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  • Writer's picturejedho.dmd

murphy's law and vertical tooth fracture (still a dead end)

A patient was referred to me for extraction. (prev dentist referred him due to sinus proximity of the tooth involved)

Upon seeing the x-ray, i saw the tooth was split in half, from top to bottom. And the tooth was also root canal treated.

fractured molar tooth with sinus approximation, root canal treated

Unfortunately for root canal treated tooth, fracture is very common after treatment. In root canal, the teeth is devascularized by removing the blood vessels/nerve bundle supplying it. This also reduces the nutrient supply and moisture content of the teeth. But to say the tooth is 100% dead is not accurate, since it still receives nutrient supply from the capillaries in the periodontal space area. Ergo i often refer to root canal treated tooth as zombies!

That's why i often refer to other dentists or discourage patients from undergoing root canal treatment for their molars, unless it is the last molar in the quadrant already. I think the more canals a tooth have, the lesser the chances of success are. Fracture, and post treatment infection are the usual complications.

A root canal treated tooth is never a guarantee that your teeth will stay healthy for the foreseeable future. It is most often a 'life extending' measure for a said tooth, and the patient must accept these realities before undergoing such treatment.

Because as Murphy's Laws of entropy states, whatever can go wrong, will go wrong, and will do so at the worst possible time!

fractured molar #16

fractured tooth specimen #16 with periapical infection

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