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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 2089
Experience:  Dentist and Anesthesiologist for 34 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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My tooth number 11 (upper left canine) has a root canal but

Customer Question

My tooth number 11 (upper left canine) has a root canal but the crown was broken and only the root is left. I am planning to have it removed and replaced with a dental implant. How complicated is the surgical extraction of this residual root? is it very hard to remove?.
Submitted: 2 years ago.
Category: Dental
Expert:  Dr. Katz replied 2 years ago.
Welcome to Justanswer.I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.The upper canine is a tooth that we do not like to remove.It forms the curvature of your face on the left side around where your lip moves posteriorly.If you have even 2 to 3 mm of this tooth still visible above the gumline..my feeling is that you should try to save it.A post can be easily placed and a new core can be built up to be crowned.If in fact that the tooth is hopeless..removing this tooth can sometimes be difficult depending on your age..the older you get the less movable the bone is..and removing this tooth can sometimes take a portion of bone with it leaving a defect.It needs to be done carefully..within the socket.I do not know the condition of your other teeth or if you have any other teeth missing on the upper.If you have all of your other teeth and you choose an implant..you will need to wear something removable for 5 to 10 months while the artificial bone adheres in the socket and the implant integrates into the bone.Has your dentist discussed a bridge as an alternative.It would be less expensive less risky and can be done in a much shorter time.Let me know the condition of the adjacent teeth and if this tooth is indeed doomed.
Expert:  Dr. Young replied 2 years ago.
I have a very different view point as this is my daily routine. A canine tooth can easily be extracted and replaced immediately with a dental implant. A root canal treated tooth can present with more complexity as the non vital root is brittle and requires patience when removed. I have extracted thousands of teeth and find that immediate replacement with an implants helps to support the bone and tissues immediately, provides one healing event, and takes advantage of the healing extraction socket. Another point to make is that of the fracture has occurrd below the gum line, simply placing a core and buildup could damage the periodontium. Crown lengthening or trimming of the bone and tissue would cause an esthetic compromise in many cases. A canine tooth is an ideal tooth to replace with a dental implant. If you have fractured your canine, conserving bone and tissue with removal and replacement with an immediate implant is a simple treatment to provide with excellent long term and esthetic success.
Expert:  Dr. Katz replied 2 years ago.
Dr. Young may be exagerating the ease at which a root canalled root of an upper canine in a 66 year old patient can be performed..The possibility of ankylosis..fusion of the tooth to the bone ..is likely...and even the most careful surgeons can destroy the canine eminence..the bone formed over this root and cause a defect.If you can keep your own root..and avoid the surgery..the benefits have been explained.Again please let me know the condition of the remaining teeth in the area so that I can better comment on your best options..Sometimes when implants are pushed by surgeons...there is an issue that is commonly seen in many professions..when all you have is a hammer ..everything looks like a nail.
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 2089
Experience: Dentist and Anesthesiologist for 34 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
Dr. Katz and other Dental Specialists are ready to help you
Customer: replied 2 years ago.
Tooth number 12 (first upper left pre-molar) is already an implant that has been there for the last 15 years, tooth number 10 (second upper incisive) has a root canal and a crown since 2009 with no problems, other tooth are natural and ok.
Customer: replied 2 years ago.
Tooth number 12 (first upper pre-molar) is already an implant that has been there for the last 15 years, tooth number 10 (second upper incisive) has a root canal and a crown since 2009 with no problems, other teeth are ok.
Expert:  Dr. Katz replied 2 years ago.
If #12 is an implant..the bridge option is out because we do not like to support bridges with abutments that absorb stress differently.Bridges must be either tooth supported or implant supported.That leaves the only option of an implant unlees the canine #11 can be saved.If it cannot ,the important thing is to maintain that outer bone surrounding the lip side of #11....when it is extracted.

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