Second attempt at permanent crown butt margin?

[Acheygirl]

Hi again. So I originally had a crown put on and after it seeded something went wrong and there was a noticeable signifiicant gap visable in my smile from the top of the crown to the gum line. I went in and we sawed it off and today I got the new crown. I inspected it before he glued and it looks great from the side you can see, however on the inside there is what I think is called a butt margin gap, enough where the tip of a fingernail can go in. I don't think I can handle the trauma of tearing it off again. I brush and floss daily. Is there any way he can maybe add a little composite resin in that little space?

 

[krlovesherkids777]

Acheygirl.

Not a dentist here, but hope you can get an answer soon. I don't blame you for not wanting it off again. Do you have another follow up? or just holding off right now?

 

[Acheygirl]

Krlovesherkids777 I just was in this past Friday so I am not sure what to do. I am concerned to call back it's just been one thing after another with my teeth. I don't think I could handle another crown removal. I am praying maybe just some resin can be placed there to keep me from noticing this small gap and ward off a food trap. I am sure this is not ideal in dentistry but at this point I am open to a composite or something along that small gap.

 

[comfortdentist]

Do you really want to patch a new crown?
Rarely makes sense so at least have a really good reason for doing it

 

[Acheygirl]

Do you really want to patch a new crown?
Rarely makes sense so at least have a really good reason for doing it

Dr Raymond,

Thanks for your reply. Would this small gap where it meets the tooth(fingernail tip width)pose any significant issue? I brush and floss religiously. I would rather just leave it alone and live with it unless this was a big issue.

 

[Gordon]

It's impossible to keep it completely clean, so it is likely to cause the tooth to fail at some point.

If you really can't face redoing it at this stage (and I do understand your feelings on it), then it could possibly be patched up with some glass ionomer, this would be a poor option but better than leaving it.

 

[Acheygirl]

Thank you Gordon. So what are the consequences of removing a permanent crown a second time? The tooth was root canaled back in December of last year.

 

[Acheygirl]

Dr. Raymond and Dr. Gordon,

Thank you so much for your replies. It was a very long day. I festered over this for a few days and went into the dentist today. They agreed the margins were off and the crown needed removed. I had it taken off today. It was sawed off and one half came off very easily the other side with some work. I was told the tooth stub looked fine no breaking etc. For the record the crown is a zirconia with porcelean I was told it supposedly can get hit with a hammer and stay in tact.

So with this being said, with the third permanent crown going on in 10 days, will the tooth still have the same prognosis of longevity based on what it's been through? I decided that I could not go through the next 10 or so years with knowing the margins were open so I was willing to take the risk. When the next one comes in this month I am going to tell them to wear magnifiers and inspect the margins with extreme precision.

Did I do the right thing by having it removed? Also if I may ask, can a permanent crown ever be temporarily cemented to make sure all is good?

 

[Mike]

You did the right thing, a root tooth won’t be traumatised by cutting the crown off so the prognosis shouldn’t be affected, it’s certainly better than risking decay at the margin.

 

[Gordon]

Yes, you absolutely did the right thing. It won't change the prognosis one bit.

Yes it is possible to cement on most crowns temporarily, certainly a zirconium one can be.

Given your dentist is now out for the lab bills for 3 crowns, then I'd bet they'll be super careful about how they fit this one. They're now making a decent loss on the work

 

[comfortdentist]

Bottom line again is that your dentist was willing to correct the issue. Also if it doesn't fit at one spot the same may be true elsewhere where you can't monitor or seal it.

 

[Acheygirl]

Dr Mike, Dr. Gordon and Dr. Raymond thank you. What is odd is that my dentist is actually quite good. I am not pleased though it should have been perfect the first time. They were very apologetic and mentioned how badly they felt about this. I wonder if the lab is messing it up? This time around they defined the butt margins higher and got a very good impression.

So last question for you all if you don't mind me bugging you. I was told that you want a crown to meet the gum line or go just a small amount up underneath it. Does this hold true for the inside of the mouth palate side? For instance, say that the crown butts up directly to the natural tooth leaving no gap but part of the natural tooth is visable. Is this acceptable or should it tuck at the gumline there as well?

 

[Mike]

It’s probably better to have a small amount of natural tooth especially palatally as it’s kinder on the gums.

The only reason for having it at (or very slightly below) the gum is appearance, unless it needs to go deeper to get the crown margin on to sound tooth material

 

[Acheygirl]

Thank you so very much. The input you offer here is invaluable. I can't thank you enough for taking the time here to read and respond to our questions.

 

[Mike]

No worries at all! I’m off work at the moment with a trapped nerve in my neck so at least this lets me be of some use ?

 

[Acheygirl]

No worries at all! I’m off work at the moment with a trapped nerve in my neck so at least this lets me be of some use ?

Ouch!! I hope you feel better soon.