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Question:
Approximately 25 years ago I had a pool accident and dove into a pool killing the nerve in both front teeth. Root Canals were done and 10 years later they were very dark. The Dentist recommended I needed crowns, which were done and I had a bad experience over the years with having a set of new crowns approximately 8 different times.
The last set of crowns lasted a period of 10 years and with these crowns were posts (which the dentists put a post on top of another post) I had pain in this area throughout the last 5 years and the dentist said that this was impossible because they had root canals. One day I was biting into a sandwich and severe pain arrived and my right tooth was very loose. After visiting the dentist I broke the root and infection was setting in and needed an extraction, which was totally devastating. I went to an oral surgeon in Melbourne, Florida. She did the extraction with bone replacement.
After 7 months, it is healing, but now I need the other front tooth extacted. I am worried because the gum is shrinking and looks like the center is pulling to one side. Also I am very worried that I will not have the natural look of the gums between the teeth, because they are shrinking. I want to have implants, but I am very scared. Will it eventually end up looking like "eggs sitting on a table??" With not the natural look of the gums tightly between the teeth. I just do not trust anyone anymore I am so scared and do not feel comfortable or trust my oral surgeon or my General Dentist. PLEASE HELP!! ...Jane in FL
Answer:
Jane, I appreciate your concern about the appearance of your front teeth. In all probability, you had a vertical fracture of the roots and that is why you continue to have problems. It does sound like implants are your best option.
Your oral surgeon was correct in grafting the socket to preserve the bone in the area. Hopefully she grafted the area with demineralized freeze dried bone and not an artificial bone substitute. It takes too long for the artificial material to resorb and convert to healthy bone. It may be questionable if it ever does resorb.
Anyway, yes it is possible to have implants and crowns made so that the gum tissue drapes properly around the tooth and not look like "eggs sitting on a table". It is just a matter of guiding the tissue with a scaffold so that it grows in the desired shape. This way you can create the proper emergence profile so that the tooth appears as if it is coming out of the gum tissue. Unfortunately, I do not know who to refer you to in the Melbourne area.
My suggestion would be to interview several dentists, ask questions anfd look at before and after photos.
Florida Reconstructive Dentistry
Mitchell Pohl, DDS
2900 N. Military Trail, Suite 105
Boca Raton Florida FL 33431
(561) 368-3440
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