Fractured tooth is a common dental emergency because it may require immediate attention to save the tooth. Usually when a patient comes to my office with a “broken” tooth, I would first take an xray radiograph to see the extent of the defect. The purpose of evaluating the extent of defect is to determine whether the tooth has enough tooth structure for the proper restoration to take place in order to save the tooth. I would evaluate whether it has any additional crack line. If there is crack line and it does not involve the root area, usually the tooth can be saved. Also, I will determine how deep the defect is. The purpose of determining how depth of the defect is to determine whether a restoration can be properly used to repair the tooth. If the defect is superficial above the gum line, the tooth can be repaired. However, if the defect is slightly below the gum line, I can perform some simple surgery to give the tooth more solid structure for the restoration to be placed. However, if the defect is too deep or at the root level, a dentist cannot possibly put a filling material or put a crown in that area because it can cause rejection by the tissue around the new restoration and then the tissue may become swollen and may cause pain.
So this patient came in to see me with a broken tooth. I have taken some xray images of the tooth and evaluate the tooth to be restorable. There is no additional crack line. The nerve chamber is not involved and patient is not in pain. The defect is slightly below the gum line so I am going to do some simple gum surgery to allow me to properly place the restoration. The type of restoration is going to be a crown because the defect is large and the existing amalgam filling is not strong enough. Crown is able to give a full coverage protection to the remaining tooth structure so that it can hold the tooth together in one wholeness.
Next I would have to reinforce the tooth by performing a procedure called the Buildup of the tooth. It repairs the tooth back to its original shape. The buildup material relies on both mechanical and chemical retention to hold it on place. Basically it is almost like a large filling. However, due to its large size and also its location, when patient bites, the lower teeth is going to hit on it and may make it to come loose. Thus, the final step is to put a crown onto the tooth to give it additional strength.
The last step is to perform a crown prep procedure. I would properly prepare the tooth and then a impression of the tooth is taken. The impression and model is going to be sent to the lab. The lab will use the model and make a dental porcelain crown.
So the patient comes back a few days ago and we are ready to put on the dental porcelain crown. I would cement the crown in place. This is how a full restored tooth looks like with a crown:
The tooth looks like it has never been broken.
Written by Daniel Tee, DDS, MS
Practicing Family Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.