What does this root resorption look consistent with?

[Duppy813]

I plan to keep an eye on it since I cannot handle my teeth being prodded at this moment.(my whole mouth is irritated it’s not even this particular tooth)

I’d also like to know: how bad does it look?
Does it appear long standing? What does it look like is going on here?
I know full examination in person is needed. Just trying to get an opinion.

Here’s some history:

The crown with the resorption and the surrounding crowns don’t contact right. Theres catching and they hit at painful angles and slopes. Definite bite trauma.

History of Invisalign (2 years)
Full braces(2 years) (however from what I know, it’s only this tooth, not multiple)

What does this look consistent with in your opinion? I was already told no infection.
If it comes into contact it gets sooo painful.
Working on getting everything replaced.
Idk if it’s the crowns doing it or just irritating it.

 

[Dr M]

It is difficult to say without having previous x-rays to compare. It might be that there was some resorption during the orthodontic treatment, depending on the size and duration of forces exerted on the tooth. It also might be normal development and anatomy of your molar, or it might appear shorter on the x-ray, due to the roots running in a different direction, since a PAN is only a 2D image.
Currently there looks like no peri-apical pathology, but there might be a small gap distal on the crown, which could lead to leakage.

The crown can be adjusted if the occlusal forces are too high. This could alleviate some of your pain, when biting down on it. Otherwise the new crown should be reduced, so that there is minimal forces on the tooth when biting down.
A general check-up with regards to potential bruxism, should also be taken into consideration.

 

[Duppy813]

It is difficult to say without having previous x-rays to compare. It might be that there was some resorption during the orthodontic treatment, depending on the size and duration of forces exerted on the tooth. It also might be normal development and anatomy of your molar, or it might appear shorter on the x-ray, due to the roots running in a different direction, since a PAN is only a 2D image.
Currently there looks like no peri-apical pathology, but there might be a small gap distal on the crown, which could lead to leakage.

The crown can be adjusted if the occlusal forces are too high. This could alleviate some of your pain, when biting down on it. Otherwise the new crown should be reduced, so that there is minimal forces on the tooth when biting down.
A general check-up with regards to potential bruxism, should also be taken into consideration.

Thankyou!!! You may have just explained why I have really bad pain and redness on the backside/inbetween crown and implant of the crown on the gums along the base. Making an apt to possibly get this sealed tomorrow if that’s a problem.

Also this crown is not new. It’s about eight years old and have had non stop problems with it plus 3 adjustments.The entire thing is shaped weird and wider/taller than the neighboring teeth. I’m about to go in and have all this crown work redone by a prosthodontist.

Thanks again!

 

[MattKW]

This type of resorption is not from the ortho treatment but from the trauma of the crown preparation. Previous Xrays re necessary to compare. The nerve is probably still alive, but you may need to have it removed (root canal therapy) to stop the resorptive process. Take all Xrays to an endodontist for opinion.

 

[Duppy813]

This type of resorption is not from the ortho treatment but from the trauma of the crown preparation. Previous Xrays re necessary to compare. The nerve is probably still alive, but you may need to have it removed (root canal therapy) to stop the resorptive process. Take all Xrays to an endodontist for opinion.

Thankyou, yes, getting a root canal in 15 days and counting. One of two root canals actually. Idk why the first endodontist sent me home after driving to him and now I’m being referred out by another dentist.

This crown has never been right since getting it eighteen years ago.

 

[Duppy813]

This type of resorption is not from the ortho treatment but from the trauma of the crown preparation. Previous Xrays re necessary to compare. The nerve is probably still alive, but you may need to have it removed (root canal therapy) to stop the resorptive process. Take all Xrays to an endodontist for opinion.

Also I do not have the original x rays to compare. Is this bad? I got the crown done like 16-18 years ago with the most recent crown replacement being 8 years ago.

What you’re saying lines up with what the dentist said when I went in 2 weeks ago.
He said it looks like something inflammatory has been making is resorb for a very very very long time and I actually remember pain on it when biting as far back as 16 years ago.

 

[MattKW]

Original xrays would be helpful but non-essential. I'm not an endodontist but in my experience that resorption won't stop unless RCT performed.

 

[Duppy813]

Original xrays would be helpful but non-essential. I'm not an endodontist but in my experience that resorption won't stop unless RCT performed.

Just got back from the endo and he said it was orthodontics but the tooth itself hurts so much in the side with the resorption.
The gums around the whole tooth have been seriously inflamed for years and I kept being dismissed about it.
Hes sending me to a periodontist first.
Says the tooth probably needs a root canal anyway because it’s hurting me so much.

Are there any clues that point towards this?
A little worried it won’t be taken care of properly bc the tooth is killing me.
From what I understand,
If it’s from crown prep trauma and the root resorption is external then it’s normally cervical, correct? But the xray does not show this.
And it’s obviously not internal which I think is usually associated with crown prep trauma.
I’m just curious as to what makes you think this.
Ever since I’ve gotten a crown something has been going on and the ONLY clue I have is that I’ve seen it clear up where Invisalign accidently created an open bite between it and the opposing tooth. I’ve been going over it in my head for so long. I just don’t know.
Except for that my teeth coming together are keeping it inflamed as hell.

 

[Duppy813]

Original xrays would be helpful but non-essential. I'm not an endodontist but in my experience that resorption won't stop unless RCT performed.

Just got back from the endo and he said it was orthodontics but the tooth itself hurts so much in the side with the resorption.
The gums around the whole tooth have been seriously inflamed for years and I kept being dismissed about it.
Hes sending me to a periodontist first.
Says the tooth probably needs a root canal anyway because it’s hurting me so much.

Are there any clues that point towards this?
A little worried it won’t be taken care of properly bc the tooth is killing me.
From what I understand,
If it’s from crown prep trauma and the root resorption is external then it’s normally cervical, correct? But the xray does not show this.
And it’s obviously not internal which I think is usually associated with crown prep trauma.
I’m just curious as to what makes you think this.
Ever since I’ve gotten a crown something has been going on and the ONLY clue I have is that I’ve seen it clear up where Invisalign accidently created an open bite between it and the opposing tooth. I’ve been going over it in my head for so long. I just don’t know.
Except for that my teeth coming together are keeping it inflamed as hell.

Also sorry for all the questions. I’ve been through the wringer with dentists and endodontists. I had to go through like seven dentists to get even one to tell me I might be having pulp issues in some of my teeth from all the restorations, which I was. I am now very very very thorough before I go in to any appointment and have had to do months of research about everything after being sent home by the first endo.