Having a broken tooth is one of the true dental emergencies in life. The tooth could be broken due to trauma from an external force, or you may have had the misfortune to bite on something hard, such as a small stone in improperly washed vegetables, or a bone fragment in a sausage. Most of the time, the fractured portion may not be that large, and the tooth can either be smoothened or restored with an adhesive restoration.

At other times, the fracture may be catastrophic, and the broken tooth would need to be removed. The extraction can either be done at the emergency appointment, or may need to be delayed, due to the limitations of the patient’s schedule. If the extraction has to be scheduled on another day, the tooth nerve may need to be removed to mitigate the pain and discomfort experienced by the patient.

Whenever there is a missing tooth, there are always four treatment options. The first is no treatment. This may be acceptable for back teeth, but when a front tooth is missing, most patients would prefer for it to be replaced. Replacement can be with a removable partial denture, a dental bridge or a dental implant. Of the three options for replacement, the dental implant is the optimal solution as it does not involved the adjacent teeth, and is able to restore function with superior aesthetics.

The difficulty in dealing with the catastrophically broken tooth is ensuring that there is a tooth replacement thoughout the dental implant treatment process.

When providing a provisional restorations, a fixed provisional restoration is the ideal option. These are designed according to where support for the provisional restoration can be identified.

If the adjacent teeth are intact or have small fillings, they can be used to support the interim restoration. The easiest thing to do is modify the clinical crown of the afftected tooth and bond it to the neigbouring teeth. However, if the tooth has broken into too many fragments, this would not be an option.

In these cases, an impression will need to be taken, and a provisional restoration can be made out of composite dental resin. These restorations would be designed with a wing covering one of the adjacent teeth. These are then bonded onto that adjacent tooth. This restoration can restore the gap created by the broken tooth, but does not have the best aesthetics.

However, there are some patients with higher aesthetic needs and demamds. For these patients, an adhesive Maryland Bridge is the restoration of choice for the provisional restoration. This is a metal framework which is overlaid with procelain. This allows for greater customization of the shape, shade and translucency of the tooth replacement, allowing it to blend in with the natural dentition.

Occasionally, there may be other options for support of the provisionals resotration. One of the adjacent teeth may have a crown that needs to be replaced. A provisional bridge can be fabricated with a cantilvered pontic or replacement tooth.

We have also encounted a patient who had an existing implant next to the broken tooth. Some of the veneering ceramic on the the implant crown and it needed replacement. We made a provisional restoration that was connected to the existing implant with a cantilever pontic replacing the missing tooth.

If appropriate support cannot be found for a fixed provisional restoration, or due to cost limitations, a removable partial denture can be used to replace the missing tooth.

After the broken tooth is removed, the extraction site is allowed to heal for 3 months. A CT scan is then made to determine the available bone volume and measure it to plan for placement of the dental implant. The need for bone grafting is also assessed at this time. A minor surgery is then performed to insert the dental implant into the jaw bone. 

After another 2-4 months of bone healing, during which the bone encircles and fuses to the dental implant, an impression is made to fabricate the definitive restoration.

The replacment of the broken tooth with a dental is not really all that complicated, but it is complex, involving multiple steps and stages, and usually takes a period of 6-8 months.

If you need more information regarding options for the replacement of a broken tooth, do not hesitate to Contact Us.