Back Molar Cracked: Is Extraction and a Dental Implant My Best Option?


Halya from NJ asks:

Recently, my last back molar cracked after eating some popcorn. The tooth had a root canal about 8-months ago. The dentist recommends an extraction, rather than a crown, because of the way the crack occurred.

My teeth have always been crowded and I was wondering whether I need to replace the tooth after the extraction? If nothing is done after the extraction will the bottom teeth shift now that there will be some room? Is an implant the better way to go?

Also, I keep hearing that there is no way to tell how deep the crack is and yet the x-ray looks like the root is intact. Why would crowning the molar be a problem if the root is intact?

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Expert Advice and Comments
mtischler's picture

Back Molar Cracked: Is Extraction and a Dental Implant My Best O

Answered By: Dr. Michael Tischler - Woodstock , NY


If the tooth is truly cracked then extraction is the only option. If you are talking about a wisdom tooth then replacing it with a dental implant is probably not necessary and would be difficult in that area of the mouth.If it is a wisdom tooth then the opposing tooth could also be removed at the same time.
If it is a second molar then replacement with a dental implant can be done and would be recommended. This will stop adjacent teeth from migrating and opposing teeth from super erupting.

Michael Tischler, DDS

Dr. Michael Tischler

drjbdmd's picture

Dear Halya- I agree with Dr.

Answered By: Dr. Jeffrey Brook - Massapequa , NY

Dear Halya-
I agree with Dr. Tishler's opinion.
The only thing I would add is that the remaining bottom teeth would not shift back to alleviate the crowding issue, if that was what you were alluding to with your question.
Good luck with the tooth.
Dr. Brook

Dr. Jeffrey Brook

ekusek's picture

Hayla, I would agree with

Answered By: Dr. Edward Kusek - Sioux Falls , SD

Hayla, I would agree with both above. There is a way to see how deep the fracture is and that is by taking a cone beam CT. If you try to place a crown on a fractured molar you will develop bone loss around the tooth, which in turn can cause a gum infection. The bottom line is that you will lose the tooth.
good luck
Dr Kusek

Dr. Edward Kusek

drkazemi's picture

Treatment for a cracked molar

Answered By: Dr. H. Ryan Kazemi - Bethesda , MD


The prognosis of a tooth with a crack depends on its location and degree. Your dentist along with assistance of an endodontist can make the determination if tooth is salvagable or not. If the crack is deep (often diagnosed on X-rays or cone beam CT or by visual examination) then it has poor prognosis and extraction is the only option. Some times it may be possible to save a tooth, but if a less than 80% prognosis is given, then it is not a good choice. Simply placing a crown on the cracked tooth will not be effective as the crack can lead to infection. You want predictable dentistry not heroic.

If tooth is extracted, then implant replacement is the treatment of choice.

I hope this is helpful.

Dr. H. Ryan Kazemi

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