Veneers for root filled teeth

[Jackie284]

Hi all,

I was looking for some advice regarding improving the appearance of my two front teeth, which are root filled and discoloured. I don't really want to go for crowns as I lost the 2 teeth either side of my front ones, when I had them crowned. The roots shattered and had to be removed when I had them changed about 5 years later. Is it possible to maybe have some internal bleaching done, and then some porcelain veneers ? I would much rather do this, knowing I have at least some tooth left,

any advice greatly appreciated,

Jackie

[Dr Pav Khaira]

Internal bleaching and veneers can have the desired effect, it very much depends on how dark the teeth are and whether a veneer is suitable.

If there is not too much of a colour difference adn veneers are suitable this would be the ideal solution. Internal bleaching can be unpredictable and I have had a few cases darken again and show through the veneer.

For large colour discrepancies I generally prefer crowns which are superb restorations and mask the colour much better. If done well, there is no reason your crowns shouldn't last you 15 years +

Hope this helps

[Jackie284]

Hi Dr Khaira,

many thanks for your reply. I would happily have the crowns, but what worries me is how the two crowns I had some years back shattered so easily, therefore the same could happen with my front teeth. Also my dentist said he would make crown that had a tooth attached to the side of each one, sort of like a bridge, to replace the 2 teeth I lost (I curently wear a denture for these). However, I'm worried this would put further strain on the 2 front crowns, maybe increasing the likelihood of them failing ?

many thanks again

Jackie

[Dr Pav Khaira]

Jackie, the answer to this is not a simple one. If your teeth are suitable for a bridge, this would be a good long term option. As with everything, it very much depends on the materials used and execution of technique. I have recently constructed a bridge that is held in place by 2 teeth and replaces 8 teeth. I am confident in my technique and choice of material and would be very surprised if anything happened to that bridge within the next 10 years.

Please remember that your own teeth havent lasted you a lifetime and statistically nor will any dentistry. However when done well, quality dentistry lasts a very long time. Poor quality work can potentially accelerate tooth loss.

There are a number of reasons crowns may fail and it happens to the best of us. If you are concerned I would discuss this in more detail with your dentist. When used appropriately, crowns and bridges can be an excellent restorative choice

[Jackie284]

thanks Dr Khaira,

I actually spoke to my dentsist about the internal bleaching and he said it may not be effective as my teeth were not that dark yet ?! Can a tooth be internally bleached after a venner has been put on ? sorry for all the questions, but when I go and see him I forget to ask alot of things I need to,

many thanks

Jackie

[Dr Pav Khaira]

Ideally all whitening should be conducted before and veneer or crown work, and a short tail out time of a few weeks to see how stable the result is. As I've said, very dark teeth generally need crowns to mask the colour discrepancy

Hope this helps

[toothfairy]

Sorry to hear about your problems with crowns Jackie. Sounds like you've been through a lot of dental trauma.

I have a colleague who has had a veneer on a root filled tooth replaced because she did not want a crown. Her original veneer was discoloured because the root filled tooth showed through. The new veneer masks it quite well, but you can see a slight shadow in certain lights. I'd say the veneer will be a better appearance than you have now, but it might not be perfect.

Whether the roots would shatter really depends on the state of the roots, how well your canals have been done and how well the crowns are made and fitted. I have had a crown replaced on a root filled tooth with no problems. I'm surprised you didn't have the teeth crowned when they were root filled, as I understand that's the usual practice because root filled teeth can be more brittle. Obviously you have to be careful not to put too much stress on a root filled crown because it's structure is slightly weakened compared to a normal crown. What can happen is that the root canal can fail if you start to disturb the tooth with the trauma of dental work. That's why you need a good dentist who will look after you properly, maintains good hygiene and make sure nothing damages the canal filled teeth.

Personally I would baulk at the idea of having a bridge attached to root filled teeth. I think that would put a huge strain on the roots and might make them fail leading to more extensive work or removal. What about implants? Are your gums and bone not suitable? What sort of state are the canines in? They must be more suitable for a bridge if they are not root filled as they usually have a strong root.

You need to have a consultation with a good dentist to go through your options. He/she will be able to examine your x rays to see the state of your roots and assess your treatment pathways. Get a few opinions and then decide what to do. Don't rush into anything, it's not worth the hassle later.

[Jackie284]

many thanks for your reply toothfairy,

Can I ask, did your colleague have internal bleaching done at all, on the root filled tooth ? I only thought a veneer might be an option for me if the tooth was whitened as much as possible before it was fitted. I really believe attaching another tooth to a front crown as a bridge, would put further strain on it, so I'm worried about that. I want lava crowns, which I believe are the best, so it certainly won't be cheap. I'm worried if they fail i'l lose the tooth, and incur further costs to remedy it,

thanks again

Jackie

[toothfairy]

Hi Jackie. I asked her and she didn't have the bleaching. She did say that the tooth behind is black and that drinking coffee is affecting the appearance of the veneer.

The crowns you're suggesting are supposed to have a very good fit and that's very important when you have a root canal because it stops any bacteria seeping in between the margin and spreading up under your gums. I've been told by an endodontist that teeth can be exposed to infection during dental treatment.

[Dr Pav Khaira]

Lava is not always the best option. It is a option. The are a huge number of factors to take into account that I won't bore you with. To mask a very dark tooth with a veneer is not a good idea due to the amount of tooth reduction that would be required. You would be bonding to the deeper layers of the tooth which is not as predictable as a conservative preparation. All crowns technically leak regardless of materials used to make them or cement/bond them. If a root canal is done well and leakage kept to an absolute minimum it will be successful. I'd agree bridging is not the greatest of ideas but is an option. If possible an implant would be a much better option to replace missing teeth.

From what you have described I wouldn't necessarily use Lava (zirconium oxide) for a crown. These crowns are difficult to get a colour match on althout it is possible. there are a significant number of other materials available whereby optimum aesthetics can be achieved. It may be that you do need a lava crown, without a consultation its difficult to say