I have a tooth that had a root canal many years ago. It now has decay under the gum. My dentist says I can get braces to pull what is left of my tooth down and then cap it or extract the tooth and get an implant. Suggestions...
Tooth With Decay Under Gums, Do I Need Braces or Implants?
Doctor Answers (12)
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Implant or orthodontic extrusion
Your dentist has been commendably thorough in giving you the two best options. Having had experience with both procedures I would recommend the implant. There are a few reasons why: 1) the tooth may not come down even if you use braces to putt it, 2) It may have a tendancy to get sucked back up after it has come down, 3) If the extrusion is successful, there may be a high liklihood that you will get decay on the root surface again. Old root canal teeth become dry and brittle and vulnerable to decay. I believe the implant is the most predicatable long-term sloution and most cost effective.
Cavities in roots
before the dental implant in dentistry, what your dentist has suggested was one of the few solutions. today with the high successs rate of dental implants, it a way much better solution for your problem. now, if your tooth is highly aesthetic, probably it wouldn't be a bad idea to do what your dentist suggested which we call forced eruption and than pull your tooth and replace it with a dental implant. the benefit of such a thing, you can bring more bone and soft tissue to the are which it was lost due to the inflammation caused by your cavity under the gum.
Implant Vs Crown
In the particular case you are describing, I would personally choose the implant over the orthodontics and crown. The deciding factor for me would be the long term solution that the implant offers.
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I would suggest to get an implant versus orthodontics.We can try with braces to move the tooth, however that is a long term procedure for one thing. Then the tooth is already compromised having a root canal for a while. This option with braces might have more chances of failure than implant.
You have to compare the prices. Braces versus implant.
Implant or Forced eruption to save root for crown.
First question is "do you need or want some orthodontic treatment anyway due to some other crooked teeth and cosmetic issues that could be improved by orthodontics." If you do, then including the forced eruption in the orthodontic treatment might be a good option to save the cost of the implant if the tooth being erupted is in reasonably good condidtion otherwise and will be a good base for a crown. If you have absolutely no need for braces anywhere else in the mouth, then it may be faster, easier, and more cost effective, to just go ahead with the implant. In any event, if you put in the implant, you will tend to "lock In" whatever orthodontic issues that are there now because the implant can not be moved later. The tooth root probably could be moved some later if needed but it would be best to make your final decision about orthodontics now. If Orthodontic treatment is never going to be done, go for the implant. Taking a CT scan of the implant site can also be helpful if there are any qestions about the tooth root or the bone support available.
Braces or implant
For your particular case both choices would work but many factors play in your decision. WIth the option to use braces to pull the tooth down you may end up with a nice result but have a tooth that has a long term questionable prognosis. If you decide to have the tooth removed and an implant placed you will probably spend a few dollars more but have a longer lasting solution. Long term the cheaper option will be the implant because implants are 97% successful
Good luck with whatever decision you make
Orthodontics or Implant to treat root damage
All the dentists that have responded are correct in stating that it is a consideration of length of duration of treatment desired. Cost and patient health could also be issues. Also aesthetics and root length and shape. Your dentist needs to look at the options and give you the details of your particular situation. He can involve a root canal specialist and /or an orthodontist to get more specific information. Research well your options as the answer will be specific to you. Good Luck!
Its all about Predictabililty
In the "old days" of dentistry, we tried our best to save every tooth. Wih the invention of root form dental implants that has all changed and in today's world, many times we choose to remove a questionable tooth in favor of placing a more predictable and long-term solution; that is, an implant. Your dentist is correct in giving you options and both are viable. My experience in this situation is that the implant will give you a more esthetic and long-lasting solution to your problem. Be sure to select an experienced surgeon as this implant is in a highly esthetic zone and needs to be placed properly for a good outcome.
Implant or Braces
With the scenario you describe, I would definitely say the implant option will be more predictable and long lasting. Sounds like the tooth you would be trying to save is already compromised and even if orthodontics is successful and a new crown is placed, the root has a significant chance of fracturing over time.
Implants are often the best choice in the big picture
In the short term, orthodontically extruding the tooth for a new crown can work. It just won't last as long as other options, perhaps only a few years (the result will be a shorter root, so a weaker foundation). The most predictable and longest lasting option, and cheaper in the long run, is the dental implant.
Web reference: http://www.bestseattledentist.com/
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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