Persistent pain year after root canals - sealer extrusion? CBCT+X ray included

Joined
Feb 5, 2024
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I have had two root canals on necrotic teeth. The teeth were painful due to tiny fillings which caused pulpal necrosis for some reason. Something in the process damaged the nerve.

There was no leasion or cold sensitivity or pressure sensitivity before the RC's, just a deep strong ache that came up within weeks after the two fillings. The RCs took this deep strong ache away and were absolutely necessary.

However it is been twelve months and I'm giving up. Both teeth still hurt and I feel it is getting worse in one of them. The pain is deep, dull whining. There is no burning or throbbing. I have had several opinions. Another endo does not want to retreat as he says the rc's look great. There is some sealer extrusion on both of them. According to the Dentist that did the RC's (Dentist who takes referral patients and does complex rc's and retreats, technically not an endo) this sealer puff cannot cause this pain and happens all the time. 2nd opinion endo said it could theoretically cause irritation but he does not want to apioectomy for this filling material alone.

- upper premolar is sensitive to pressure to very chewy food - normal/majoritt of food i can eat.
- lower premolar has no pressure sensitivity can eat just fine.
- both tooth have sensitivity to percussion. I've been told RC teeth sometimes always keep some percussion sensitivity.

I'm wanting to extract but the orofacial pain specialist says this could be neuralgia and does not approve extraction It does not behave like neuralgia to me. During this year I have had periods of 2-3 months without any noticeable pain.

Any suggestions? Could the sealer that causes this? I don't know the brand of sealer.yet
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