Re: My left tooth... again

John wrote:
Some things I wanted to try to better understand further before I opt
to get the tooth pulled:

- How can a successfully RCT-ed tooth still cause pain? I've been
told if it has a crack in it, but what is the mechanism? The only
living thing the crack could be touching is the periodontal ligament.
Can that really cause significant pain?

Yes.

- Can gutta percha overfill that is visible on an x-ray and seems to
be coming out of the tooth root apex be the cause of pain? I would
think so, especially if it is impinging on the nerve in the jaw. Is
that actually a possibility? See http://geocities.com/dtminer40/tooth.jpg
for the xray, which I've linked to before on a file sharing site, but
this one is easier to get to.

That doesn't look like a gutta percha overfill, it looks like a puff of sealer there. Either way, these rarely if ever cause pain. The sealer is gradually resorbed by the body (gutta percha won't be).

- Is there a good explanation for these pain symptoms: dull ache all
the time, ranging from almost unbearable to almost nonexistent; not
much increase in pain with downward pressure; significant increase in
pain with lateral pressure.

Thanks for any thoughts,

I remember this x-ray. The most likely causes of pain are fracture or a missed canal, leaning toward fracture. However, I cannot see it. If the tooth is re-x-rayed, there may be more evidence if there is a fracture.

Steve

John.



--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001
.

Relevant Pages

  • Re: My left tooth... again
    ... How can a successfully RCT-ed tooth still cause pain? ... living thing the crack could be touching is the periodontal ligament. ... there may be more evidence if there is a fracture. ...
    (sci.med.dentistry)
  • Variable percussion tenderness on RCT and crowned tooth after 5 weeks?
    ... Pre-RCT pain was exquisite when trying to sleep, ... Tooth was sensitive ... Post-RCT pain was minimal except for tenderness to contact ... the hallmark of a fracture.) ...
    (sci.med.dentistry)
  • Re: Metallic taste in mouth and pain after filling replacement
    ... second amalgam filling. ... regular dentist drill out the old filling where the pain was ... I had the tooth refilled yesterday. ... Considering the dentist was able to visualize a crack, ...
    (sci.med.dentistry)
  • pain from cracked tooth after onlay
    ... left jaw) treated for a crack which ran right through the rear inner ... The dentist gave it a Cerec onlay (which reaches down ... stretching in a curve from the cusp across the centre on the tooth. ... began to notice quite a lot of pain on biting. ...
    (sci.med.dentistry)
  • Re: pain from cracked tooth after onlay
    ... left jaw) treated for a crack which ran right through the rear inner ... The dentist gave it a Cerec onlay (which reaches down ... stretching in a curve from the cusp across the centre on the tooth. ... began to notice quite a lot of pain on biting. ...
    (sci.med.dentistry)