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I was wondering if you can inform me a little more about tooth fractures. When you have a tooth with a fracture that extends into the pulp, when do u decide to extract vs root canal?

thank you


In mosts cases, this decision is based more on the ability to restore the tooth with a filling or crown. Root canals can be done on severely fractures teeth, but if the fracture extends below the gum line, it can be difficult to fill or crown the tooth. When the pulp is exposed on a fully formed tooth, a root canal is almost always necessary unless it is just a pinpoint exposure of the pulp, which may respond to just a pulp cap.

Hope this answers your question.

Gary Backlund DMD, MSD

---------- FOLLOW-UP ----------

QUESTION: Thank u doctor, but I'm a recent dental grad and wanted to review this.
If the tooth is restore able, fracture from the medial ridge (well a bove gingiva) and into mesial pulp but not across pulp chamber. Root canal vs extraction, i think .
If extends across pulp chamber to distal root , recommend extraction mostly likely spilt or would u even try to do endo if patient willing?  What's prognosis on that, poor?


I guess I need clarification....are you talking about a complete fracture or a crack or split of the tooth with segments still on place?


Gary Backlund DMD, MSD

---------- FOLLOW-UP ----------

QUESTION: Removing an amalgam, see a fracture internally, from mesial marginal ridge down into pulp chamber and into mesial pulp, but not look like split thru fur cation  to distal pulp.
Hope this more explains it. Thank u again ;)

Thanks..that helps a lot. Now I have the picture and I think I can help more. In situations like this, I ALWAYS get the patient involved in the decision because this is one of those unpredictable situations. Assuming the patient wants to try to save the tooth, I would do a root canal, followed by a very well fitting temporary crown and leave it in place for up to 3 months to evaluate healing and prognosis without committing to the expense of a crown. After 3 months, I would go ahead with the final restoration and keep your fingers crossed. If the patient is not a gambler, I would extract.

Hope this answers things.

Gary Backlund DMD, MSD


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Gary Backlund, DMD, MSD


I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.


25 years practicing as a specialist

American Association of Endodonists, Past President Washington State Association of Endodontists.

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