Options for a short tooth after root canal treatment?

Question

I'm 22. At 13, I had root canal on right front tooth after infection (tooth had been previously damaged from an accident so had prior reconstruction). Because my teeth weren't straight, that tooth was rebuilt shorter to look even. Now that my teeth are straightened, that tooth looks shorter. Also, the tooth is darker than the others since the treatment. I've been given several options: Internal bleaching and bonding; veneer; or crown (porcelain-metal composite). Which option is favourable?

Nima Raoufinia, DDS · Answer

I would recommend a crown to be placed to not only give you the aesthetics you're desiring but also to reinforce and strengthen the tooth.  Remember that teeth with root canals are always weaker.

Peter J. Drews, DDS, MAGD · Answer

Unfortunately there will never be ONE answer to a treatment.  Every dentist has different training and opinions on the "Best" treatment.  So this is my opinion only and if you dentist has a different opinion it is OK.

1.  Since you are only 23 years old I would be conservative in my treatment.  In my opinion I feel you should start with the internal beaching and bonding.  You stated that 9 years ago you had trauma to the tooth.  Just like getting a bruise on you leg, you hit your tooth causing damage to the blood vessel inside your tooth.  At a young age your pulp chamber (hollow space inside your tooth) is very large.  When the provider did the root canal he might of left some blood product in the upper portion of this hollow space which dentist call pulp horns.  Blood product is broken down into bilirubin which stains the tooth from the inside.  Internal bleaching will breakdown the pigment to small enough molecules that diffuse out of the tooth, or to those that absorb less light and appear lighter.  After the correct color is achieved your dentist can bond to increase tooth height.

2.  Crowning or Veneering the tooth is initially a great option.  Unfortunately I have learned that all things eventually change.  Meaning the teeth next to this crown or veneer will change color as the years go forward.  So when I do crowns or veneers in the front of your mouth I suggest you always perform this procedure in pairs.  The human eye looks for symmetry.  If you crown the front right tooth you will eventually need to do the front left.  So just a heads up on possible future treatment.

Steven Goldy, DDS · Answer

The option I recommend for your short, dark tooth is a "Lava" crown.  This has no metal, but a zirconia core to cover and mask the darkness underneath the porcelain.  If your tooth is very dark, a veneer will not mask all of the darkness.   I have done many cases this way and had excellent results.

Steven M. Goldy, DDS

Options for a short tooth after root canal treatment?

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Options for a short tooth after root canal treatment?

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