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Dentistry/Apicoectomy or Root Canal Tooth#8 Has Crown.


My Tooth
My Tooth  
Is there a nasty scar left behind? I want go get this procedure done as an alternative to a root canal. Reason being for not wanting a root canal is because the dentist is required to remove my crown. It took 4 different visits and couple months to get a color shade closet to the rest of my teeth. I don't want to go through that hassle again, & fearing I would have to settle on a crown I don't like that I'm stuck with. I have cheap dental insurance (denti-cal). Any advice on what I should do. I'm tired of dealing with this tooth. It is my front tooth by they way , tooth #8 I believe.

Hi Nicholas,

I'm sorry all this is going on. The picture you sent does show a very nice crown that matches your other teeth very well....I can understand your concern.

I'm afraid what I have to say you won't like much...but here goes....

When a tooth abscesses, the nerve(pulp) dies and the purpose of a root canal is to remove all that dead material and replace with filling material. If only apical surgery is done, you are depending 100% on the seal at the end of the tooth to seal in the dead material. Two problems...there may be lateral canals, which happens a lot, that will allow material to leak out of the tooth and create a lateral abscess. The other problem is creating a 100% perfect seal at the end of the tooth. Either of these can cause the problem to just surface in a different way.

If this were my wife's mouth, there is no way I would just do an apicoectomy. I would insist on a conservative root canal first. Should that fail for any reason, the chances of an apicoectomy solving the problem go way up.

Usually it is possible to carefully drill a small hole in the back of the crown without damaging the crown and complete the root canal, then place a filling to seal it from the back side.

If I were going to have this all done, I would certainly have it done by an endodontist. This is all we do all day everyday, so are pretty darn good at this type of thing. That doesn't mean that the crown won't be damaged, but is, by far, a much better choice in my opinion. Sorry for the bad news, but that's the way it is. It ultimately your decision because it's your mouth, your time and your money, but that's what I would suggest if you were my patient.

As for your question about a scar, it sort of depends on the dentist, but for most endodontists, the scar is minimal and under your lip, so you would have to lift your lip to see it unless you have a really broad smile.

Hope this helps with your decision.

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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