upper molar - extraction/ apicoectomy and potential nerve damage?

Discussion in 'Endodontics' started by rienwww, Feb 14, 2019.

  1. rienwww

    rienwww

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    Healthy, 42y old, no smoker, don’t take any medication, very active. I have never had any health problem. Describing the events from last 3 months.
    Dental situation:
    12 weeks ago,root canal revision on upper right molar – tooth 16 – gave discomfort in one root canal. 10 weeks ago after cheek swelling, tooth 17 was extracted in emergency due to wrong diagnosis. After few days, first major episode of “attack” on 01/12/2018. Dentist did apicotoemy on 16 tooth (05/12/2018), removed a cyst (but not in a canal of discomfort). Major attack followed again several times until final Extraction of tooth 16 (17/12/2018). Felt relief and situation improved over time, but minor/major attacks persist
    So, 8 weeks ago, I had 2 upper molar extraction and surgery (apicoectomy), basically on the same spot, which still gave hard time for the wound to properly heal – it still takes the time, but dentist said yesterday it is normal due to the conditions.

    All blood test good for infection markers. No temperature, fever, dhiarea and almost no sharp pain during all this time, only episodes of attack and almost constant stiffness (rather than numbness) on the gums.

    Main Problem/ Attacks:

    After root canal, and first extraction, I had first sudden stiffness/inflammation/numb around the gums on tooth 16, but without particular pain. The right part of the face became numb – up to the roof of the head, BP and pulse went up, I was able to measure constant resting pulse 110, accompanied by the bowel movement. Episode lasted almost whole night. I became swollen beneath the right eye, with redness next to the nose, and cheek slightly swollen. Vision blurred a bit on the right eye. Tiredness and exhausted. After 2 days same attack repeated and lasted few hours. Same attack after surgery (with 170/110 BP and 110 pulse), showing probably that the surgery was unsuccessful. After problematic molar extraction, felt a relief for the first time in 2 weeks.
    After that, the attacks have been more minor in nature, but continued, and honestly influencing my life. During the day, there is still sensitivity around the wound in form of stiffness (that is very low during non attack time). During the attacks that are up to 2h, and that always start with increased stiffness in that part of gums – now I have instead of numbness - rush comes to the right side of the face (or bowel movement), while pulse jump to 95.
    I can’t say what is causing the attacks, but had impression maybe by the wind/ or cold/touching the wound.

    I do have constant ringing in the ears (tinnitus) with changeable intensity during attack since surgery. I am still constantly very lightly swollen beneath right eye – it gets a bit bigger during attack time (almost 2 moths now swollen). Also, I have impression that the corner of the right lip went down a bit. Cheek close to nose also can very lightly swell. There is small bump in mouth roof after surgery.


    Overall, after the tooth extraction I could concentrate to work, I had part of my energy back, I put back weight that I lost before. It might look like there is some progress. Or I just get used to this.However, it is still far away from good, particularly when I still have episodes like this


    Questions:

    I am looking for any diagnosis and potential cause - what might be the reason for this? Damaged nerves? If so which ones? Is this permanent or is there a chance for improvement or aggravation of the condition? What additionally I should test? Would I be able to do implants (if this area is sensitive)….


    Dentists that I visited said that I should wait more and hopefully will resolve on its own


    thanks
     
    rienwww, Feb 14, 2019
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  2. rienwww

    honestdoc Verified Dentist

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    You may be experiencing Bell's Palsy when your right corner lip drooped down. Another possibility may be trigeminal neuralgia. You may need an evaluation from a neurologist and ear, nose and throat specialist who may request CT scan to locate any possible swelling, tumors, etc.
     
    honestdoc, Feb 14, 2019
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