Hello doctor, I had an extraction and an implant placed for tooth ​13 about six weeks ago, and I am supposed to get a crown placed on the implant in about six more weeks. Sadly, apparently due to the change in my bite caused by having number 13 tooth, a bottom tooth broke through an old filling in the 14 tooth and cracked the tooth, and I was experiencing constant low-level pain in that tooth. My dentist drilled out the old filling and filled the tooth eight days ago, and he said I still have a crack he could see, but does not know how deep it goes. He wants to try to wait for six weeks and do the crown for the 13 implant and 14 at the same time. He said I may need a root canal for 14 or possibly extraction, and he would know more when he drills it for the crown, and he said I should contact him if the pain gets bad. I had a lot of pain for three days after he drilled and refilled the tooth, and then the pain got much better, but yesterday, day seven after he drilled and refilled, I had very intense pain, and it still hurts a lot today. Does the pain mean I need a root canal (or extraction). Or is there a good chance the tooth will still be fine with just a crown? Also, if the crack in 14 is really deep and extraction is recommended, can I add a second crown for 14 to the implant I already had placed for 13? I have read that you definitely can put two crowns on one implant, but I was not sure if that requires the implant to be centered between the crowns. In this case, the implant would be off center, directly under the 13 crown.
Hi. Thanks for giving all appropriate history. Tooth 14 that is having intense pain is indicating for root canal treatment (attachment removed to protect patient identity). If it would be a crack deep down to root you would be having sharp pain when you bite from it, otherwise pain would be mild. But in root canal case, you would be experiencing sharp lancenating pain and throbbing pain in continuous manner that increases when you lay down straight at bed. Moreover, your dentist will check clinically after opening the chamber of tooth that it is going for root canal or extraction. Again I would say from your given history I am suspecting it to be root canal case. Now, if it would be root canal of 14, then everything would be good as 13 will have cap on implant and 14 will have cap on root canal treated tooth. But ,in case of extraction you can surely have two crowns on support of 13. As a single implant is able to support atleast three crown in anterior segment of jaw and two definitely in posterior segment. Be easy with it. Hopefully, there will be no need of involving any third tooth in bridge cover. It would be best if you can provide me with clinical picture of both teeth and radiograph of the quadrant that is under procedure, so that I can suggest you more accurately.