Custom Tooth Replacements

Failed Root Canals - Crown Post Buildups

Root Canals are routinely used to extend the life of a tooth when tissue problems arise (root infections, inflammations, minor fractures, etc) otherwise threaten the potential loss of the tooth. Although a highly successful treatment, failures do unfortunately occur.

Branched or hidden canals (what can't be seen or accessed easily) probably represent the most common reason for failure and possible need for retreatment.

Failed Crown and Post Treatment
Too Conservative

The location, patient occlusal characteristics and bite pressure dynamics of a tooth needing root canal therapy can also be a factor in failure. Molar teeth are subject to the most extreme biting pressures a patient can create. Molars are also subject to bruxism and clenching.

The unusual biting and clenching behaviors can create lateral forces upon root canaled structures that eventually cause failure.

Central Incisors too, if treated with a conservative treatment that is "too conservative" are also prone to failure. Centrals, after all, are our "main biting teeth."

Porcelain crowns that have been fortified with a metallic or ceramic post and buildup can also fail for very similar reasons. Location, functional capacity of the tooth and sufficiency of the crown placement are the major factors in determining the endurance of a tooth replacement.

Best Conservative or Retreatment Choice

Conservative treatment that preserves as much as possible of the original tooth structure is, by default, always the primary recommendation.

Most reconstructive dentists who practice comprehensive dentistry will, however, perform additional assessments that involve occlusal studies to determine if a particular conservative treatment has the endurance and longevity of treatment that we, as patients, all want.

Loose Left Central Incisor
Failed Crown and Post Buildup

Retreating a tooth that was treated too conservatively is frustrating, more time consuming, involves more costs and may cause additional tissue loss. See the above right picture of an inadequate conservative treatment that failed within hours of being treated.

The photo pictured here, at the immediate right, shows early stages of failure that is causing changes in the gingival tissue.

A larger diameter post and more accurate insertion of the post may have produced a more stable treatment outcome, assuming that the patient's bite characteristics didn't play a major role in causing a lateral force to operate upon the new restoration.

Improperly Sized Post Treatment

Notice how the post is broken in two and that lateral movement of the underlying structure has occurred.

Dr. Sussman and the patient agreed that the only definitive treatment remaining for replacing the tooth with a structure that would meet or exceed what Mother Nature provides is a dental implant.

The fear of being toothless while the implant site is healing was overcome with a custom treatment that included specialized bone grafting products (BioHorizons Grafton), Legacy Implant and a hand crafted temporary acrylic crown.

All treatments were provided during the same appointment. Extraction, bone grafting, implant placement and attachment of the temporary crowns were completed sequentially.

To assure the best possible outcome for the patient's overall treatment, the adjacent front tooth was prepared for a porcelain veneer. The risk of having even the slightest variation in color shading and texture was thereby eliminated.

Dental Implant Immediate Surgery Rochester

Implant and Zirconia Abutment

The implant design and placement of the temporary restoration assured that the implant would become fully osseointegrated within the usual time frame of about 3 - 4 months.

The combination of a specially selected implant with width and length properties that created the best placement possible with bone regeneration products assures a healthy integration into the jawbone.

The temporary restorative products (crown and veneer) were placed to provide an acceptable cosmetic and functional result that enabled the patient to eat, smile and speak normally.

Precision Implant Placement

At the completion of implant surgery healing, the new permanent porcelain crown and porcelain veneer were placed, providing a picture perfect example of desireable treatment outcome.

Since both front teeth were being treated, the patient took advantage of tooth resizing opportunities that wouldn't have been available with the placement of just one crown.

Following the renowned Rule of Golden Proportions, the new crown amd veneer were sized to create a smile line that was more natural.

Her new teeth would have a matching incisal edge that corresponded with the patient's overall smile, appearing more natural.

Recontouring of the gingival arches (also known as crown lengthening) of both incisors addressed the attention to detail for creating the cosmetic result desired by the patient.

New Porcelain Central Incisors

Efficiency of Dental Implants

Dental implants are not known routinely as a conservative treatment. Rather, it is a technology for ideal tooth replacement that has the best bone conserving treatment qualities.

In addition, properly placed dental implants thrive in high bite pressure environments.

Implant surgery, nonetheless, can "acquire" qualities of being a conservative treatment (in terms of costs and retreatment activities) when certain conservative treatments are known to be a "gamble" and eventually fail.

Root canaled teeth that endure the brunt of biting and chewing are unfortunately associated with treatment failures. Tooth structures that have been "re-filled" one too many times can also cascade into a series of treatment failures that can typically end up with an implant tooth replacement.

Even bridgework in a location where bite pressures are extreme can fail for some patients.

Whenever doubt arises about the long term endurance of a particular tooth treatment, patients are encouraged to get multiple consults from dentists who have access to today's advanced treatment protocols.

Questions?

Patients seeking additional information about material on this page or other implant related treatment possibilities are invited to contact our doctors directly for more information via email or to schedule a complimentary private consultation.