The Gum Still Look Dark After Replace All Porcelain Crown? (photo)

If the tooth had a root canal you could try to bleach it from the inside. There is a limit to what can be done with a dark root or tooth. The other option is to try to remake that one tooth and see if the lab can block out more of the darkness.

Dear Doradoung,

The work looks fantastic, I congratulate you for getting the color you WANTED!  That is always the hardest thing for the patient.  I do see the issue with the root.  Was that tooth dark?  In my opinion, I would remove that veneer and have them opaque the veneer.  All that means is that the porcelain doesn't allow the light to shine through.  If you do whitening, the color tends to rebound with time and the problem can return.

 

Hope this helps,

David SIlber, DMD

 

Placing veneers over very dark and stained teeth is very difficult because many times we can't completely block out the color, veneers are very thin. You may want to simply remove that one veneer and place a jacket crown all porcelain with a material like Emax, Bruxir, or Empress during the try in stage if still not happy attempt to bleach the tooth first and or remove some gum tissue if the tissue is stained good luck

 

Kevin Coughlin DMD, MBA, MAGD

It appears that the root may be dark from a root canal.  That is the dark root showing through the thin tissue.  Nothing can be done about this.  You had a very nice result. 

It is NOT anyone's fault. Your underlying root is probably non-vital on that tooth and therefore, much darker than the adjacent root. There are cosmetic techniques that can try to eliminate that dark gum look, but they are costly and not guaranteed to work, although they usually do.

I would guess that the tooth with the dark gum has had a root canal done. First to overcome the difference in color and still have veneers look very natural it is important not to use making the veneer opaque as a solution and it looks in your picture like that is what was done. The normal procedure I use for a tooth which has had root canal therapy in order not to have a color problem is to: (a) Bleach the tooth and first few millimeters of the root by internal bleaching, (b) Create a color block at the gum line (one type is called "the Dickerson ditch", and (c) Use opaque blocking on the tooth after it is prepared for the veneer.  For a healthy tooth that has not had a root canal the procedure is the same except the bleaching is done on the outside.  

You had pretty nice work with veneers. Too white for my taste, but some patients want them super white. Unfortunately, cases like that are sometimes unpredictable due to the dark root showing through the tissue. So, we try to bleach the root before the final restoration, which is not effective all the time. Another way- to perform tissue graft to thicken the gum and camophlage the dark shade. However, both of this steps are late at this point. 

Nothing works 100%, but this is SO close to perfect that any attempt to fix may not be significantly better and very expensive.  It is likely that this is a dead tooth, maybe even root canal treated.  This darker root will show through the gums.