Root canal retreament done wrong or just failed

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May 2, 2019
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So I had a root canal that failed and experienced extreme pressure when biting on the tooth. This is tooth number 30. My dentist suggest I have a root canal retreatment done to save the tooth and wrote me clindamycin this took care of the swelling. Well, I had my retreatment done and about a day after the swelling returned about a day but is stable. The endodontist wrote me clindamycin again, but the swelling is still there but no where near as extreme as before. I went back to the dentist and she told me typically you have a follow up appointment after a procedure like this. After the initial follow up the endodontist suggest that I either pull the tooth or see a oral surgeon, but he still recommended that I get the core build up done on the tooth. So once I got back to the dentist she told me the x ray she took after the retreatment looks nothing like the one she recieved from the endodontist. The last xray I had from my dentist was taken about a half week after the retreatment. She also mentioned it looks like he went too deep on the right or front root and the infection is still present. Do you think the endodontist should be able redo just that root to solve this whole issue. I feel like I'm being tossed around. Sorry for the quality of the xray and I truly appreciate any feedback.
 

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honestdoc

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Unfortunately, when a root canal fails, the likelihood of success for a redo root canal is greatly diminished. When the endodontist is removing the existing core and old root canal filling material, a lot of damage to the tooth and stress to the roots can occur. Roots can easily fracture resulting in the need to pull the tooth after all the time and money invested. There is a species of very resistant bacterial called enterococcus faecalis that can re-infect previous root canals. I don't see significant findings on the x-rays. Since you were taking Clindamycin, you may be allergic to Penicillin or Amoxicillin. If so, you may discuss with your dentist about taking Clindamycin and Metronidazole aggressively to treat the swelling. There will be a lot of digestive side effects so take it with meals, yogurt (some pharmacists will argue that it counters Clindamycin's effectiveness but I like it for reducing side effects) and plenty of probiotics. If you are not allergic, try Augmentin aggressively. Lastly, you may have to extract the tooth.
 

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honestdoc

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That seems to be the case but the endodontist did all he/she could. Many times with an infection, the end root is softened or resorbed from the body's attempt to fight off infection. With softened root ends, the filling does not have strong enough "stop" to prevent overfilling. Fortunately the filling is biocompatible. Although it is not ideal and potentially irritating to surrounding tissues, I've seen overfill cases heal. The concern is the swelling. The overfill has nothing to do with infection. Hopefully it can be resolved.
 

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