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Dental and Oral Health Center

Fracture of lower right second molar

03/20/2007

Question:

I believe I have fractured one of the roots of this second lower molar. I also believe I already have had a successful root canal on this tooth. My pain is sharp upon pressure to the occlusal or buccal portion of the tooth. Does this seem like a reasonable conclusion?

There is no sensitivity to heat or cold or sugar.(This is why I am fairly sure of a previous root canal.) Only pressure. I am debating on whether I need to go straight to the periodontist or to my general dentist. If I do need an extraction, I will most likely opt for a dental implant if there is enough bone structure in dental ridge.

Answer:

Yes, it is a reasonable conclusion. Second lower molars are prone to fracture of the roots in a vertical fashion - more so, if they have been treated with a root canal. After root canal treatment, teeth become more brittle.

I would recommend you go to your general dentist first, get a test to determine if there is a vertical root fracture, and get an x-ray of the tooth as well. In addition to this, you would like to discuss with your dentist the possibility of you inadvertently grinding or clenching your teeth. After this preliminary examination, then your dentist will have more information regarding your current situation, thus, favoring a team approach between your dentist and the periodontist you work with.

If an extraction is deemed necessary, the replacement of that tooth with a dental implant will be the best available option. Implant dentistry should always be a team approach between the dentist/prosthodontist and the periodontist. The placement of the dental implant is determined by the future crown that your dentist/ prosthodontist will use to replace the missing tooth.

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Response by:

Jose I Arauz-Dutari, DMD Jose I Arauz-Dutari, DMD
Formerly, Assistant Professor of Periodontics
School of Dental Medicine
Case Western Reserve University