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Dentistry/Back molar too short for crown to grip


My lower L. 2nd molar at the back (#37) was badly damaged, had root canal treatment and filling and was then fitted with a crown in 2009. In 2012 this crown started to come off very often. My dentist said that my molar (height ~1 mm above gum line) was very short. Each time this crown came off it was recemented, but the last time on 24/12/2014 it was swallowed while eating. There is no LL tooth #38, and LL 1st molar (#36) had root canal treatment and was fitted with a crown in 2007 and has had no problem. The LL second bicuspid is perfect and does not even have a filling.

Doctor, what are my options ? ( I wish my back molar could grow 1 mm upward so that the crown won't come off but that's impossible !)

Dear Dorothy.
I am sorry to hear that you are having an issue with your tooth. However, it is not uncommon. Sometimes, space limitations and even ½ mm make a huge difference. In general, once a compromised crown is de-cemented (comes out) twice, I advise my patients that the next step has to be reevaluated and possible redesign of the crown or the treatment plan as a whole.  There are generally two ways in which one can make a crown “taller”. The first is by making the post and core to rebuild the tooth taller. However, this is limited by the space allotted by the opposing dentition so it is not always possible. As I suspect, this is probably your case. The other way is to perform crown lengthening surgery. That involves removing some gum and bone in a proper manner around the tooth, exposing more tooth structure for the crown to cover. However, this method is limited by the anatomy of the tooth itself and certain necessary biologic requirements around the tooth that only your dentist, or dental specialist, typically the Periodontist, understands and of which he/she is aware. Of course a combination of these two treatment modality is sometimes necessary. If your tooth cannot be helped by using the aforementioned techniques, the only other option is careful extraction of the tooth and replacing it with an implant a couple of months later. Unfortunately, I cannot possibly recommend treatment for you over this limited forum since I cannot examine your x-rays and your mouth.  However, I believe that this information will allow you to intelligently discuss the case with your dentist. I do not know the availability of high end, specialty care in your area, but if your dentist cannot evaluate and do the procedures I have mentioned, I am sure he/she can recommend an excellent specialist. I am sorry for the delay in answering your question. I tried to get to all questions as quickly and as efficiently as I can. Best of luck.  


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Zev Kaufman, D.D.S.


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.


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.

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.

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.

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