Hello. On a routine cleaning this past Friday at a new dentist, I discovered I have a fractured front tooth and was told to come back for an emergency consultation. Now, I am 24, healthy, and had absolutely no idea this was even an issue on tooth #10 as it is below the gum line--what I would consider a "sub-crestal coronal root fracture" from research. I went back and talked to the surgeon, and he prompted that I should go for a bone graft and implant. After doing extensive research between the initial findings and this appointment, I was curious to know why there was no options for a shot at restoring this tooth, as I'd rather not do an implant for cost reasons--given I'm in NYC, I am hoping to find a second opinion sometime later in the week on this case, or maybe a good recommendation for a dentist in the city or surrounding area. Thanks so much.
Horizontal/Transverse Root Fracture: Case
- Thread starter Tamms0647
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Dr M
Verified Dentist
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- May 31, 2019
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Good day
Unfortunately sub-crestal means that it is below the bone level. If you tried to restore this, you would have to remove the crown part, and then do a root canal treatment with a post and crown, but this would present with several issues. Because it is below the bone, there would be no seal , and the root canal will have constant issues with regards to micro leakage etc. Also due to the fracture, there would be no ferrule, as well as an unfavorable root-crown ratio, leading to fracture of the remaining root part.
I agree with your dentist-in my opinion, extraction with immediate implant placement, with additional bone grafts, or even the recently published socket shield technique, would give you the best outcome.
Unfortunately sub-crestal means that it is below the bone level. If you tried to restore this, you would have to remove the crown part, and then do a root canal treatment with a post and crown, but this would present with several issues. Because it is below the bone, there would be no seal , and the root canal will have constant issues with regards to micro leakage etc. Also due to the fracture, there would be no ferrule, as well as an unfavorable root-crown ratio, leading to fracture of the remaining root part.
I agree with your dentist-in my opinion, extraction with immediate implant placement, with additional bone grafts, or even the recently published socket shield technique, would give you the best outcome.
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Hey update, if you're interested. We went to a board certified Endodontist, did some CT Scans, and discovered the tooth is completely dead and calcified. He recommended we leave it as it is not causing any pain nor is it loose / mobile.
Thoughts? I read a handful of case studies on this fracture and it seems as this is one way to go--of course you can extract it, but it all depends on one's opinion of the situation.