Dear Sir/Madam,
I am glad that I found this website - truly a wealth of good information, but unfortunately I am still hesitating and looking for the best solution. My problem is as follows: at the age of 16, because the upper central incisor was grey, I had it crowned; after 13 years I replaced the metal crown with a porcelain one. Two years later I developed a granuloma, and they cleaned the root and the bone. Even after that, if I press, a little pus still drains every day through a small opening in the gum. I think that because of this the adjacent lateral incisor is also “dying”. The dentist already noticed that when the crown was replaced.
Because of this I am hesitating between:
1. an implant (this solves the problem of the central incisor, but the question is what will happen to the lateral incisor?!)
2. a bridge - in this case I am also thinking about making both lateral incisors longer or more attractive, because they are shorter than the central incisors and canines.
I am uncertain about the decision because of the other healthy teeth (relatively healthy - with a small filling on the neighbouring central incisor); everyone advises me to keep my own teeth as long as possible.
I have one more problem: discoloration of the gum above the central incisor, which is ultimately the biggest aesthetic problem I want to solve.
What do you advise?
Thank you very much for your answer.
Dentist Tomaž Rotar answers:
Dear Sir/Madam!
If only the central incisor, or also the neighbouring lateral incisor, needs to be replaced, placing an implant is certainly the best solution. With such a solution we replace the missing tooth without interfering with the hard tissues of the adjacent teeth. The solution is modern and logical. If you want to reshape the neighbouring teeth and this cannot be achieved in any other less radical way than with dental crowns, then a bridge is of course also a solution. The solution is radical, but it likewise provides good aesthetic and functional results. I would also emphasize that dental crowns can be reshaped in other, less radical ways: composite build-ups, aesthetic veneers... The discoloured part of the gum above the central incisor is the result of a metal post in that tooth or of an apicoectomy with retrograde filling, and it can be removed with a minor surgical procedure (together with implant placement).
Have a nice day!