Crown is moving

[oceanmd]

I bit hard an a popcorn and and a piece of it went under the gum along the crowned tooth #5. The crown was placed 12 years ago, root canals were done and a short post inserted.

A few days after it happened I went to see a dentist to check on this tooth, and I felt discomfort and some pain when using water pick around that side of the tooth where the popcorn shell damaged the gum. The X-ray was done and no visible damage to this crowned tooth was determined. It was recommended to give it time for the gum to heal.

Gradually after, the crown started to move. I have the appointment scheduled to go to the dentist and would like to be prepared for possible treatment options.

What might have happened to the crown? Is there a chance to glue back the same crown? Might I need a new crown?

I would appreciate the professional opinion

 

[Dr M]

It might be that the post either came loose or fractured. If the post is only loose, it can be recemented, if the seal is good. If the post fractured, but the remaining tooth structure looks okay, a new post and crown can be made. If the post fractured in such a way, that it can't be removed without fracturing the tooth, the best option would be to consider extraction, with replacement of the missing tooth.

 

[oceanmd]

Thank you, Dr M, for your reply.

My dentist suspects the root fracture and referred me to a Periodontist / Implant specialist for a 3-D X-ray.
I am still experiencing pain on one side of the tooth when using water pick on the side of the tooth.

I am reading about implants now and have a few questions:

1) Do you absolutely always have to use bone graft after you surgically remove a tooth.

2) What is the best material for a bone graft?

 

[Dr M]

The best material differs based on various factors, such as size and shape of defect, position of tooth in mouth etc.
It is however not ALWAYS necessary to place a bone graft. If you did indeed have a root fracture, the extraction might be more of the surgical type and therefore lead to more bone destruction and therefore a graft might be more beneficial.

 

[oceanmd]

Thank you, Dr M,

Will a 3-D X-ray show if there is a fracture in the root?

Can a body start the bone growth and create its own bone tissue after a tooth extraction?

 

[Dr M]

The CBCT scan will more accurately be able to tell if there is a fracture, yes.
If the extraction is atraumatic and the bone socket is more or less preserved, the body is capable of filling the socket with its own bone yes.

 

[oceanmd]

The CBCT scan will more accurately be able to tell if there is a fracture, yes.
If the extraction is atraumatic and the bone socket is more or less preserved, the body is capable of filling the socket with its own bone yes.

Thank you for your reply, Dr M,

Will the socket be filled by the existing bone kind of sliding into the hole? Or will my own bone be generating NEW bone tissues?

 

[Dr M]

You can google bone formation in extraction socket. There are some nice videos that will most likely explain it better than me. But usually the socket fills with granulation tissue, that changes into woven or unmineralized bone, that eventually becomes fully hardened. The adjacent bone does not slide into the socket. It is new bone.