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Dentistry/durability of temporary crowns / risks to artificial hip

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QUESTION: I'm struggling to get information in trying to balance risks related to a temporary crown placed over a root canal; the basic question is about likelihood of temporary crown failure at, say, 13 wks after the endodontic procedure. My elderly father got a root canal, temporary placed via someone I think likely to be quite a good endodontist (that is, the temporary likely is a pretty good job).
    At about 4 wk after the procedure, when the general dentist was about to return from vacation and place the permanent crown, dad fell and cracked his femoral head, requiring a cemented hemi-arthroplasty (i.e, fresh placed with very high risk posed by any bacteremia).
    So one option is to use prophylactic antibiotics, take off the temp, and place the permanent crown (now he's at about 7 weeks post root canal; this approach would call for the temp to last a total of 8 wk).
   However, the trauma surgeon (who put in the metal femur) looked worried and hoped that things could wait until what would amount to 13 weeks for the temporary crown. If the crown fails while dad is being ignored at the nursing home, then it seems the risk to the hip from infection would be extreme. So, any thoughts on how long the temp is likely to last (or on management choice)?

ANSWER: Mark,
worry about the leg and not the tooth.
Loss of the temporary crown will make absolutely no difference to the dentist who is in charge of making the permanent tooth.
If the crown is lost for any reason, it will not affect or effect the root canal therapy.
The root can go for years without a crown on it. The crown is only necessary for esthetics and chewing.
All the best,
Dr. Moss

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

QUESTION: I understand the part you put in the answer.
But my question was aimed differently: my understanding is that if the temporary comes off the exposed open structure of the root canal provides an invasion route for oral flora, potentially causing bacteremia and "seeding the joint" (peri-prosthetic osteomyelitis, which would be a catastrophe).
So the management comes down to an assessment of the likelihood that the temporary crown is lost if one tries to keep it there another 8 weeks.

Answer
Mark,
sorry if my answer appears unclear.
I did understand your question.
I am not aware of any way that loss of the temporary crown will increase your dad's chance of a bacterimia in his blood stream. Once the root canal is filled the only exposure to the blood stream is through the periodontal membrane that surrounds the tooth. Crown or no crown does not change the situation, that exposure will always be present, but highly unlikely.
Good luck ,
and all the best.
Dr. Moss

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Stephen J. Moss

Expertise

I am a professor emeritus at New York University, with a background that includes extensive research, scientific writing and biology. I also am an international consultant in health education, particularly in developing education on new science for health professionals and consumers. I am a past president of the American Academy of Pediatric Dentistry, former head of the NYU Division of Oral Biology and I represent the World Dental Federation at the United Nations. I travel around the world to provide health education to professionals and consumers.

Experience

Having retired from New York Universit, where I directed the pediatric dentistry training program, a walk-in dental clinic and research on oral biology, I formalized my professional and consumer health education initiative in the form of Health Education Enterprises. This entity consults and provides information on new science pertaining to oral and general health, particularly leading edge concepts that can be employed in the health professions to improve the public's health. As such, I am an expert in communicating new science and its usefulness to professional and lay audiences alike. I also had a pediatric dentistry practice in New York City for nearly 30 years.

Organizations
I am affiliated with the American Dental Association, the World Dental Federation, the International Association of Pediatric Dentistry and the American Association of Pediatric Dentistry among other formal organizations. My experience has included a research fellowship at the National Institutes of Health and work at the Forsythe Dental Research Center

Publications
lpha Omegan USA, Nowa Stomatologia Poland, Journal of Public Health Dentistry, The Journal of the Southeastern Society of Pediatric Dentistry USA, News Bulletin Japan, Journal of Marmara University Dental Faculty Turkey, Italian Journal of Paediatric Dentistry Italy, Asian Dentist Singapore, The Journal of the Israel Dental Association Israel, ROBRAC Brazil, Italian Journal of Paediatric Dentistry
Italy, FDI World, STOMA Portugal, Pediatric Dentistry The Philippines, Modern Stomatology Bulgaria, Journal of the Indian Society of Pedodontics and Preventive Dentistry India

Education/Credentials
I obtained a doctor of dental science (DDS) degree, a master of science degree and am a board certified pediatric dentist.

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