I am 34 and had a root canal at an early age on my front left top tooth. It was chipped and filled however over the last couple years it has become noticeably discolored. I am now confused with all the advise from multiple dentist. 1. 2 veneers on 2 front teeth. 2 veneers easier to match 2. 1 veneer on discolored tooth. Veneer looks better 3. Porcelain Crown due to discoloration and brittleness of veneers Help! I would like to know A which looks better and B what has less of a risk of breaking
Dental Crown or Veneer for Front Left Top Tooth? (photo)
Doctor Answers (9)
Dental Crown or Veneer for Front Left Top Tooth?
Its is a hard decision for you to make,but you have to do what will make you happy and comfortable with your smile. The tooth with the root canal and chipped composite will need a crown, simply because RCT discolor teeth and need more support and strenght with a full coverage porcelain crown. This tooth will look good with just a crown and if you go to a great Cosmetic dentist , matching your existing color can be hard but not impossible. The best aesthetics and perfect matching will be if you do the tooth next to it, to your right as porcelain veneer. When you work just one tooth is right there to the center in front of your face and when two things are made at the same time, everything match perfectly. I hope this makes sense, again you have to make the final decision and both options are great options, but do you want perfection? or you can settle as long as it looks better than what it is...
When to crown VS veneer
Any dentist who thinks veneer will cover up the darkness your tooth is not a cosmetic dentist. In order to mask this kind of discoloration, enough reduction ( removing tooth) has to happen in which case you are looking into getting a crown to begin with. Also whenever you have a root canal there has been a filling placed in the tongue side of your tooth to cover the access hole they made to perform a root canal. So your tooth is damaged from inside and has a filling anyway, so in this case the concept of preservation of tooth structure as a factor to choose between veneer and a crown is moot.
So now we know you need a crown diagnostically. The next question is how many teeth to involve int he process to satisfy your desires Cosmetically. The answer : the more the better. Even if you did two, the middle teeth match, but the laterals ( the ones next to them ) will look different. How different? depends on the dentist and the lab.
In conclusion: you will need a crown on the dark tooth, and veneers on the rest. The more you veneer 6-8 teeth , the more aesthetic they will look .
Crown vs. veneer for root canaled tooth
My general rule is full-coverage crown for a root-canaled tooth due to the added strength that's needed to protect the more brittle tooth. I can also tell you that one of the hardest cosmetic procedures in dentistry is matching a single front crown or veneer to the surrounding natural teeth. This requires a meticulous dentist and a laboratory that can do nice customizing to get the color right. I can't see anything wrong with your right front tooth, but you may still want to consider getting that tooth treated for a more predictable result. So my suggestion is veneer on right tooth, crown on left one.
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Veneer or crown for the central tooth after endo treatment
In the situation when the root canal treatment was performed earlier, it is extremely important to cover the tooth with the permanent restoration. If the tooth is already discolored - the all-ceramic crown will be the more viable, long-term, aesthetic option, especially for anterior area. Usually it is performed after the full mouth teeth whitening, so that the final restoration will be looking more aesthetic.
Crown or Veneer for Front Tooth?
It's very hard to make a diagnosis from a picture. However, the dark Root Canal tooth will probably be stronger with a porcelain crown, and the adjacent front tooth should get a Porcelain Veneer at the same time. The reason being, it is EXTREMELY DIFFICULT to place a porcelain restoration on only 1 FRONT tooth, and have it match in texture, color and luminescence to the adjacent tooth. If the 2 are done at the same time, by a HIGH QUALITY dental laboratory, under the direction of a VERY HIGH QUALITY and EXPERIENCED cosmetic dentist, then the 2 teeth will match.
Veneer or Crown? Always Go As Conservative As Possible...
From your photo, it does look like you are a candidate for veneer(s) over crown(s). My rule of thumb is that the more healthy natural tooth structure you can keep intact, the stronger the resulting restoration. In other words, unless the whole back (lingual) side of the dark tooth is blown out from the past root canal, then you would want to use a veneer...because with a veneer we can contour a little bit of your tooth back (to make room for the veneer, whereas with a crown we have to grind down (destroy) your tooth to a nub to make room for the crown. A dentist who is always recommending crowns over veneers (giving the reason that veneers are fragile and break) is a dentist who has not invested the time and money to continue his/her education to become skilled and experienced in veneers procedures.
On the question of whether to do 1 or 2 veneers -- here is how I handle that with my patients. If you do your 2 front teeth, we have a better chance of getting an excellent match/result in fewer visits. If we just do the 1 tooth, it may take a few try-in visits before we get the porcelain to match the way we want it to. ...btw my fee is the same for 1 veneer or 2 since with 1 veneer we are going to need more visits.
I hope this helps!!!
All answers are acceptable
There is no right or wrong way about it. The root canal treated tooth benefits most from a full crown, as this allows covering of the access hole from the root canal therapy. Adequate thickness is needed to mask the discoloration, and matching teeth can be difficult. Often the fee for a single tooth in this situation is double the usual, as it is common to take several visits to get the color and shape dialed in. Doing both front teeth is a bit easier and would cost roughly the same, so having the fee the same to do one as to do two at the same time makes sense. Ultimately, it comes down to what YOU feel most comfortable with.
Crown or veneers ove root canal tooth
Based on the information you have provided us I would more than likely place a crown. Root canal teeth need more support and strength and an all porcelain crown will help provide that. Speak to a qualified dentist and see what your options are. Get multiple opinions if you feel unsure.
Crown or veneer?
In your situation I would reccomend to crown endodontically treated tooth #9 that is severely discolored. However your treatment probably would not end here, if you are concern about esthetics. It is one of the biggest challenges in esthetic dentistry to match one front crown to the natural teeth. That is why I would highly reccomend to place a veneer on adjacent front tooth #8. That way you can achieve better results. Good luck!
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.