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Cyst long-following root canal

User Level:
Patient
Posted by: heshamsaeed  (7 years ago)
I had a root canal for my lower left 2nd molar, about 20 years ago. Few days ago I felt minor tolerable ache with hot/cold food or drink. The tooth is fixed and strong.

The dentist made an X-ray and Panorama and found incomplete filling of the root canal, in addition to a cavity around the roots. The dentist told me to extract the tooth and put an implant.
Being a Radiologist, I made myself a CT scan with panoramic reconstruction. The cyst was shown to be opened onto the inner surface of the mandible. I didn't show the CT yet to the dentist, but I wonder if this would alter the management (putting an implant in a defective bone?).
I need a 2nd opinion.
User Level:
Dentist
I had a root canal for my lower left 2nd molar, about 20 years ago. Few days ago I felt minor tolerable ache with hot/cold food or drink. The tooth is fixed and strong.

The dentist made an X-ray and Panorama and found incomplete filling of the root canal, in addition to a cavity around the roots. The dentist told me to extract the tooth and put an implant.
Being a Radiologist, I made myself a CT scan with panoramic reconstruction. The cyst was shown to be opened onto the inner surface of the mandible. I didn't show the CT yet to the dentist, but I wonder if this would alter the management (putting an implant in a defective bone?).
I need a 2nd opinion.


It is never possible to place an implant immediately after extracting a 2nd molar. A graft would have to be done with the extraction. The graft would integrate over a period of month and close the perforation of your jaw. After healing, it would help the dentist if you get another CAT scan of the site, so he can measure exactly how long an implant to inventory, in order to completely miss the inferior alveolar nerve during surgery.
Posted 7 years ago
User Level:
Patient
Posted by: heshamsaeed  (7 years ago)
Thanks Dr. for you kind reply.
Currently, I had a course of Amoxycillin 500 for 5 days, t.d.s. The pain subsided and I am fine.
Do you think I -still- have to extract my tooth?

Thanks in advance
User Level:
Dentist
Thanks Dr. for you kind reply.
Currently, I had a course of Amoxycillin 500 for 5 days, t.d.s. The pain subsided and I am fine.
Do you think I -still- have to extract my tooth?

Thanks in advance


No, you are not "fine." You are only temporarily free of symptoms. Antibiotics alone NEVER cure dental problems. If you don't have the tooth taken out you will lose so much bone you won't be able to have an implant.
Posted 7 years ago
User Level:
Patient
Posted by: heshamsaeed  (5 years ago)
It's me again after more than a year. Here is the history: Tooth extracted - graft - implant done - Implant broken after 3 days - replaced - broken after two weeks - replaced - now it seem ok after 3 months ... However:
Since I had the 3rd replaced, there is minimal discomfort/ache at the region, especially with cold hot food or drink, which I failed to localize for some time. 5-6 weeks later, I can localize it more at the next tooth (1st molar), sometime radiating to the submandibular region. Occasionally I can feel it spontaneously. X-ray done and the tooth and the adjacent ones were free. My dentist says it is likely an 'allergy'

Few days ago, I accidentally made a strong bite with it on a hard seed (guava seed), and I felt severe pain for seconds, then it subsided.

I am worried about it. What could it be? What should I do?

I've uploaded selected CT panoramic cuts done 10 days ago.
Thanks in anticipation
User Level:
Dentist
It's me again after more than a year. Here is the history: Tooth extracted - graft - implant done - Implant broken after 3 days - replaced - broken after two weeks - replaced - now it seem ok after 3 months ... However:
Since I had the 3rd replaced, there is minimal discomfort/ache at the region, especially with cold hot food or drink, which I failed to localize for some time. 5-6 weeks later, I can localize it more at the next tooth (1st molar), sometime radiating to the submandibular region. Occasionally I can feel it spontaneously. X-ray done and the tooth and the adjacent ones were free. My dentist says it is likely an 'allergy'

Few days ago, I accidentally made a strong bite with it on a hard seed (guava seed), and I felt severe pain for seconds, then it subsided.

I am worried about it. What could it be? What should I do?

I've uploaded selected CT panoramic cuts done 10 days ago.
Thanks in anticipation


The images are pretty blurry. I don't understand what broke. The implant did not break. Did the dentist put a temporary crown on it, and that broke? This is not regular protocol.

Probably #19 needs a root canal. The x-ray you provided is no evidence. Either the first molar is cracked, or the pulp is inflamed or dead, or both.
Posted 5 years ago
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