Split Molar #14 Needs Help


Joined
Mar 4, 2021
Messages
5
Is there any way to save this #14 Split Molar from extraction?
Split#14.PNG
 
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Dr M

Verified Dentist
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May 31, 2019
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Good day

In the CBCT scans you provided, you can see that the crack penetrates the floor of the pulpal or nerve chamber.
In such a case I would recommend extraction.
 
Joined
Mar 4, 2021
Messages
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So as the tooth extraction date nears, just a final check to see if the tooth can be saved with a root canal procedure and a crown as the aae.org website suggests (see cracked tooth discussion attachment picture).

The actual #14 molar is shown in a mirror view picture from a recent dental visit. The tooth has basically been in the same shape for the last 3 weeks. On some days it feels great and secure when chewing food. On others it feels like it swollen underneath it and elevated compared to the surrounding teeth. This situation eventually subsides with rest and the tooth resecures itself. The swelling and resecuring then repeats itself over and over again syndromatically.

Temporary dental filling material is shown in the picture running the length of the crack and has been helpful sealing the crack and keeping bad odor minimized. However it only lasts about a day and needs to be refilled in order to be smooth feeling. A recent switch to orthodontic wax proves to be a superior solution as it is easier to work with and holds just as well.

My only concern is that the extraction doesn't need to be performed and could possibly be saved. It is not clear if the crack shown in the #14 CBCT scan matches the Non-treatable condition in the aae.org picture and extends into the gum line or it is more on the Treatable side with a root canal procedure and a crown.
 

Attachments

  • CrackedTooth.PNG
    CrackedTooth.PNG
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  • Cracked#14.png
    Cracked#14.png
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Joined
Mar 4, 2021
Messages
5
OK. But on researching the cracked molar problem, the following 2 restoration methods were found. It was hoped that either might be able to work in this case.

A: Placing a orthodontic band around the tooth to hold it in place, followed by endodontic treatment to restore the core, followed by a crown to secure it biomechanically from the top. Hopefully advanced endodontic filler would fill, seal and cement the tooth together below the gumline securely. The teeth previously had braces and orthodontic bands before.

B: An alternative procedure was found where the tooth was carefully extracted, repaired externally from the body, and then replanted a few weeks later.
 

MattKW

Verified Dentist
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Mar 18, 2018
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No, the crack extends into the fur cation area and so it is HOPELESSLY infected. An ortho band might physically hold the broken pieces together, but no endo treatment can clean and seal that crack. You must extract, then consider implant.
 
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