Could pulsing/pain in the tooth still be present after RCT, even after the pulp has been removed......... if one of the canals wasn't fully treated?

[ToothPatient]

Tooth being an upper 2nd molar.

I know the endodontist missed MB2, he found the entry, but didn't treat the entire canal cause he said he couldn't get his file in easily, so he just left it.

Pain I had prior to the RCT is less, but not gone, and I'm getting that pulsing pain in the root area of the tooth still.

He seemed to think that having removed the pulp, any pain inside the tooth should be gone, and the abscess and all associated pain should have cleared up.

So in short, if MB2 canal wasn't entirely treated, can the tooth remain painful, even if all other canals and the pulp has been removed?

Or is that unusual?

Not fully treated canal in question.

 

[Dr M]

Yes, any untreated canal could lead to the symptoms you are experiencing. If he has trouble navigating the canal, he should perhaps refer you to someone else. You get some endodontists who perform these procedures under a microscope, and you get modern, super flexible files, that make navigating a difficult canal easier. Some endodontists also use a laser as an adjunct in order to increase the disinfection process of the canal.

 

[Dental cure and care]

It is not unusual for a tooth to remain painful after RCT if one or more canals were not fully treated. The presence of residual infection in an untreated canal like MB2 can indeed cause ongoing pain despite other areas being treated effectively.
If your endodontist did not treat the MB2 canal completely, it is quite plausible that this could be contributing to your lingering pain symptoms even after pulp removal from other canals.

 

[ToothPatient]

Yes, any untreated canal could lead to the symptoms you are experiencing. If he has trouble navigating the canal, he should perhaps refer you to someone else. You get some endodontists who perform these procedures under a microscope, and you get modern, super flexible files, that make navigating a difficult canal easier. Some endodontists also use a laser as an adjunct in order to increase the disinfection process of the canal.

He went back in, claiming he'd removed everything initially but obliged to have another look, as the pulsing nerve pain was so powerful.

Re-cleaned the main three canals with files, then used a microscope on the orifice that was mb2.

It didn't form an entire canal as he explained, but went about 4 mm in.

In any case, whatever he did, significant reduction in pulsing nerve pain this time, two days on from the re-treat.
Still an occasional pulse, but only every six hours or so, not persistent as it had been.
Hopefully another few days that will have dissipated entirely.

Personally I don't know if it was the remains of the abscess clearing up (as there was an abscess upon first treatment 9 days ago), or just missed nerve or something.
But on the initial treatment I could feel the files get to the end of each canal, as they did on this occasion also.

 

[ToothPatient]

He also mentioned if the pain continues, then the cause would be inexplicable at this point (which I'm also inclined to believe at this point, given how much effort he seemed to put into finding and treating mb2, which only amounted to an orifice, not a full canal) and the tooth would require extraction.