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Porcelain crown on top of bad root canal??
Back in Sept 06' I had a root canal due to a cracked tooth. nothing more. I was sent to an Endodontist, where the procedure was done. That was that. Seeing as it is the front bicuspid, I paid $1250- for a Princess Crown. So my Dentist put that on. Several months later here I am with Pressure pain. It isn't horrid pain, but nonetheless, I saw the Endo, and he played around with it. Then he took a photo. Then he said see your Dentist about it. Well, it was not a case of a bad bite here. I continued to complain. I told him that he should talk to my Dentist and decide as 2-professionals what needs to be done here, and please send a copy of the x-ray to my regular Dentist.
Bottom line, my dentist said they see a circular field in the x-ray...usually meaning a re-do. In my case now I have to have the endo go thru the gumline as to not crack my all porcelain crown !!! dang!!! I know for a fact the endo did not take a picture after finishing the procedure. 1st mistake. It took 2-visits to do a ONE CANAL TOOTH???? that was a first for me. He said my canal was long, I heard a 23 called out. He said he would pay if he got to do it thru the tooth, but since its surgery, my Insurance has to pay..... I personally think he messed up. This has never happened to me and I have had several root canals. Please I need advice. Might I lose this front tooth?
thanks cindy
Bottom line, my dentist said they see a circular field in the x-ray...usually meaning a re-do. In my case now I have to have the endo go thru the gumline as to not crack my all porcelain crown !!! dang!!! I know for a fact the endo did not take a picture after finishing the procedure. 1st mistake. It took 2-visits to do a ONE CANAL TOOTH???? that was a first for me. He said my canal was long, I heard a 23 called out. He said he would pay if he got to do it thru the tooth, but since its surgery, my Insurance has to pay..... I personally think he messed up. This has never happened to me and I have had several root canals. Please I need advice. Might I lose this front tooth?
thanks cindy
my tooth was chipped. Not cracked. Thats here-nor-there..whats done is done. All I know is I am in pain. And I need to know about this type of surgery they are gonna perform. I have the worst taste in my mouth. OMG. And little blisters as well. I am certain I have bacteria that has formed probably in that tooth. Last nite I woke up and I was congested in the sinuses and I blew my nose and it was all blood. then I woke with a BAD headace on the other sinus. I have decided to call my dentist tomorrow, and have him look in my mouth, the irritation that is occuring and have him explain to me about the surgery. I am one for NOT ASKING QUESTIONS. especially when it comes to my teeth !!!
cindy lou
cindy lou
with a cracked tooth you are not guarenteed it will not need removal someday. with the all porceline crowns they sometimes use a cement that i hate, its thick and sets fast and if you dont get it seated properly it can have results simular to your experience. you should have been informed that with a cracked tooth a root canal may fix it, but its not a guarentee. as for the bleach smell, it was probably just that they rinsed your canal out with, common practice.
Cindy I hope your sinuses clear up soon. Sinus infections are no fun at all.
As for the tooth I would have a long chat with the endo guy and get him to tell you the pros and cons of each procedure before you go ahead. Also to explain why the root canal failed when there was no infection to start with and whether he thinks you ever needed a canal treatment (he should know whether the root he took out was live - if it was dead you needed the treatment).
I have all porcelain crowns now too but with some sort of crystal core which is supposed to be very strong. I do sometimes panic that my canals might fail, especially when I get run down and get aches in any tooth. (I have had one RC 11 years, another 9 years and a third 6 years so far).
I was reading about all this on another in-depth website after I sent you that link. It may be that the endo did not seal the canal tightly enough or it maybe that the crown you have is not fitted perfectly at the neck and allows bacteria to reach the root canal area (or both). Some dentists can pop crowns off (it was not something ever suggested to me during my treatment). Having a long root is not a bad thing, as it probably means more bone around the tooth. In my experience it's normal to have two visits for a root treatment. My endo filled the canal with what smelled like bleach (!) left a temp filling and the tooth empty for a week to let any infection drain out before filling the root.
One further option is to watch and wait because some teeth can feel sensitive and painful every so often after a root treatment and will settle down over time. In my case I had two like that and both had crowns which did not fit perfectly at the neck. When new crowns were fitted the teeth have pretty much settled down. Someone is liable in your situation and it is not you. You should get some legal advice too. If your health policy doesn't cover negligence, the dentist and endo should both have some form of professional liability insurance, especially in the states where they can be sued. The only way to get compensation if liability is involved is to get a second opinion before the work is revised. It may of course be that you are just unlucky and one of the 10% of canals that fail.
In any case I hope you feel better soon and get this sorted to your satisfaction.
As for the tooth I would have a long chat with the endo guy and get him to tell you the pros and cons of each procedure before you go ahead. Also to explain why the root canal failed when there was no infection to start with and whether he thinks you ever needed a canal treatment (he should know whether the root he took out was live - if it was dead you needed the treatment).
I have all porcelain crowns now too but with some sort of crystal core which is supposed to be very strong. I do sometimes panic that my canals might fail, especially when I get run down and get aches in any tooth. (I have had one RC 11 years, another 9 years and a third 6 years so far).
I was reading about all this on another in-depth website after I sent you that link. It may be that the endo did not seal the canal tightly enough or it maybe that the crown you have is not fitted perfectly at the neck and allows bacteria to reach the root canal area (or both). Some dentists can pop crowns off (it was not something ever suggested to me during my treatment). Having a long root is not a bad thing, as it probably means more bone around the tooth. In my experience it's normal to have two visits for a root treatment. My endo filled the canal with what smelled like bleach (!) left a temp filling and the tooth empty for a week to let any infection drain out before filling the root.
One further option is to watch and wait because some teeth can feel sensitive and painful every so often after a root treatment and will settle down over time. In my case I had two like that and both had crowns which did not fit perfectly at the neck. When new crowns were fitted the teeth have pretty much settled down. Someone is liable in your situation and it is not you. You should get some legal advice too. If your health policy doesn't cover negligence, the dentist and endo should both have some form of professional liability insurance, especially in the states where they can be sued. The only way to get compensation if liability is involved is to get a second opinion before the work is revised. It may of course be that you are just unlucky and one of the 10% of canals that fail.
In any case I hope you feel better soon and get this sorted to your satisfaction.
thank you so much.. Very informative indeed. I am now on anti-biotics. Very strong ones ! And I don't feel well, so I am leaning towards sinus infection seeing as I work with sick patients all day ..
I just woke up after sleeping 4-hours.
About my crown, I swear this crown has no metal. when I held it in my hand it was like a jewel. I could have bought a Real Set of Porcelain China for that cost..LOL. I wonder what the mark up is on these things ? I often wonder. It fits quite well. Yes I know there is some recession on anything u put in your mouth. But lots of my other crowns have metal showing, very ugly indeed.and i have lots of recession. I also have an awful taste in my mouth for about 2 weeks also. Could be sinuses, could be bacteria in my mouth..just don't know.
again thank you. I have a feeling I am not gonna want to do this surgery after i view this website here. The Endo doc offered to do it either way actually. thru the tooth or not.Its my crown, and again I will sign a waiver ...he doesnt' care how we go about it. So the surgery is scheduled and i will have stitches and all. good God. what a mess.
Hey did I tell you I have an HMO Dental Plan. thats how I got myself in this mess to begin. I have since cancelled it.
I just woke up after sleeping 4-hours.
About my crown, I swear this crown has no metal. when I held it in my hand it was like a jewel. I could have bought a Real Set of Porcelain China for that cost..LOL. I wonder what the mark up is on these things ? I often wonder. It fits quite well. Yes I know there is some recession on anything u put in your mouth. But lots of my other crowns have metal showing, very ugly indeed.and i have lots of recession. I also have an awful taste in my mouth for about 2 weeks also. Could be sinuses, could be bacteria in my mouth..just don't know.
again thank you. I have a feeling I am not gonna want to do this surgery after i view this website here. The Endo doc offered to do it either way actually. thru the tooth or not.Its my crown, and again I will sign a waiver ...he doesnt' care how we go about it. So the surgery is scheduled and i will have stitches and all. good God. what a mess.
Hey did I tell you I have an HMO Dental Plan. thats how I got myself in this mess to begin. I have since cancelled it.
By the way have you tried rubbing some oil of cloves on at the neck of the tooth by the gumline? This won't make the infection go but it may give you some temporary relief.
Hope this lets me post the link now :
http://en.allexperts.com/q/Dentistry-966/Root-canal-retreatment-vs.htm
Hope this lets me post the link now :
http://en.allexperts.com/q/Dentistry-966/Root-canal-retreatment-vs.htm
I'm sorry you are in so much pain. If you have an infected incisor, then you can get feelings in your nose because the end of the root is often infected under the nasal passage.
My endo was on my front teeth too. The dentist had to drill a small hole through partial porcelain on mine too. This is done at the back of the crown at an angle which will access the remaining tooth. Whether an endodontist can drill through a crown without breaking it is a matter of skill. I cannot see what difference it makes drilling through partial porcelain as in my case or total porcelain. Either way you drill through porcelain. He is probably just covering himself, because if he screws up he has to pay. Given that you had not infection to start with and then your root has failed, do you really think this endo is skilled enough? By talking about gum surgery, he must be talking about an apicoectomy where the tip of the root is cut off (my endodontist talked me through all eventualities including diagrams during my first root treatment). An apicoectomy is usually a last resort where I live, but there may be a different policy where you are. It also weakens the root but may save the tooth. Has the endo explained all this to you?
There are different types of crowns you can have on your front teeth but over time your gums can recede over any crown. 100% porcelain crowns are not exempt. Some metal ones have a metal neck and this shows and looks unsightly if the gum recedes. These are less common these days as most have a neck covered in porcelain. Basically recession is down to how well you clean the teeth and how well the crowns are fitted. If there are any gaps or a poor fit you are more likely to have recession whatever the crown type.
I think you're talking about what we call the lateral incisor (one of the teeth alongside the two front teeth).
See the attached link which goes into the pros and cons of each type of treatment, and decide for yourself what you think of the comments. The comments are made by a dentist.
drill crown vs gum surgery link
My endo was on my front teeth too. The dentist had to drill a small hole through partial porcelain on mine too. This is done at the back of the crown at an angle which will access the remaining tooth. Whether an endodontist can drill through a crown without breaking it is a matter of skill. I cannot see what difference it makes drilling through partial porcelain as in my case or total porcelain. Either way you drill through porcelain. He is probably just covering himself, because if he screws up he has to pay. Given that you had not infection to start with and then your root has failed, do you really think this endo is skilled enough? By talking about gum surgery, he must be talking about an apicoectomy where the tip of the root is cut off (my endodontist talked me through all eventualities including diagrams during my first root treatment). An apicoectomy is usually a last resort where I live, but there may be a different policy where you are. It also weakens the root but may save the tooth. Has the endo explained all this to you?
There are different types of crowns you can have on your front teeth but over time your gums can recede over any crown. 100% porcelain crowns are not exempt. Some metal ones have a metal neck and this shows and looks unsightly if the gum recedes. These are less common these days as most have a neck covered in porcelain. Basically recession is down to how well you clean the teeth and how well the crowns are fitted. If there are any gaps or a poor fit you are more likely to have recession whatever the crown type.
I think you're talking about what we call the lateral incisor (one of the teeth alongside the two front teeth).
See the attached link which goes into the pros and cons of each type of treatment, and decide for yourself what you think of the comments. The comments are made by a dentist.
drill crown vs gum surgery link
Let me restate my issue..ania. I cannot have a redo root canal thru the crown "only" becuz its a Princess Crown..Let me explain what that is. It is a crown that is made of 100% Porcelain !! It is a cosmetic crown, and never covered by insurance. I paid $1250-cash for it. It is my front bicuspid, which is nxt to my front tooth. It is recommended to use all porcelain in the front 4-teeth becuz over time the regular crowns, Pontic with stainless steel and porcelain overlay) is not suggested due to eventual recession. with all porcelain crowns there is no recession, nor is there any metal showing at all.
That is why my dentist, and the Endodontist have talked and made a clear decision that going thru the gumline is best cuz "all porcelain crowns" crack easier !!
so i don't have a choice. I never had any infection. just a cracked/chipped tooth. My dentist said I had a choice, root canal w/crown, or no root canal, and just a crown. The tooth was stable..But I chose the root canal, becuz if I put a $1250- crown on and the tooth failed at a later time, they would have to destroy the crown.
As it turns out everything I worried about, actually happened !!
Last night this very tooth was hurting real bad.!! This morning my nasal passages and sinuses are hurting. I don't know if its the tooth, or I have a sinus infection????
However since the tooth was hurting first, for the last 2 wks. on and off, I think i have developed an infection...... I will call endo today.
That is why my dentist, and the Endodontist have talked and made a clear decision that going thru the gumline is best cuz "all porcelain crowns" crack easier !!
so i don't have a choice. I never had any infection. just a cracked/chipped tooth. My dentist said I had a choice, root canal w/crown, or no root canal, and just a crown. The tooth was stable..But I chose the root canal, becuz if I put a $1250- crown on and the tooth failed at a later time, they would have to destroy the crown.
As it turns out everything I worried about, actually happened !!
Last night this very tooth was hurting real bad.!! This morning my nasal passages and sinuses are hurting. I don't know if its the tooth, or I have a sinus infection????
However since the tooth was hurting first, for the last 2 wks. on and off, I think i have developed an infection...... I will call endo today.
You must have had an infection present if they did a root canal and this infection was not treated properly. I guess I mean that surely the root would not be infected now if there was no infection there from the cracked tooth to start with. Unless, the procedure killed the live nerve but did not remove it all. Ive read somewhere that it's the dead nerve that causes the infection because it's like leaving any dead stuff inside your body.
Anyway I had three pretty successful root canals done through crowns and they did not crack. One tooth was particularly delicate. These were not however premolars but incisors. I don't think he should be doing anything through the gum just so as not to crack the crown. Endo is usually done through crowns at the front, but I have no experience on having it done on more substantial teeth like molars where you have more than one root and you have a different structure. However, the endo should be used to drilling through crowns. Having gum surgery just because your endo is nervous seems rather drastic. Go to another endo for an opinion and for some advice on professional liability of the other endo. In my experience dentists are happy to say all sorts of things about other dentist's work but not their own!
Anyway I had three pretty successful root canals done through crowns and they did not crack. One tooth was particularly delicate. These were not however premolars but incisors. I don't think he should be doing anything through the gum just so as not to crack the crown. Endo is usually done through crowns at the front, but I have no experience on having it done on more substantial teeth like molars where you have more than one root and you have a different structure. However, the endo should be used to drilling through crowns. Having gum surgery just because your endo is nervous seems rather drastic. Go to another endo for an opinion and for some advice on professional liability of the other endo. In my experience dentists are happy to say all sorts of things about other dentist's work but not their own!
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