Q: Dr. Crapo: Six months ago I was eating dinner while vacationing in Los Angeles, when all of a sudden I felt a very large hard piece in my food. It was a crown that had broken off leaving a big hole and very bad smell and taste. The next day I found an emergency dentist who said that the roots left in my bone should be extracted and a bridge placed to fill the space. I told him I wanted him to do whatever he had to, to glue that crown back in. He said it was almost impossible as diseased gum tissue had started to grow up through the roots. I pressed him to glue in back in, so he did his best. It held for about five months. When it came out again, I saw a dentist and he told me the same thing, but again I persuaded him to glue it back in. As you can see I don’t want to lose anything that’s mine. The second guy said it would be best to take the roots out, put some bone in the hole and then get an implant. When I asked him what the bone was, he said it was cow bone. Cow bone! I don’t want anybody else’s DNA in my body and that’s no bull! I want someone to save this tooth! I don’t care what it costs. What’s wrong with that? Got any ideas!
A: Normally a tooth that has diseased gum tissue growing up between the roots is removed because of decay that has eaten away the base of the tooth, and part of the roots as well.
To put your mind at rest, bone collected from different animal species and also bone collected from those who have donated it for medical purposes, is treated, so that foreign DNA is not being put into your body. The DNA markers are removed so there’s no host against graft rejection. This is also done with skin tissue used in burn units as well. I’ve used it for over ten years without incident. My first counsel would be to extract the roots, graft the bone, then place an implant and crown.
Having said that, there is an outside possibility to save at least some of the root. If part of the root system is decayed, a root amputation will eliminate the bad portion and with careful surgery, enough of the remaining root can be used to support a new crown. But, you could end up spending nearly as much to save your tooth, as putting in an implant. And the final result may not be as strong. Few perform this operation anymore because implants have become so predictable. However, make sure to discuss with the attending dentist, an alternate plan, in the event the surgery is not possible.