Can an Existing Crown Be Ground Down or Built Up to Change it’s Shape?

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  • #1290

    I am posting this here for Roger.

    To Whom it May Concern,

    My problem began back in September of last year when I was told that I had a crack that was circumferential in tooth #21 which extended just above the nerve root. My  dentist said that he would try to save the tooth however because of the extent of the crack that he was leery about fixing it. However he proceeded in doing so and approximately 3 months later started developing pain in the same tooth after placing a zirconium crown and spending $935. My dentist reassessed the tooth and my dentist been told me that the only option I would have now is to have the tooth extracted and to put an implant in its place. The cost of this implant was approximately $3300 which was reduced from approximately $5200 after insurance. This extraction occurred on December 24, 2014.

    I followed up with him in approximately 2 weeks to have sutures removed and an x-ray were done in this area to assess the bone graft etc. I had noticed at this time when looking at the x-ray that the titanium implant  was positioned closer to tooth 22 rather than being in the center of the gum line. I asked if this is going to make an difference with regards to crowding when I receive the implant. I was told this is not a problem. I waited approximately 1-1/2 months more at which time I was reassessed again for proceeding with the abutment. Apparently from the x-rays taken at this visit the dentist felt that there was satisfactory bone growth however he wanted to wait approximately 3-4 more weeks before proceeding with attaching the abutment. The abutment was placed along with a healing cap I was told to return in approximately 10 days.

    Impressions were taken at this visit so the implant could be fashioned. Upon return 7-10 days later the area was assessed and he felt that the implant could be attached to the abutment. It turns out after placement of the implant that there is a step off of approximately 3-4 mm from tooth 22 to tooth 21, and from tooth 20 to tooth 21 a 2-3 mm step-off. As a result of this this is affecting my chewing because of the height difference to adjacent teeth as well as it causing me to have jaw pain during and after chewing.

    My dentist at this visit also stated that from the previous visit when my impressions were taken to the current visit which I speak of my teeth apparently had shifted somewhat and this was over 7-10 day period. After implanting the crown it was noted that there was approximately a 1-2 mm gap between tooth 20 and 21 able to get floss adequately between however, there was no space between tooth 21 and 22 do to the crown butting up against tooth 22.Therefore, I was instructed to return in approximately 1 month to reassess the tooth to allow for settling. He also stated that he was to remove the entire crown and have it “built up” and also grind down the surface to open the space between tooth 21 and 22. My question is, can a already manufactured crown be built up to match the height of the other teeth or does a new crown need to be created. It there a possibility of the material that is placed upon the existing crown will crack or fall off creating problems in the future. Also because of the titanium post placement being close to tooth 22, can the existing crown be ground down to create a  gap for floss to fit? What am I to do about this situation, and do I need to seek legal representation. Your reply is greatly appreciated


    Hi Roger,

    It may be possible for the crown too be ‘built’ up by a dental technician adding additional ceramic material to the crown, or they might choose to remove all the ceramic material before remaking the crown. This shouldn’t affect the integrity of the crown as any cracks should be evident before it leaves the dental laboratory and before it is fitted.

    However, it might be worth seeing another dentist for a second opinion on the placement of your implant as you mentioned it seemed very close to the adjacent tooth. Grinding down a crown so you can floss could potentially affect the integrity and strength of the crown. It would also be interesting to get another opinion as to why your teeth have apparently shifted position to such a degree in a relatively short space of time.

    Best regards,


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