Root canal hole visible after restoration - what could have caused this and how can it be corrected? (photos)

Question

I had a root canal on a front tooth due to trauma. The endodontist placed a temporary filling, and the tooth seemed fine despite slight discoloration. My dentist later restored it without a crown, using composite and internal bleaching. However, the root canal hole is now visible from the front, which wasn’t an issue before. My dentist agrees but doesn’t want to intervene further, suggesting I wait. Why did the final restoration cause this, and what are my best options to fix it?

YeahSmile - Cancun · Answer

It sounds frustrating to notice the root canal filling showing through your front tooth, especially after all the effort to restore it. Let me explain why this might have happened and how it can be addressed:
Why the Root Canal Hole is Visible Now:Material Thickness: When your dentist restored the tooth, they likely placed a composite material to seal the root canal access. If this composite layer is too thin or translucent, it can allow the darker filling material underneath to show through.
Tooth Discoloration: A tooth that’s had a root canal can sometimes become darker over time. This may make the filling area more noticeable, especially if the internal bleaching wasn’t fully effective.
Restoration Placement: The position or finish of the composite material might not blend perfectly with the surrounding tooth, making the filled area stand out more than before.
What Can Be Done to Fix It:Redo the Composite Restoration: Your dentist can remove the current filling and replace it with a more opaque composite material or layer the composite better to hide the discoloration and blending issue.
Veneer: A porcelain veneer is a thin shell placed over the front surface of the tooth to completely cover discoloration and imperfections. This is a more permanent and aesthetic solution, especially for front teeth.
Crown (as a Last Resort): If the tooth is structurally weak or the discoloration is severe, a full crown can be placed. However, since your tooth doesn’t currently need a crown, this option is only for cases where other methods don’t work.
Why Your Dentist Suggested Waiting:Your dentist may want to monitor the tooth to ensure it remains stable after the root canal and bleaching process. Sometimes, rushing additional treatments can stress the tooth. However, if the visibility of the hole is affecting your confidence, don’t hesitate to ask for a quicker solution or consult a cosmetic dentist.

Miller Vieira Paula, DDS · Answer

The visibility of the root canal hole after the final restoration likely stems from the color or translucency mismatch of the composite material used or an insufficient amount of material placed in the access cavity. Here's why this might have happened and what you can do:
Causes:Translucency Mismatch: If the composite material doesn't match the opacity or shade of the natural tooth, the root canal access may appear visible, especially in the front teeth, which are more translucent.
Insufficient Layering: If the filling material wasn't layered correctly or wasn't thick enough, the discoloration or shadow from the underlying structure may show through.
Bleaching Effect: Internal bleaching might have lightened the tooth unevenly, creating a mismatch between the restored area and the natural tooth.
Options to Fix:Composite Replacement:Have the composite removed and redone using a more opaque material or better color-matched layers.Consider a skilled cosmetic dentist for this, as they may have advanced techniques for front teeth restorations.
Porcelain Veneer:A thin porcelain veneer can be bonded to the front of the tooth, masking the access hole and providing a natural appearance. This is a durable and highly aesthetic solution.
Crown Placement:If the tooth structure is compromised or the cosmetic issues cannot be resolved with a composite or veneer, a crown may be the best option. Modern all-ceramic crowns can look very natural.
Consultation with a Specialist:Consult a prosthodontist or a cosmetic dentist to explore your options. They may have advanced tools and techniques to achieve the best result.
If you prefer to avoid a crown, you might emphasize to your dentist that the restoration's appearance is unacceptable and explore a more aesthetic approach with composite or veneer.
Best RegardsDr. Miller Vieira Paula

Root canal hole visible after restoration - what could have caused this and how can it be corrected? (photos)

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Root canal hole visible after restoration - what could have caused this and how can it be corrected? (photos)

Answers (2)

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Everything you need to know about Tooth Repair

Our mission is to create a world where every investment in modern beauty is Worth It.