Long story.....sorry.

In 2004 or 2005 I noticed tooth # 30 was painful when I pressed on it with my finger. This tooth had been root canalled in the early 1990’s and had a crown on it. I saw an endodontist who said the xrays were normal and sometimes teeth with crowns are painful on percussion. At that time I was also dealing with chronic osteomyelitis of my maxilla.

In March 2006 I received a Fibula Free-flap surgery to rebuild my right maxilla due to chronic osteomyelitis. I had multiple infections after the initial surgery. I was on multiple antibiotics for several years after surgery. I have pins/clips and screw remnants remaining in my body from my maxilla to my neck.

2007 through 2013 I had gradual worsening pain/stiffness in my lower jaw neck region, also heaviness in my lower jaw. It was thought to be due to remaining hardware.

January 2014 – Had severe pain and tenderness when I touched my face on the right lower side. (When I washed my face or slightly pressed on the area from the outside)

I looked at the cd of the ct scan from July 2013 and saw an abscessed tooth in my right mandible, tooth # 30. I did not have a tooth opposing tooth #30 in my maxilla since 2001 and have not chewed on my right side since 2002; therefore, I did not realize how painful the tooth was on percussion.

I saw my dentist the same day. He put me on antibiotics and told me to see an endodontist. I saw the endodontist. The pain in my lower face was worse and I had visible swelling. I had a golf ball size lump under my gums in my mandible. The endodontist opened the tooth and cleaned out the old root canal and put in medication, Calcium Hydroxide. He then put a temporary filling on the tooth. He made a cut into my lower gums below the tooth to drain the abscess. He got out a lot of pus and left it open to continue draining. He said the abscess was very large and the tooth might have to be extracted. He said it was very close to the nerve.

After a few days the pain from having the root canal cleaned out and the abscess lanced subsided and I felt GREAT!!! The best I have felt in years. No pain or heaviness in my lower jaw and neck. I could press on tooth #30 and I felt nothing.

On February 14, 2014 - I went back to the endodontist and he finished the root canal. He cleaned out the Calcium Hydroxide and filled the canals with Gutta Percha. I still felt great for a few days, but then had a gradual increase of pain and pressure. By February 24 the whole side of my face and under my jaw was swollen and VERY painful. All the teeth in my right mandible hurt when pressed on and the jaw would quiver at times.

I a ct scan of my jaw. The ct scan showed that the abscess/cyst had enlarged. There was a piece of root/bone that had broken off the tooth. There was now a break in the cortical bone. There was also a learge amount of sclerosis.

In April I had the tooth extracted by an Oral Surgeon. He put me on Clindamycin before the extraction. The oral surgeon pulled the tooth, irrigated the socket with saline and had me bite on gauze. There was no debriding of the socket done.

The pain decreased a bit after the extraction but I did not get relief of the heaviness in the lower jaw. It still felt like something was in there. Over the pass year the pain has increased. The gums around teeth # 28 and 29 are very sore to touch and look like they have lines of fluid in them.

Could I have a residual infection due to the long-standing infection and me being on multiple antibiotics? Also, the socket was not debrided.

I uploaded ct scan pics from 2007, 2013, 2014, and 2015. All the same view.

Attached Thumbnails