relevant Pages

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