I realize you can only speak in sweeping generalities without an exam and charts, but a general idea is all I need at this point.

I think I have the numbering system right, but just to be sure we're talking about the upper right side, starting from the back.

#1 and #2 have been extracted for one reason or another. #3 broke off essentially at the gum line after a massive filling failed. My dentist did a root canal and a crown on the stub.

The crown came off a couple of weeks after the initial cementing. Things were cleaned up, the gum was worked away from the stub a little further and the crown was reattached with a different cement. That lasted about a year, until today. Came off again.

So, I'm sure the dentist will reattach it yet again, but I just don't have a lot of confidence that it will last, hence my questions:

1. Can the crown be pinned to the root to provide a more positive attachment?

2. Might it be better to go with an implant in the #2 position and then a bridge between #2 and #4?

3. Another option?

Thanks for any input you may have.

Not a dentist here. A lot depends on how much money you want to spend. Implants are more expensive but are more permanent replacements.

Success rate of endodontics (root canal) is around 80%; failure is most often related to fracture (root or crown). Restoration as you describe may require crown lengthening (gum surgery), or a core buildup (adding material to the "stub"), possibly with post(s), any of which adds to the cost and neither of which is guaranteed to be "permanent." Success rate of implants is generally in the 90%+ range once the implant is integrated into the bone - whether an implant can be placed depends on many variables, including medical history, social history (smoking, for example, can cause a poor prognosis), and anatomy of your face (an upper implant can require lifting the sinus and grafting bone). In your case a better option might just be to extract the remains of #3 and replace with a single implant (every tooth doesn't need to be replaced just because it's missing). I would discuss with your dentist and get a range of treatment plans (and costs), along with some reasonable guesses of success for the long term. Good luck.

^^^^^^

I agree

OP, You mentioned an implant #2 with a bridge to #4. That is not advised. A bridge won’t last if it is supported by a natural tooth on one end and an implant on the other due to differences in mobility.

Exactly what I needed to know. Thank you.

I'll post back after I've talked to my dentist. This guy is a peach, actually credits his patients with having the ability to process information and make reasonable decisions.

FWIW before committing to an implant, have an Xray taken to confirm sufficient jawbone to support it. Wife had two implants fail for lack of bone support.
Good luck!

Get an implant, bone graft if needed

Anything else is a temporary solution

Cry once...

I worked in the implant industry for three years, email me if you have specific questions

Saw Doc Painless today.

Turns out it wasn't a cement failure as I thought. More of the root broke off.

After some discussion, we (I like that he take my input seriously) decided that anything short of an implant is just kicking the can down the road.

He's quite excited, he just got back from a seminar and they have a new procedure for installing the implant post that he's itching to try. Something to do with the burr that drills the socket being reversible and packing the bone fragments from drilling back into the surrounding bone on the way out.

New enough that I have to wait two weeks while he gets the equipment in.

Not gonna be cheap, but he treated me as well as he could by not charging for the new crown portion seeing as the initial procedure failed and only charging me the standard extraction rate for what will likely be a surgical extraction.

I went and cleaned out my backup savings account. As I was closing the account the teller said "I hope it wasn't anything we did."

"Nope," sez I, "It was my rainy day account and my dentist just informed me there's a flood coming."

I just had the titanium implant put in my jaw about a month ago. I was surprised how big the drill bit was that they used. I am guessing it was a ~1/4" bit. I have to wait another few months to get the post and crown put in.

Good luck with yours!

quote:

Originally posted by xantom:
I just had the titanium implant put in my jaw about a month ago. I was surprised how big the drill bit was that they used. I am guessing it was a ~1/4" bit. I have to wait another few months to get the post and crown put in.

Good luck with yours!

Thanks!

How was recovery?

Doc told me it'd be 3 months after the implant to let the bone heal around it before they put the crown on.

Not a dentist here, but I can say for certain the ideal time to schedule your appointment - tooth hurty.

quote:

Originally posted by rusbro:
Not a dentist here, but I can say for certain the ideal time to schedule your appointment - tooth hurty.

Booooooooooo...

Mine is for Threeth O'clock.

Fortunately, the root has had a root canal so there's no pain/sensitivity involved.

Last checkup my new NC dentist found a problem at the margin of a 10+ year-old crown from my old VA dentist.

He pulled the old crown off and was surprised and very interested to find a buildup on posts, still intact and solid. He was quite impressed and put a new crown on top of it.

quote:

Originally posted by PHPaul:

How was recovery?

Doc told me it'd be 3 months after the implant to let the bone heal around it before they put the crown on.

Yep that the same time frame my provider gave me. I think the tooth extraction was worse.
Tooth #18 for me. The implant went smoot. Drilling that hole was the worst part of it. I was expecting a lot of pain after. It wasn't bad at all. I am about 6 weeks out now. I will be going in around the first of March to get the crown.

quote:

Originally posted by PHPaul:
I think I have the numbering system right, but just to be sure we're talking about the upper right side, starting from the back.

#1 and #2 have been extracted for one reason or another. #3 broke off essentially at the gum line after a massive filling failed.

Don't forget your wisdom teeth when numbering. #1 is (was) a wisdom tooth that is likely long gone, as are #'s 16, 17, & 32.