Tooth changing color after root canal treatment

[Lilith]

A friend of mine had a RCT two years ago on tooth #8, and capped it with an all porcelain crown. It looked great at first, but now her tooth turned really gray compared to rest of her teeth. Any suggestions on what she can do to improve the situation? Thanks.

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[simpledoc]

the tooth is probably discolored as in many cases, because of the dead cells and due to incorporation of blood pigments (from the tooth pulp), which I am sure must have been the case, even before the RCT was started.
Are you 100% sure that the tooth has an All Porcelain Crown? if not the greyness is due to the metal; IF NOT, the porcelain probably is being worn down and exposing the tooth structure (which was previously discolored) and hence the grey color.
No, coming to the solution, you already know it by now...3 options:
1. Replacing the crown.
2. Grinding the facial surface and direct composite veneering (not recommended).
3. Laminating the facial surface of the crown.
4. Bleaching(?? 😕 ) (not sure of this one..)

 

[johnkimdmd]

Also consider...

With RCT, sometimes the gutta percha is left too high and tooth will discolor. Are you sure it's not an all ceramic crown? Well, if there's no metal substructure, and you're sure it's the underlying tooth (and not cement or extrinsic stain), you can do a walking internal bleach. You would have to access through the crown (or take the crown off if she would need a new crown anyway - hard to tell from here), and mix sodium perborate with sterile saline (a lot of ppl just mix the perborate with lidocaine), pack it into your access (you probably had composite in there originally, just remove enough to make a pseudo endo access), temporize access with IRM, and leave it in for two weeks and repeat until you get the desired color change. Oh, make sure the gutta percha is below the CEJ when you have the access open.

 

[DcS]

http://forums.studentdoctor.net/showthread.php?t=178008

 

[Lilith]

Thank you for your inputs and suggestions. 🙂

 

[groundhog]

Maybe they did a build up with colored plastic and did not get back down to the tooth on the margins when the final prep was cut. The gums have since receeded a bit and the plastic is starting to show. Nah.....that is crazy. It should not happen.