What's causing sensitivity/irritation in my gums after having a root canal tooth crowned?

[ToothPatient]

It's primarily around the mesial gumline on the upper left 2nd molar (the crowned tooth)

The irritation then extends to the palatal gumline as well.

I've had it crowned for about 9 months and the prosthodontist changed out the crown 3 months ago (was originally gold, now zirconia).

This is where the irritation is, the mesial margin of the gums.

This is the contact on the occlusal face.

Even though the teeth meet flush all around, is it possible that contact point is irritating the tooth to the point the gums become a little inflamed?

Does that happen?

I assume the prostho with shave down that contact point slightly, but would that alleviate the gum irritation?

Maybe clanking teeth irritates the gums?

Water flossing and flossing does ease the irritation a little.

 

[ToothPatient]

Possible the "biologic width" has been violated due to the mesial margin having been too deep during crown placement?

Deep margin elevation or crown lengthening may be necessary?

Irritation is occurring on the mesial surface, and this was the restoration prior to the RCT and crown.

Would deep margin elevation be straight forward for a prosthodontist to perform?

 

[Dr M]

A prosthodontist should be able to perform deep margin elevation yes.

 

[Dr M]

I would also rule out any excessive cement in the area or food debris stuck

 

[MattKW]

A very deep margin as ToothPatient suggests. Sometimes the gum will react if too deep ("invades the biologic width"). It's not a gingival margin elevation that would be needed, but perhaps a form of gingivectomy/crown lengthening, usually performed by a periodontist. You also have very little interdental space. Talk to your prosthodontist about your concerns.