- Joined
- Dec 26, 2023
- Messages
- 80
Maxillary incisor #11 creates a "sensation" (not urgent but steady). Gums are nice and pink, there is no cavity. Tooth is sensitive to lateral palpation.
GENERAL QUESTION: how common are root fractures in upper incisors?
I think it is a sprained tooth (possibly from bruxism) or it is phantom referred pain from a recent molar "event" (see below), but how can this unambiguously diagnosed. I am afraid it is yet another cracked root...which would mean the tooth has to be extracted.
Recent (2023) history:
Early June: Molar #46 cracked noticeably, and superficially
Early July: X-rays yielded no anamolies
Late July: Bonded
Mid Aug: Bonding broke and permanent toothache set in
Late Aug: Bonding restored, pain getting worse
Early Sept: Referred to endodontist who performed X-ray and CBCT scan: X-ray clean, CBCT scan indicates rarefying osteitis...and possibly fractures.
Early Oct: 4 root canals (phase 1), pain increases two days later substantially (headache added)
Early/mid Dec (11 weeks later): another X-ray confirmed ongoing lesion at root apex. I decided not to have #46 obdurated.
Mid Dec: Molar #46 extracted by oral surgeon, who confirmed crack in root. Biting on that black rubber puck for 1-2 hours may have affected the ligaments...It has not been three weeks...
Bottom line: RCT was unnecessary as CBCT scan did not have the resolution to image the "lethal" root fractures. Root fractures obviously constitute a problem with diagnosis.
The potential problem with unambiguous diagnosis of the incisor: imaging may not reveal root fracture AND rarefying osteitis. How do I avoid another unnecessary RCT?
If it is a sprained tooth, there would obviously be no rarefying osteitis.
I may try a nightguard first.
GENERAL QUESTION: how common are root fractures in upper incisors?
I think it is a sprained tooth (possibly from bruxism) or it is phantom referred pain from a recent molar "event" (see below), but how can this unambiguously diagnosed. I am afraid it is yet another cracked root...which would mean the tooth has to be extracted.
Recent (2023) history:
Early June: Molar #46 cracked noticeably, and superficially
Early July: X-rays yielded no anamolies
Late July: Bonded
Mid Aug: Bonding broke and permanent toothache set in
Late Aug: Bonding restored, pain getting worse
Early Sept: Referred to endodontist who performed X-ray and CBCT scan: X-ray clean, CBCT scan indicates rarefying osteitis...and possibly fractures.
Early Oct: 4 root canals (phase 1), pain increases two days later substantially (headache added)
Early/mid Dec (11 weeks later): another X-ray confirmed ongoing lesion at root apex. I decided not to have #46 obdurated.
Mid Dec: Molar #46 extracted by oral surgeon, who confirmed crack in root. Biting on that black rubber puck for 1-2 hours may have affected the ligaments...It has not been three weeks...
Bottom line: RCT was unnecessary as CBCT scan did not have the resolution to image the "lethal" root fractures. Root fractures obviously constitute a problem with diagnosis.
The potential problem with unambiguous diagnosis of the incisor: imaging may not reveal root fracture AND rarefying osteitis. How do I avoid another unnecessary RCT?
If it is a sprained tooth, there would obviously be no rarefying osteitis.
I may try a nightguard first.