Issues of crown(xray attached)


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Hello,



I would like to ask how my teeth looks - the one with root canal treatment on left - in terms of fitting. Each of the four radiographs was taken more or less at the same time at different clinics.

Separately, I would like to ask how come the very last one looks different from others.

Please open the attached pdf document that contains my radiograph for you to share your expertise with me.



Unfortunately, I don't have knowledge about radiograph or dentistry at all. It would be appreciated if anyone can answer my question in plain language.





Thank you for sharing expertise!
 

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  • radiograph_dental_20220821.pdf
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Dr M

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Good day

From the x-rays, it seems that the crown might be slightly ill-fitting. The crown surface is not fitting precisely over the prepared area on the tooth, and this might create spaces where bacteria can infiltrate and then lead to decay forming.
What did the dentists, that took the x-rays, advise or comment?
 

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Thanks for you reply.
The attachment contains four x-rays. Each of the four x-rays was taken by different dentists. First three dentists suggested immediate replacement to reduce risks as you mentioned. But the last one(
who placed my crown) said that everything is fine.
Here is my question: 1) does the quality of the last x-ray good enough to evaluate the quality of fitting-issues of my crown?: 2) Is it possible for each x-ray of same area to look different just like my last x-ray vs. the other three x-rays? Thanks for your expertise!
 

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Dr M

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The quality of the last x-ray is a bit poor and the ill-fitting margins cannot be fully evaluated on this x-ray. This discrepancy could be due to the angle at which the x-ray was taken. I agree with the other dentists that the crown should be replaced.
 

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Thanks for your reply! May I ask you questions? 1) Given such a margin as indicated in the first three x-rays, would a normal dentist be able to see that margin using naked eyes or using dental loupes ?; 2) Given the poor quality, would it be reasonable for a dentist to re-take another x-ray after the last x-ray? Thanks!
 

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Dr M

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You can sometimes feel the gap with a dental probe, but it might be possible to view it with dental loupes or even the naked eye. If the quality of the x-ray is poor, I always try and take another x-ray in order to make an accurate diagnoses.
 

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Many thanks for your reply! Like I mentioned, all other dentists suggested a replacement whereas my dentist who actually placed the crown keep arguing NO replacement needed based on the last x-ray which I believe looks not precise enough. That makes it hard for me to smoothly communicate with my dentist. What would be my rights and options in this situation I'm facing? Thanks!
 
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Dr M

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I would mention to this dentist, that you received more than one second opinion, that disagrees with his assessment. Unfortunately if you go ahead with treatment at another dentist, the costs will be on you for the crown replacement.
 

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honestdoc

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The dentist who placed the crown should redo the crown at no cost to you. This happens to all of us dentists. The 2nd molar is very difficult to access and to obtain accurate moldings (impressions). If the dentist uses the digital scanner, that scanner is not accurate. Without telling the dentist how to do the job, you may ask to take multiple impressions. Otherwise you may have a case with the licensing Board.
 

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Thanks for your reply, honestdoc! Do you think that the last radiograph alone (without regard to other x-rays) indicates that margins of the crown is reasonably good enough? Thanks!!
 

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honestdoc

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I only see 1 x-ray. The margin on the Mesial surface (towards the midline of your mouth next to adjacent molar) looks open. As long as you keep the area clean, you should be fine short term (months).
 

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I only see 1 x-ray. The margin on the Mesial surface (towards the midline of your mouth next to adjacent molar) looks open. As long as you keep the area clean, you should be fine short term (months).
Many thanks for your reply! Are you able to see all the 4 x-rays in the attached pdf document? I wanted to know whether the very last x-ray indicates reasonably good margin of the crown. This is because the very last radiograph is the one my dentist(who placed my crown) took. Thanks!
 

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honestdoc

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Have your dentist review all of the x-rays. The last one covered the open margin due to angulation. That is not an excuse to leave it.
 

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