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    Thread: Root canal on tooth broken below gumline?

    1. #1
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      Default Root canal on tooth broken below gumline?

      I am getting different opinions from different dentists.

      I have a broken molar which is about 1/4 broken below the gumline (break goes about 2mm below at deepest I reckon but the tooth doesn't look very solid even here - a bit shell like).

      The dentist who impressed me the most (in just about every way) said I would need crown lengthening to re-establish the biologic width otherwise I could face gum irritation, a gum pocket and unstable bone loss. He also offers an implant as an alternative (which, while it would mean being toothless for several months, and is very expensive, sounds the better option).

      Two others seemed to think a root canal might work. One didn't mention crown lenghtening. Another said they didn't think it would be needed when I asked, and cord or electrosurgery could be used where the break is below the gum. Both said it was worth trying to save the tooth.

      I am not sure what to do.

      Any dentist opinions gratefully received.
      Last edited by no_idea; 5th February 2010 at 19:25.

    2. #2
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      Default Re: Root canal on tooth broken below gumline?

      i am not a dentist, but this has happened to me Several times. i also went to different dentists and got different answers. one extracted a tooth right there on the spot..i am pretty sure he could have saved it now, looking back on it, but i was in so much pain i got scared and didn't feel i had a choice. worst mistake ever.
      he also told me i would need another molar removed and wanted to take it that day. i waited and went somewhere else, where they did a root canal, a crown legthening, put a post and core build up in it, then the crown on top. which saved my tooth.
      i have Two more that are broken that badly as well, and my endodontist and my dentist both agree the same course of treatment would work for them as well.
      the post i think is the key, it gives the tooth structural support. and since the tooth was broken so badly, the crown lengthening gave room for the post.
      i am a big fan of implants, but i see them as a last resort. if they HAVE to take my tooth, then i think i would get one...but as long as i can keep what i have, i will.
      just my two cents, good luck with whatever you decide!!

    3. #3
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      Default Re: Root canal on tooth broken below gumline?

      If you're going to look at it logically, then for the price of crown lengthening, endo, post core and crown, you're not going to be much cheaper than with an implant... with less chance of a successful outcome.

      However, since teeth are parts of our bodies, it's difficult to be entirely logical about it unless one has pointy ears

      Your first dentist sounds like they're talking the most sense. In other words it's what I would do

    4. #4
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      Default Re: Root canal on tooth broken below gumline?

      Thanks, Gordon. Yes, logic and stastistics suggest the dental implant is the better option. I don't like the idea of crown lenghtening affecting bone around other teeth. And even the good dentist wasn't overly optimistic about the tooth's chances. The only trouble is that the thought of the implant surgery terrifies me... I know literally millions of people have had it done but it is a scary thing. And there is the possibility of nerve damage.

    5. #5
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      Default Re: Root canal on tooth broken below gumline?

      Your first dentist makes sense in that he understands what it takes to restore a tooth properly. Today it seldom makes sense to do a root canal, crown legthening(gum and bone surgery), post and core, and crown. I agree with Gordon
      While every case is different but today by sectioning the molar and use of a piezo surgical device an extraction can be amazingly gentle then after grafting bone the implant placement is also a much easier procedure then it sounds.
      Dr. Raymond Kimsey, DMD
      www.comfortableimplantdentistry.com

    6. #6
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      Default Re: Root canal on tooth broken below gumline?

      He said he would cut off the crown (well, the few bits that remain), allow the gums to grow over the root and then extract the root and stitch up the gums. He didn't mention a bone graft. Not sure if that is always needed.
      Last edited by no_idea; 8th February 2010 at 12:09.

    7. #7
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      Unhappy Re: Root canal on tooth broken below gumline?

      [QUOTE=comfortdentist;70137]Your first dentist makes sense in that he understands what it takes to restore a tooth properly. Today it seldom makes sense to do a root canal, crown legthening(gum and bone surgery), post and core, and crown. I agree with Gordon
      QUOTE]

      hello again.
      i am not trying to fuss at all, really...but i think it is a bit much to say that it doesn't make sense to undergo those procedures to save a tooth. i have been to several dentists that all agreed it is the best option. for two of my molars, in fact. my dentists try to save my teeth if at all possible. once you extract, you can't go back. as said "Your first dentist makes sense in that he understands what it takes to restore a tooth properly."
      which means yes, you can restore a tooth properly, and maintain it for years and years, if not a lifetime if you are lucky.
      if you are concerned about bone loss, i would be equally, if not more worried about extraction vs. those procedures. your teeth make your jaw structure. once you extract, bone loss can start to occur almost immediately. even with an implant you can still incur bone loss, and even tho it is a very small failure rate on implants, it usually always occurs due to bone loss. or rejection, even.
      crown lengthening is a very commonplace procedure, and only a millimeter or two of bone is removed. they made one small circle around the tooth, that is it. for me at least.
      and have you read about how many people require such things as sinus lifts and bone grafts to get implants? scary.
      the only part about it that can seem illogical to me, is the financial cost. which is substantial.
      when i talked about it at work, and my coworker told me it was stupid to spend all that money and how i should "just yank them out", it really truly upset me. it still does.
      this is my mouth, and if i want to save my teeth, i don't want to be judged for that.
      not to say that anyone here is judging. i just know that this forum is read by hundreds, if not thousands of random, scared, and confused people, and i don't want them to be mis-informed, or made to feel like they aren't doing the right thing.
      i am really broke, and i save penny by penny in a special savings account to pay for my teeth. in the end...money is paper. and i am flesh and blood. i think Gordon was right as well, "since teeth are parts of our bodies, it's difficult to be entirely logical about it"
      and i also made sure to discuss how much they were going to legnthen, so as to make sure i Can get an implant later. if i have to.
      sorry if I offended anybody, definitly wasn't my intention. i apologize, actually, to the original poster, to go off track. i just think it needs to be said.
      just wanting to help someone like me.

    8. #8
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      Default Re: Root canal on tooth broken below gumline?

      Thanks. Another dentist had a look yesterday. She said the tooth is badly decayed and while a root canal was possible, she recommended an implant if I wanted a long term solution.

      May not be ideal for every tooth but that is what I am going to do.

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