Dental Education Lecture: Save Loose Tooth
Previously, we discuss that one of Mrs. Liu's bottom front teeth becomes loose in two years. Our tooth becomes loose because it loses bone support. Two years ago, the root of the tooth (#26) is surrounded by bone (* in Fig.1). For unknown reason, the bone is gone in two years (* in Fig.2). Since the nerve of the affected tooth is dead, we remove the dead nerve and finish root canal (R in Fig.3).
To handle the loose tooth, we use white filling and a wire to tie the loose tooth with the neighboring teeth (splinting: S in Fig. 3 and 6). In five months, the bone starts to grow around the root (* in Fig.4). In another 9 months, bone grows more and binds to the tooth (arrowheads in Fig.5) more tightly (as compared to Fig.4). But Mrs. Liu complains that she has a little pain when she bites heavily. X-ray shows that the bone is lower on one side than the other (compare dashed white lines in Fig.5), because of accumulation of tartar (*). To save this loose tooth, Mrs. Liu must step up her own oral hygiene effort, using min-brush and visits dental office to get professional cleaning more frequently.
When bone recovers to normal as indicates in Fig.1, the splinting can be removed.
Since bone has grown in part, it appears that the tooth has partially regained its stability. The splint was shortened one year after treatment for easy cleaning (Fig.7 s, as compared to Fig.6).
Mrs. Liu is doing fine with the treated tooth. Although bone does not restore completely normal, the bone immediately next the root (Fig.8 arrowheads) is much denser (whiter) than before (as compared to Fig.4,5). The shortened splint is still being used (Fig.8 s).
Xin Wei, DDS, PhD, MS 1st edition 06/30/2010, last revision 07/13/2013