Crowned tooth aching after a hard bite

[oceanmd]

Hello,

I would appreciate advice and recommendations.

I bit hard on a seed on a zirconia crown placed 2 years ago. At that moment, I was afraid that I broke it, but i did not. It happened almost two months ago. Since then, the crowned tooth is aching, it is a dull irritating pain.
My dentist took an X-ray and did not see anything wrong with this tooth. (By the way, a few years ago, I bit on something hard with another crowned tooth and X-ray did not show any problems but within 10 day the crown with a piece of the tooth fell out. I guess, X-rays do not always show problems).
My dentist sent me to the endodontist, who took CT scan (I think that what it is called) of the area and did a cold test. After the cold test, there was a sharp sudden pain, which subsided, and then I felt the "usual" dull pain in this tooth. The endodontist said that he could do a root canal but does not think that this tooth needs a root canal.

After it happened, I took ibuprofen for 5 days, but I do not think that it help much.

Now my questions:

1) This is tooth # 4. What to do about it? I have a dull pain in this crowned tooth. The pain does not keep me up at night, but the thought of what to do about it does keep me up.
2) I am scheduled for a scan to have an implant crown ordered for tooth #5. What should I do about this? Should I continue with this work of placing an implant crown on tooth # 5 or should I postpone it until I decide what to do with tooth #4?

I will be very, very grateful for your professional opinion because I literally am not sure how to proceed here.

 

[Dr M]

Do you perhaps have an x-ray that you could share?

 

[oceanmd]

Dr M., thank you for your opinion and your help.

Is it possible that I have damaged the tooth structure (whatever is left from the tooth) under the crown?

 

[Dr M]

There is a chance that you might have a crack, but if the endodontist did a scan, then he should have picked that up. I would suggest that you perhaps try to adjust the bite on that side. Try and reduce the crown so that you don't apply too much pressure on the tooth. The ligaments around the tooth might be be inflammed due to too much occlusal forces.

 

[oceanmd]

This has already been done two weeks ago, the crown was reduced, I still have dull pain in it.

I am at a loss here what to do about it.

 

[Dr M]

If you cannot manage the pain, the only option then is to do a root canal. If the pain persists even after the nerve has been removed, then most likely there is a crack in the tooth.

 

[oceanmd]

Thank you, Dr M, what if I am managing the pain, there is still dull pain, but I am managing it.
What should I do then? Can it eventually resolve or is it unlikely?

Should I go ahead with placing the implant crown on tooth #5? Or should I postpone it?

Thank you so vey much for your help.

 

[Dr M]

I would postpone it, until the pain becomes more severe and can't be managed. Once a tooth is removed, it is gone, and you can't get it back.