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Medical Forum / General / Dentistry / July 2005Apicoectomy repost
Posted this in 2003: "My dentist is recommending this because I am still getting infection around the root apex (#25) after several root canal retreatments. The root canal looks good, on the xray, with no more bone loss since it was done last year. No pain, just a little pus which drains out the gum every month or so. I'm tempted to leave it alone and see if it heals itself. Also, the tooth was crowned 5-6 years ago and there is some filling exposed below the crown which he mentioned may be a point of entry for infection. " Last 8 months no longer draining fistula. Can I assume the tooth is finally 'stablized and healing'. What are the odds it will reinfect? Thanks No way to predict, especially without seeing you IRL. Has a root fracture been ruled out? How about a second canal?  Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > Posted this in 2003: > [quoted text clipped - 12 lines] > > Thanks > Posted this in 2003: > [quoted text clipped - 10 lines] > > Thanks I feel uncomfortable about this tooth. If the tooth was draining for years and no apico was done, I think it's unlikely the infection would spontaneously heal after so much time. The history of these chronic infections is that they wax and wane. The tooth should be examined and x-rayed. Assuming the root canals were done carefully by a competent operator and it was still draining after "several" retreatments, there is something else likely going on, like an undetected fracture. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > I feel uncomfortable about this tooth. If the tooth was draining for > years and no apico was done, I think it's unlikely the infection would > spontaneously heal after so much time. I had a tooth that was like this. It started after a second root job on it. It oozed on and off for a few years with no pain. Then I moved abroad and the dentist here is much better. He did a full X-Ray and that showed a black shadow where there was clearly medium size cyst. My previous dentist must have been able to see it on the x-rays he did but never said anything. It turned out tooth was also cracked but that didn't show on the x-ray - I asked to see the tooth when it was extracted and the split was surprisingly wide. No problem since it was extracted. > > I feel uncomfortable about this tooth. If the tooth was draining for > [quoted text clipped - 9 lines] > asked to see the tooth when it was extracted and the split was surprisingly > wide. No problem since it was extracted. These cracks seldom show up on x-ray. However, their presence can sometimes be inferred if the x-ray shows bone loss in an area other than the crest of bone or the tip of the root. To be fair, the crack often opens up when you extract the root, so it's tough to say it wouldn't have been seen on x-ray--IF it were in the correct axis. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> Posted this in 2003: >> [quoted text clipped - 21 lines] > >Steve Or a missed canal. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>>Posted this in 2003: >>> [quoted text clipped - 28 lines] > Take out the G'RBAGE > wubbabubbazG@RBAGEyahoo.com Possible. I was assuming a root canal "done carefully by a competent operator" would have seen all canals. Considering how small and tortuous they can be, this might be an unfair judgement. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Not always possible to find all the canals without sectioning the tooth. Fortunately most of the "strange" canals re-connect with the main one closer to the apex. Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >> >>>>Posted this in 2003: [quoted text clipped - 41 lines] > > Steve |
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