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About Zev Kaufman, D.D.S.
Expertise
I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.

Experience
Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Organizations
Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Education/Credentials
Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

You are here: Experts > Health/Fitness > Dentistry > Dentistry > Root Canal

Dentistry - Root Canal

Expert: Zev Kaufman, D.D.S. - 11/7/2009

Question
Hello!Well,my question is about a root canal that I had last February. My dentist told me that after I get my root canal I should go to get a crown. Yet I didn't go and a few months ago, the filling of the root canal fell. Now have started to feel pain and I noticed that the area inside the tooth is black and a bit of skin came off.I feel very worried,I am already planning to see my dentists and I do regret not treating my tooth on time. Is it possible that I could loose my bone? What are the possible procedures for this problem? I thank you for your time and I hope that I provided the best information I could.

Answer
Dear Christine:
Unfortunately, your situation is very common. At this time, the root canal therapy that was performed for you is probably infected again. Studies have shown that even excellent root canal therapy, if not sealed with a proper crown, will get re-colonized by bacteria within three weeks. It is also up to the patient, on the advise of their dentist, to act right away and have the tooth restored. In my practice, I routinely prepare a tooth to receive a crown, make a proper provisional (temporary crown) and only then refer the patient to the Endodontist (the root canal specialist) to get root canal treatment. I have been advocating this approach for years.
No point of crying over spilled milk, however. There are two choices for you at this time:
1. First ask your dentist if a crown can be fabricated. Then go see an endodontist to see if a re-treatment if this tooth is possible, and if the chances of a successful re-treatment are in your favor. Studies have also shown that if a re-treatment of the root canal is done by a specialist, rather than your general dentist, the chances of success are 20%-25% higher. It is well worth paying the extra fee for the Enodontist.
2. If your dentist tells you that a crown cannot be made, or the endodontist gives you very low probability of successful re-treatment, I suggest to have the tooth extracted, before it gets infected, wait for the bone to heal and have an implant placed and restored with a proper abutment and crown.
Either way, you have to pay for a crown and a core build-up of the tooth or an abutment for the implant. Those costs should be similar. The variability is in paying for the re-treatment of the root canal vs. extraction and placement of the implant, which are more expensive.
In this day and age, unless the tooth has good structure left, and the root canal can be done predictably, the implant is a better long term choice.
www.aae.org will have a link to locating an Endodontist near you.
Best of luck,
Dr. Zev Kaufman

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