Root canal failure of crack? What to do


Joined
Jan 15, 2020
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Hi,

So back in September I had a root canal on #12. Pretty straight forward and everything was done by an well known and skilled Endo. They suggested all was straight forward and looked great. I went home but a few weeks later it began to hurt again so I went back. We tested other teeth to no avail and decided to retreat #12 so medication was placed. Felt ok for a few days but never quite right. Went back and I told him it just does not feel right so we opted for the cone 3D x-ray. He looked it over very closely for several minutes and said it looked very good no cracks etc. We went back in #12 removed the medication and put more medication in and sent home to wait and see. While inside the tooth he commented I cannot see any cracks present. At that point there was never improvement. The tooth just hurt. This pain was mixed with a sensation of vicks vapor rub in the tooth, odd sensations. So when I went back we thought maybe it was the tooth next to it as it tested now with more cold sensitivity. We root canaled that tooth just last monthwhich was indeed inflamed within. At that sitting he also compelted 12 with the final step. I thought I was good to go but not the case. Both teeth are completed. I got a crown on #12 hoping things would settle. They never have on tooth 12.

The tooth next to 12 feels ok. But 12 is off. I feel strange when I tap on it on either the side of the tooth or taping on the chewing surface. As I sit here if I tap I get mild discomfort coupled with a strange cold sensation. The tooth feels like it's got icy cold gel on it at times combined with an ache that comes and goes.

What are the odds its fractured if the 3d xray did not show it? What are the odds it will ever settle? I am really considering having it removed.

Lastly I have read of stories of Atypical odontalgia. When I revisited the Endo he asked me some questions and asked about Trigeminal Neuralgia but said my descriptions did not fit. Could I have Atypical Odantalgia? What concerns me is, if I do have this condition I understand tooth extraction will not help and can worsen things.

If I have a hidden crack or split in the root would I have this odd cold burning sensation in the tooth? I have seen my Endo over 10 times don't think there is anything more he can do. Not sure where to go from here.

Thanks for reading!
 
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honestdoc

Verified Dentist
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Vertical root fractures are very difficult to detect. Did the dentist perform a periodontal probe to check for gum attachment loss? If there is a vertical fracture, it won't have any attachment loss until after 3 weeks. It is difficult to assess what happened to the tooth. Was the skilled Endo a board certified Endodontist? A remote possibility is the presence of a 3rd canal which would have been verified in the CT scan as well as the Endodontist. Another remote possibility is a sinus infection. If the team of dentists cannot identify the problem, go see an Ear, Nose, Throat specialist.
 
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Joined
Jan 15, 2020
Messages
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Thank you for your reply. I am not sure if he did a probe check on the gum. I did go in about 10times total and there was a lot of examination, several 2D xrays and a 3D scan. He is a board certified Endo. I remember looking at the 3D scan with him it was fascinating to see all the views of the teeth. He commented on one of the roots on #12 the outer side of the gum leans out more towards the gum but he did not think that was the issue. I am 1 month out of the final completion all of this began in early September of last year. I sometimes get a dull burning and other strange sensations in or around the tooth.

One thing worth mentioning right after the second retreat (whatever is invololved in that process) After he was completed and started telling me how things looked good in the tooth, I began feeling pain above the tooth like an ache. This is fully numb long before the numbing wore off. I told him this is strange but it hurts. He said he only see's that in about 10% of his patients. He injected numbing on the inside near the roof of the mouth and about 6 min later that strange ache went away. I often wonder why it ached? It was not a horrible pain but my typical achy sensation I get.
 

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