Question about implant vs. crown!

Question

Hello! I recently had a bad accident and knocked most of my two front teeth out. My dentist was able to perform two root canals and I was close to needing full extractions, but he was able to put two porcelain-fused-to-metal crowns over the remainder of my teeth as they healed nicely.

Here are my questions:

1. One of the crowns does not fit very well. He can take the crown off to re-fit it, but there is a risk that doing so will cause the underlying tooth to break more--and likely need an implant.

2. If I need an implant, will there be any cosmetic downside? Currently, with two roots canals and crowns, there is a slight discoloration from the 'dead' teeth under my gums (not from the crowns since they have a porcelain margin--i.e. not metal is visible). I imagine an implant would actually be a cosmetic improvement? Am I wrong?

3. If my teeth are healthy and the problem is merely cosmetic, would a viable alternative be placing a veneer on the neighboring tooth to 'even' out the ill-fitting crown (it simply juts out a bit far)?

Sorry for so many compound questions!

Answer 1

I can only answer from the implant perspective. If the natural tooth can be saved then that is the best answer. As for dental implants see my smile I have a mouthful. I love them. Dental implants can be a beautiful alternative if done correctly

Answer 2

You can certainly get the crown cut off and replaced with a white porcelain post and all porcelain crown.  I would not even think about having a porcelain fused to metal crown on a front tooth.

Answer 3

As you have said, the dentist can remove the crown and have another made that looks nicer. Sometimes when fabtricating one anterior (front) crown at a time it is difficult for the lab technition to get a perfect match.

If the dentist feels that removing the crown may damage the tooth then perhaps your best bet is to veneer the tooth next to it-- if the dentist suggested that as a solution to the aesthetic arrangement. One veneer can also be difficult to match.

Implants are great, but single anterior implants do not always match perfectly either and you may find that you have the same problem with the appearance.

The best bet is to discuss your options again with the dentist he/she knows what he/she can accomplish best with respect to their own artistic ability to improve your smile.  Saving your natural tooth is always the best option.

Note: I have seen crowns cut from many teeth that have been root canaled-- then new impressions can be taken to have new crowns made, it can be done without damaging the tooth. If the doctor tries to remove it with a tapper or an air-driven crown remover, then yes, it can break the tooth. (Just food for thought.)

Hope this has helped