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Root Canals

Possible failed root canal or maxillary nerve

02/14/2007

Question:

I have had 2 root canals performed nearly 6 years ago (#13). There was problem with # 15 where the diamond tip drill head was broken off and wedged in root tip. It was temporarily filled and extracted 2 months later. No crown was performed on either root canals. A year later, CT scan showed infection around base of #15 and an apicoectomy performed. However I still had pain on left hand side of face, after surgery was performed.

A year later, dentist rechecked #15, but found no other problems with this root canal. He isolated this tooth by creating a bigger gap between it and #14, and reduced its height so it did not come into contact with other teeth. It has been like that for 2 years. Further CT scans show no problems with sinus nor any infection around teeth. However I still have pain on left hand side.

I was referred to an oral surgeon where after half an hour, was diagonosed with neuralgia of the maxillary nerve . Was prescribed nortripyline but it has had little effect. The #15 tooth is still very sensitive and sore to touch on its side, although it is not sore on biting. Also, I can smell source of mucosal infection on left hand side (ie isolating nostrils) – at back of throat. I believe that the root canal performed on this tooth has failed and that the source of ongoing pain is with this tooth, rather than solely due to maxillary nerve damage.

I want to request an extraction of #15, but the dentist strongly recommends for this not to happen. Can you suggest anything else?

Answer:

Your case seems very complicated with many factors to consider.  Since you have an extensive history with much work done, it is hard for me to make specific recommendations without an evaluation.  However, I did notice that you kept referring to your dentist and you also mentioned a referral to an oral surgeon.  If you are questioning whether you have a problem related to a root canal, the person that would best be able to evaluate that would be a root canal specialist.  I would suggest that you seek an evaluation from an endodontist. 

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Response by:

Melissa McCartney Drum, DDS, MS Melissa McCartney Drum, DDS, MS
Assistant Professor of Endodontics
College of Dentistry
The Ohio State University