Is this vertical root fracture?

[Vandy]

This is regarding my molar tooth (number upper left 6). I m attaching two x-rays. The first is the original one, and the second one is on which I have drawn colored jagged lines where I believe the vertical root fracture to be present. Please confirm if it's a vertical root fracture and let me know if this tooth can be saved somehow. I wish to save it if it can be done safely. If possible, what are the options? So far I have read about bonding/replantation. Would it work and is there any other option? I don't want an implant or bridge.

This x-ray is the only one I was given. It's from the last cleaning session and the dentist was pressurizing to seal it. I refused as there was pain n swelling after chewing. After this, the dentist just filled the canals with calcium hydroxide and it is still not sealed.

I am also attaching my actual tooth pics just so u can see what it looks like from outside.

The pain increases only after chewing. Even though I am not chewing on that side, there is a chronic slight swelling n soreness on the gum above that tooth n it feels sensitive to hot liquids.

 

[MattKW]

• That X-ray image is not clear enough to see or say anything meaningful. I would need an unaltered digital image.
• Cracks often don't appear on standard dental Xrays anyway, and are straight, not jagged.
• The outside photos show nothing unusual. If there was a crack, it will sometimes appear as an isolated periodontal pocket.
• Sensitivity to heat cannot be coming from this tooth because the nerve has been removed. And the tooth in front has alreay been root-filled, so I would be looking more closely at the tooth behind that has a large filling.

 

[Vandy]

Thanks for your quick reply. The first x-ray is the only unaltered original one I have got at present. I will try to get another one soon. The swelling n pain is above this tooth only. The tooth behind it (number 7) feels absolutely normal when I bite with it. I put my cold finger on each tooth separately n found number 7 to be indeed sensitive to cold but not heat, whereas number 6 is sensitive to heat n not cold. Number 6 hurts most if pressed right at the center of the filling. On the x-ray, there seems to be a slight gap at the base of the pulp chamber. Maybe that's where the heat is penetrating through? Also it feels like something hard is hitting something hard (like when ur filling is too high) but that feeling is inside my gums above that tooth n feels very sharp n not the usual kind. I know u just said that a fracture is not jagged....but it seemed to me (by the shape of the colored jagged lines I drew) as if the jagged lines were once together and aligned, but now the mesial half of the tooth has shifted up by a few mm (maybe due to chewing force), making the jagged lines out of alignment n now the sharp points r hitting against each other when I bite. The tooth also felt very slightly loose last week (though it doesn't now after a week of avoiding chewing completely). I can bite on even peanuts with number 7 but cant even bite on bread with number 6. So the problem is definitely with 6. Going by the symptoms, what could it be? And if it is indeed vertical fracture, can it be repaired/saved?

 

[Vandy]

When I had told that dentist that I was still having pain, she tried to convince me that the pain was due to inflammmation (not infection) due to "the wound". She then had put metapex inside the canals and told me to wait for it to heal, so I decided to give it sufficient time to heal and wait for a month to pass and then re-assess. However, there was absolutely no improvement (neither better nor worse). The same situation persists (pain only upon chewing or pressing tooth from below manually or even with tongue. Otherwise no consistent pain).There is no longer slight swelling n soreness on the gum above that tooth, but pain only upon pressing the tooth from below (and sometimes from the side as well). So today i visited another clinic in my area just to get another xray (thinking that metapex is visible on xray) as I was very curious to see whether or not the metapex has reached to the apex or not, as well as any other problem. I am attaching that xray and request you for your valuable advice if you can see any problem on it. (You can compare it with my previouslyattached xrays from December if you require.) I thank you in advance and really appreciate your advice.

 

[Sonia Salamuri]

Isn't there a carie under the number 7 restoration?