Hi anneva,
My suggestion would be to see a different oral surgeon asap. Not one that is associated with either of your dentists. It is best for him to have your pre op xrays of the upper right quadrant and also take new ones to see where that graft is sitting and what #4 looks like radio graphically.
The bump over #4 needs to be properly diagnosed. Is it a fistula from an infection in #4 ... is it a bony protrusion or a splintered bone from the extraction?? I would do nothing with that bump until it was diagnosed.
Root canaling #4 is not going to solve your problem. In fact it will exacerbate it because it will definitely cause #4 to become infected if it is not already. Root canals do sterilize a tooth, they do not cure the infection inside of a tooth, they create further problems down the road just as you have experienced with #3. Root canals do not fail... that is something patients are told but the fact is that they are a flawed procedure as there is no access to the tiny canals that remain chronically infected. That is why you can rc a tooth a hundred times and the tooth will remain infected.
Regarding the placement of the graft at the time of the extraction... a graft should only be placed in bone that is healthy. A tooth that has been root canaled twice has undoubtedly be sitting in diseased bone. Therefore, that graft may be exacerbating whatever other problems you have going on in that quadrant. Do you have any other teeth in that quadrant root canaled?
You should have been informed that replacing an infected root canaled tooth with a dental implant carries an elevated risk of failure due to the long term disease in that area of bone from the chronically infected tooth. So you may not end up being a good candidate for the implant in the long run anyway.
I hope you see this before you head out to the dentist today. I would see a different oral surgeon for evaluation before letting anyone do anything else to this area.
Please keep in touch here...
Bryanna
Quote:
Originally Posted by anneva
I have found a lot of useful information on here but I need some input on what to do next...like tomorrow morning.
History: 2 failed root canals on #3. Extracted by Oral Surgeon on 09/11/2014 placed bone graft. He said everything went well and to come post op 2 weeks. Prescribed lortab for pain as needed.
09/13 continuous pain that I thought was normal but then developed slightly larger than eraser head hard bump above #4. Extremely painful. Touching it makes me feel like i'm going to pass out. Horrible breath, swollen from eye down to neck, swollen lymph nodes. 2 dozen mouth ulcers, I have been dealing with salt water rinse and oragel. I feel that these are under control.
09/15 went back to OS because temp remained low at 96 and I felt I had the flu. Constant throbbing pain at extraction site and bump over #4. OS said sounds like dry socket but it couldn't be because I have a graft. He gave me anti-biotics and sent me home.
09/17 Pain is so bad I can barely function. Bump over #4 is slightly larger. Pain at #4, extraction site, palette where sutures are, and some pain with #1. OS said he could debrive the site and treat as dry socket, but that it was completely impossible that was dry socket and I would have wasted the graph and may not be able to have an implant in the future. He suggested that it was a two-tooth problem to begin with and my problem is the #4 tooth. He recommended I have a root canal done on #4 before I remove the graph.
I scheduled a root canal with an endodontist and called my regular dentist to keep her in the loop. She wanted to see me and take x-rays (since the OS didn't.) She felt the bump over my #4 and said it felt hard like a bone fragment, possibly mine or from the graft. She performed a pulp test on all upper teeth and #4 responded similar to all others and she said it is a viable tooth. She thinks my body is rejecting the graph and that's why I have so much pain and tenderness around the extraction site and the bone fragment is causing #4 to be extra sensitive. She recommended a removal of the graph, an excision of the bump, and to just let the extraction site heel and to worry about a graph or implant later. She spoke with the OS and he is certain that the graph isn't the problem and I should just go ahead and have a root canal. He said removing the graph will almost ruin any chance at a healthy implant and doesn't want to excise the bump because "that's unreasonable to think it's a piece of bone."
I have to make this decision tonight. This is my thinking and my dentist agrees but doesn't know if it's going to be correct.....
1. The bump over #4 is definitely a hard bony-line mass. It's jagged if you press on it.
2. The extraction site and all sutures are very painful 7 days post op
So, if I opt to have the graph removed and insist that he excise the bump, I may not be able to have the implant later (at this point I don't care) but I should be pain free in a few days because there won't be any foreign objects in my mouth. Do I ask him to pack it like a dry-socket with the medicated stuffing or just stitch it up?
If I don't have the graph removed and opt to have a root canal on #4 (a viable tooth) , this is what the OS wants, then I may continue to have the same problem and pain with the graph. I have an apt with OS for graph removal at 9:30 am and root canal apt at 2 pm. So, I have overnight to figure this out.
This pain is a 10 and that's saying something since I've had my spine fused. |