Gap Between Teeth and Crowns

9 crowns done 2 years ago. new dentist says to replace all of them The rootcanals are also were done poorly and need to be redone And there is a chance that some teeth will break at the gum line when he removes old crowns. And the I will be needing an implants The rest of the teeth will be needing posts another dentist opinion – crowns are needed to be replaced but no need for implants or core posts. Please advice x-ray:

Doctor Answers 7

Porcelain Crowns, Implants versus Crowns

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This is a challenging question as implants when properly placed can last a long time and be very esthetic.

It appears from the xrays that the teeth can be saved.  I agree with the others , the first step may be to get an endodontic assessment of these teeth.  If they can be treated or retreated predictably then it may be worth saving your natural teeth.  Another thought is to have a dentist gently remove the existing crowns on questionable teeth to assess their restorability.Nice temporary crowns can be made for you during this interim phase.

Removing the crowns is usually not a problem if the dentist sections the crowns in half and gently removes them.It is never wise to try and "tap" them off and there is no reason to do so.  

Once again, to really answer your question, it would be necessary to see your teeth and smile in person.


Houston Dentist

Replacing existing dental work

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The Root canals don’t look to me like they were done “poorly.”  I don’t see any pathology, the fill seems to be adequate.  Are you having any pain or discomfort? If not, then I wouldn’t touch the root canals.

Most of the crowns look decent.  Are you happy with how they look? If you are happy with the esthetics, I would recommend not to replace all 9 crowns.  There may be an open margin on a crown or two, but I wouldn’t feel comfortable diagnosing something like that without an in-office exam.

I think you’re wise in seeking other opinions before following through with such aggressive treatment.  It’s definitely worth it to get a consultation from another dentist before making a final decision.  It may be a good idea to return to the dentist who performed your dental work to repair/replace any necessary work.

Peter Mann, DDS
Manhattan Dentist

Replacing crowns

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I recommend in consulting with not only your dentist but an endodontist   & Periodontist specialist before starting any treatment the endodontist can evaluate the root canal teeth & determine if they can be saved & the Periodontist can also evaluate your teeth & check for any bone loss & also determine if your gum tissue is healthy. Keep in mind without a healthy foundation any restorations you decide to do will fail, it's like building a house, if the foundation is week eventually the house will fall.

Lawrence Gilbert, DDS
Woodbury Dentist

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Crowns with open margins

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Most of the crowns have open margins.They will need to be reoplaced.

However as far as I see onthe xrays, maybe not all of your rcts need to be redione unless the teeth are symptomatic.

Dr Barba

Antoaneta Barba, DDS
Santa Ana Dentist

Fix defective crowns or replace with implants?

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The choice between fixing existing teeth or replacing them with implants should be based on proper diagnosis, likelihood of predictable treatments, and their long term prognosis.

Fist, the existing root canal teeth should be evaluated by an endodontist and see what they think. Next your restorative dentist must determine how easy it is to repair defective teeth, even if endodontic retreatment is possible. Do they need heroic measures, or relatively simple and predictable treatments are possible. Then they should collaborate along with your surgeon and determine best course of action.

In my opinion, if saving the teeth requires heroic treatment measures but still with questionable outcome, then the best option may be extraction and replacement with implant that we know has great success and longevity.

So the key is diagnosis, discuss pros and cons of treatment options, and choice of the option that provides the best success and predictable outcomes in long term. No heroics.

H. Ryan Kazemi, DMD
Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 7 reviews

Second opinions are good

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While some teeth show issues that would benefit from remaking, the root canals may not be needing replacement.  I would suggest an evaluation from an endodontist (a specialist with nerves of teeth) and see what they say.  It appears some crowns were splinted, which usually is done for support.  Are we dealing with gum disease issues?  An evaluation from a periodontist would be a good idea as well.

It may not be as bad as you fear, but SOME remaking of crowns may be necessary.

Remake of recent crowns

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It certainly sounds as though you have significant problems with the tooth structure supporting the first set of crowns. You are wise to seek multiple opinions. The important thing is to find a dentist you trust and feel rapport with and then take his or her advice. It is not uncommon to need multiple posts and remakes. There is an entire industry around remaking botched cosmetic dentistry.

Mickey Bernstein, DDS
Memphis Dentist

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.