Prevention of Tooth Loss after Breakage on a Deep Bite Patient

Published Date 04/07/2017

A destructive, deep bite can complicate treatment plans and need great emphasis to be placed, first and foremost, on how and why the tooth broke, rather than how to fix it. A cosmetic case this is not!  Instead this is a case with multiple existing crowns added as the patient broke off anterior teeth, a deep bite, wear facets, and now another anterior crown that has broken off.  I have to decide “shall I repair and restore this tooth by placing a new crown, or remove the remaining tooth and place an implant?” 


 In this circumstance, I opted to replace the crown, due to patient’s desire to preserve his teeth, and the ability to get a decent ferrule around the remaining tooth structure.  Careful consideration will be paid to the bite, and the destructive forces that have been applied to the previous crown and to the one that I plan to make for the patient.  I do not want history to repeat itself!   I did “pave my way with words” by informing the patient that if there were complications with this crown, that an implant would be the subsequent course of action in his treatment plan.


Dale is a 75 year old man with breakage of the underlying build up material and porcelain-fused-to-metal crown on #10.  He had this crown placed in January of 2011 initially.   The crown became displaced in 2015 and was re-cemented and splinted to the adjacent teeth with composite material.  I told the patient that these measures would likely only “buy him time” and give him a chance to gather funds for a new crown as #10, but that this was simply a temporary measure.  Several months later, the crown became dislodged again.  The patient was ready to move forward with treatment, as the lost crown proved unsightly in the anterior and made him feel like a “hillbilly.”


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Dr. Kate Gross earned her Bachelor of the Arts in Human Biology at the University of Kansas and completed her Doctorate of Dental Surgery at the University of Missouri-Kansas City. She is a member of the American Dental Association, Academy of General Dentistry, and the Crown Council. She is an Achievement Award recipient of the American Orthodontic Society, and past president of the Salina Dental Society. She enjoys attending continuing education courses that present ways that patients can improve their quality of life and have a healthy, beautiful mouth and smile. Most recently, Dr. Gross has completed courses for Invisalign®, sleep apnea, and comprehensive orthodontics.

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