Upper molar lost cusp ~30% surface area, 1/8" wide at gum line, some below gum. Has large silver filling. Dentist said remove & won't miss it much. Second opinion w/only 1 x-ray, suggested an implant (over $5000!). I'm 62, healthy, active, plan to enjoy 102. Do all to keep natural teeth healthy & functioning. Today's materials & adhesives may keep it working for say a decade; when more choices will be available. Please give some "best solutions" that keep tooth functioning for several years.
November 11, 2015
Answer: Instead of removal, repair a molar with cusp broken off? If you have enough bone around the roots of your molar, your tooth can be saved!!! Because it broke below the gumline, it probably will require a crown lengthening procedure. Depending on how far below the gum that it broke and how close to the level of the bone supporting your molar will determine the type of crown lengthening. It it is at least 2 mm above the bone level(x rays will allow this to be determined), then only a soft tissue crown lengthening will be required using either a laser, scalpel, or electrosurgical unit to remove some of the soft tissue covering your tooth down to the break. If there is not 2mm of bone, then you will require an osseous crown lengthening procedure where some bone is removed from around your tooth to create an area of 2mm of healthy tooth structure above the bone level. This will allow your gum tissue to heal and be healthy. You may also require root canal therapy, depending on severity of breakage and your symptoms now and after crown lengthening and preparation of your tooth for a new crown. If you have pain or extreme sensitivity, you should consider having the root canal prior to final cementation of the new crown. The costs for these procedures can add up, so your other alternative is to have the tooth removed and have an implant and crown to replace it. If you really want to keep your natural tooth, and expense is not a concern, then the above described procedures should make your desires possible. It is also important that your entire mouth is free of gum disease and that you visit your dentist regularly for maintenance, and that you practice good oral hygiene at home. Anything otherwise, and these treatment will not last a long time. Good luck and let us know if you have any further questions and how you make out.
Helpful
November 11, 2015
Answer: Instead of removal, repair a molar with cusp broken off? If you have enough bone around the roots of your molar, your tooth can be saved!!! Because it broke below the gumline, it probably will require a crown lengthening procedure. Depending on how far below the gum that it broke and how close to the level of the bone supporting your molar will determine the type of crown lengthening. It it is at least 2 mm above the bone level(x rays will allow this to be determined), then only a soft tissue crown lengthening will be required using either a laser, scalpel, or electrosurgical unit to remove some of the soft tissue covering your tooth down to the break. If there is not 2mm of bone, then you will require an osseous crown lengthening procedure where some bone is removed from around your tooth to create an area of 2mm of healthy tooth structure above the bone level. This will allow your gum tissue to heal and be healthy. You may also require root canal therapy, depending on severity of breakage and your symptoms now and after crown lengthening and preparation of your tooth for a new crown. If you have pain or extreme sensitivity, you should consider having the root canal prior to final cementation of the new crown. The costs for these procedures can add up, so your other alternative is to have the tooth removed and have an implant and crown to replace it. If you really want to keep your natural tooth, and expense is not a concern, then the above described procedures should make your desires possible. It is also important that your entire mouth is free of gum disease and that you visit your dentist regularly for maintenance, and that you practice good oral hygiene at home. Anything otherwise, and these treatment will not last a long time. Good luck and let us know if you have any further questions and how you make out.
Helpful
