Gum problem

[Enamel Hunter]

Hello,

I had a 10+ year old chipped crown on an existing root canaled tooth #46. The chipped crown was removed on Oct 09 and cleaned under and prepped for a new crown. The dentist also performed “perio lengthening” on the outside of my gum just below that tooth. I had a temporary crown placed and waited for the permanent crown schedule later.

During this time the gum area outside and below tooth #46 was swollen and very irritated.It wasn’t painful unless any contact or pressure was placed on the gum area through chewing or brushing.
On October 27 the permanent crown was placed and dentist said that he suspected that the material of the temporary crown must have caused the gum pain and irritation as well as the perio lengthening so he asked me to monitor the area and return for further diagnosis if the problem persisted.

As of today November 05 the swelling has almost gone away and minimal to no pain is present during brushing or chewing. However in contrast, the gum now looks a lot worse where there is a U shaped red and raw looking tissue (picture attached) to the outside area gum of the tooth. Any idea what is going on?

 

[honestdoc]

In order to properly assess, we will need a Bitewing and periapical x-ray. You mentioned that you had perio lengthening surgery and the tooth had a previous root canal. There are some scenarios. There is a chance the perio lengthening surgery was not adequate and the new crown margin violated the perio biologic width of 3 mm minimum (1 mm sulcus, 1 mm junctional epithelium, 1 mm connective tissue to bone). Worst case scenario, the tooth may have a vertical root fracture and may not be saved. The dentist may perform a perio probe to detect any gum attachment loss and if so, will confirm or rule out the above scenario.