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Dentistry/How much time do I have?


tooth #8
tooth #8  
Hello I asked a question in the past & you answered it great. I have a gum infection above tooth #8. I have a pfm crown placed over it when I had a prior root canal done back in 2007 with crown build up as well. fast forward to present time and I know need a second root canal and possibly even a new crown. I just don't have to money at the moment. I don't want to do an Apicoectomy which I believe is cheaper. I'm afraid I don't have a lot of time & fear losing my tooth and having to get an implant. I don't think Ill like an implant. What I'm asking based on my xray is how much time do you think I have to save some money for the procedure, before the infection gets so bad I lose my tooth? Thank you.

I have reviewed your xray again and I am quite concerned about you putting off treatment.
You have a fairly substantial amount of bone damage around the end of the root in the bone.If you get a recurrence of swelling,or  fluid build up, more bone will be lost. Currently there appears to be a circumferential area  and it has not damaged or compromised the periodontal bone around the tooth at the gum line. If that damage occurs with a flare up, the loss of the periodontal "gum" bone support results.Thus, your long term prognosis is greatly reduced.
Currently you have a reasonable chance of a good prognosis with IMMEDIATE treatment.
You could attempt to retreat the root canal through the crown.That is the best. However, as I believe I stated before, there is some risk of needing a new crown. Its also possible from a monetary standpoint that you can just fill the access opening in the back of the crown with a filling if the treatment is performed in this way. Also, if the crown does come off, it could be temporarily relined and recemented with a post and core until you have the funds to replace it.
Another alternative is performing the apical surgery( apicoectomy)and not touching the crown. If the bone damage increases before treatment the prognosis is reduced.
If you get treatment now, an implant probably will not be necessary. If healing would not occur after treatment, a fixed bridge
or implant is an alternative.
Good luck. I hope this helps with your decision. Do not wait any longer before treatment.


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robert block


I would prefer to answer questions related in my specialty of Endodontics( ROOT CANAL THERAPY) I am a Board Certified Endodontist with a special interest in advanced surgical endodontic procedures. I know root canals create a lot of apprehension in patients, and they usually have many questions about the procedure. I can address patient concerns either before or after their root canal treatment. I also have re-treated numerous patients who have had previous endodontic treatment. As a result of these clinical failures,and the increase in the use of dental implants, its important patients understand the alternatives of therapy. There are often many components to treatment that interrelate the disciplines of endodontics, periodontics and restorative dentistry.Patients frequently question the importance of considering all facets in a clinical regimen. Hopefully, I would be able to educate and contribute some information from the endodontic perspective.


Diplomate American Board of Endodontics, 35 years plus private practice experience. Formerly Professor and Chairman, Department of Endodontics at US dental school. Editorial journal reviewer for the endodontic section of The Journal of American Dental Association. Serve as a reviewer on several editorial boards.

American Association of Endodontists, College of Diplomates, American Board of Endodontics

Over 150 publications, abstracts, case reports, chapters in textbooks. J. Dental Research, J. of Endodontics, J. of Oral Surgery Oral Medicine Oral Pathology,The NEXTDDS J.For example: The Single File Approach for Predictable Endodontic Canal Instrumentation:The Wave One, THE NEXTDDS J. 4-2:13-17 Fall 2014 Non Surgical Management of an Endodontic Failure Utilizing Contemporary Technology, www.THENEXTDDS 5-1:60-63 Spring 2015 Are You Still Using Formocresol? An Update, Tn. Dent. J. 89-4:14-19 Fall 2009 Management of Endodontic Failures, Oral Surg.vol.66:711-Dec.1988

BA. DePauw University, DDS. University of Michigan, MS. Medical College of Virginia, Virginia Commonwealth University, Gen. Practice Resident, University of Connecticut, Endodontic Resident Medical College of Virginia, Virginia Commonwealth University

Awards and Honors
Numerous Awards and Honors, Edward P. Hatton Award( Int. Assoc. of Dental Research), Endodontic Memorial Research Award ( American Association of Endodontics) Outstanding Endodontic Department Teaching Award (given by dental students)Fellow American Academy of Dental Science

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