Nightmare for Crown Wear

After several year wear, crown may be out of our tooth.  If the crown comes out clean, we can glue it back.  The crown wearer will be happier.  However, if the crown comes out with some tooth structure, the crown may be not securely glued back.  This is nightmare for crown wearers.  Lily is one of them.

One week ago, Lily came to our office for consultation.  She notices bad odor from one of her front teeth (Fig.1).  The suspected tooth has a crown (C), post (P) and root canal (R).  Other than those, the tooth looks fine. 

Yesterday, she returned to office for emergency.  The crown came out (Fig.2-4).  The tooth had fractured.  Part of fracture line (Fig. 2 arrowheads) is underneath the gums (G and white line). The gums are irritated and bleeding (Fig.3 G).  What we can see is the remaining root. There is almost nothing for the crown to grasp.  Therefore the crown after recementation may be not very stable.  The post (Fig.4 P) and some tooth structure (*) came out with the crown.  The future of this crown is not so good.

It appears that Lily needs extraction and implant.  By the way, Lily has lost three back teeth (Fig.3 *).  When we lose back teeth, we tend to chew with our front teeth.  These skinny teeth may break under stress and pressure, particularly after root canal.

Xin Wei, DDS, PhD, MS 1st edition 10/20/2011, last revision 10/20/2011