My crown fell off and my tooth has split and i need to have the root removed

Q. Hi My Crown fell off my front tooth and when I went to the dentist he said I would have to have the root removed as it has split but that I would have to wear a Denture for 6 months before he could put a fixed crown back there no other way of having this done as I cant imagine having to wear a denture, he has fixed the crown back on for now M

A. Dear M, thank you for your question.

If the tooth has fractured then unfortunately the only treatment is to remove it. Normally when a tooth is extracted there is a period of 6 months during which the bone remodels and there is normally some shrinkage as well. This may be why your dentist suggested waiting for 6 months before a permanent replacement was made.

There are 2 options for the replacement of the tooth:

The first is a dental implant. if an implant is to be placed then the remaining roots need to be removed very carefully to maintain as much of your natural bone as possible. the socket is then packed with synthetic bone to make sure the integrity of the ridge is maintained. This way the bone does not shrink back. A period of 4 months is the normal waiting period for the bone to become strong enough to place an implant. Due to the fact that the teeth on either side of the gap are not going to be involved in supporting the new implant, a denture is the usual method for temporary replacement of the tooth during the healing period.

Occasionally a fibre bridge can be made. This is a reversible treatment and one that I do for my patients if they can’t tolerate a denture. It is made primarily made of white filling material, it can be laboratory made or made at the practice. This is something that if you are a suitable candidate can be very satisfactory for the healing period. It does require more work by the dentist and if it is made by the dental laboratory will also be a more expensive option.

If you have decided to have a bridge to repalce the tooth then the teeth on either side of the gap will ultimately be shaved down slightly so that the bridge can be placed. If one of my patients was in the same situation as you are, the tooth would be removed, the socket would be packed with synthetic bone crystals and stiches would be placed. On the same visit I would prepare the teeth on either side of the gap and place a tempoaray bridge which I make myself or get the laboratory to make it. This is then glued in with temporary glue for the healing period. Over the next 10 -12 weeks the temporary bridge is modified so that I can make sure the gum and bone remodels around the false tooth to make it look as if were growing out of the gum. It can occasionally take longer 12 weeks. Once I am happy with the contour of the gum tissue I will replace the temporary bridge for a permanent one.

It sounds like the dentist you go to is planning on making a bridge for you which will probably be functinal but if the bone is allowed t recede and shrink back the final aesthetics may not be perfect and also you are limiting yourself for future implant treatment. Bridges on average can last for 10 -15 years but they do ultimately fail and when they do it is because one of the teeth that the bridge is attached to fails. This may then leave you with 2 gaps which will then need to be filled.

Talk to your dentist a little more about options available to you and express you concerns and hopefully he/she will be able to come up with a treatment plan that your are more happy with

Kind Regards
Dr Komal Suri

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This post was published on Sunday, March 9th, 2008 at 3:09 pmand is filed under Dr Suri's Answers, Experts Answers, Q. Broken teeth, Q. Dental Bridges, Q. Dental Implants. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

One Response to “My crown fell off and my tooth has split and i need to have the root removed”

1. Adam Says:
   April 19th, 2008 at 2:37 am

   Thanks for the great article, Dr. Suri.

   My periodontist also said the 6 month waiting time was for the bone to heal.

   Best,

   B.

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