A new crown

[pombears]

Hi, I have had a hideous crown on one of my front central teeth for about 9 years and it's roughly 3x the thickness of the tooth next to it. It was caused by a cycling accident some years ago and half of one of the front teeth was knocked off. I think it's had a root canal treatment (vaguely remember the dentist pulling out something long and stringy) but after the nerve was removed it began to move forwards, and the crown was stuck on top of it to be in line with the back of my teeth but it protrudes quite a bit, and is curved.

Is it possible to have it removed to get a new crown that looks like a normal tooth? Will it be removed by yanking it out and is it a painful process? Lastly will I be able to have invisalign to move the tooth back?

Thank you for your time!

[Dr Mohsen J. Esfahani]

Thank you for your post.

It is possible to change a poorly contoured crown to a better shaped crown and this is usually done by cutting the old crown off with dental drills. The drilling takes around 10-15 minutes and is a painless process especially if the tooth is root filled. You should be able to have Invisalign to pull the tooth back into a more aligned position. Usually if you are thinking of doing Invisalign, we do Invisalign first and change the crown once the Invisalign treatment is completed but it can be done the other way round too if you wish.

[pombears]

Thank you for your reply!

Does any part of the crown go under my gum? Will the drill be used to remove those parts? The gum area above my current crown looks a little bruised but doesn't hurt, and when I run my finger across it feels a bit bulkier than the adjacent areas, can these be fixed too?

Also, because my current crown is so bulky, when I have it replaced will I be left with a gap between the gum and the new flatter crown?

[Dr Mohsen J. Esfahani]

We need to see your gums to see why its bruised near the crown margin. It could be that the crown has violated the biological width and caused gum inflammation. In such a situation the tooth will need crown lengthening. It could also be because the crown does not fit well and traps food underneath its margin which then causes gum inflammation. If the current crown does not fit well, a new better fitting crown will remedy the situation.

After a new crown is made, the gum reshapes around the new crown very quickly. So there will not be gap between the gum and the new crown.