Hi JoJo,
First I have to say thank you for sharing your story here with us. For several years I have provided information on this forum about the chronic and progressive infection that resides and eventually proliferates from root canaled teeth. Anyone reading your thread and viewing your ct scan images, irrelevant of whether they have any knowledge of dentistry or not, will be able to appreciate the magnitude of your dental infection. It also describes how endodontists and some other dentists refer to the radio graphs of infected root canaled teeth as "normal".... unfortunately this reference does not mean healthy, just simply normal as in typical.
My first thought is.... what happen to cause the osteomyelitis in your upper maxilla? Did you have root canaled teeth in that area? Were you or are you on Bisphosphonate drugs for bone density?
I am not surprised, but still livid that someone performed such extensive surgery on your maxilla without removing root canaled and infected teeth prior to that surgery. If the endodontist did actually tell you that teeth with crowns on them are "normally" painful he was very mistaken. Crowned teeth should feel like your natural teeth, if they don't, then there is a problem. Tooth #30 should not have been allowed to progress to such a horrific state of infection. In addition to that, there was no excuse for the dentist to not debride the bone thoroughly when he finally extracted tooth #30. Just curious, are you comfortable being treated by these dentists or do you feel like they have perhaps not treated you properly?
The only reason you had relief after tooth #30 was re root canaled and the oral abscess was lanced and drained is simply because in doing those things, the pressure from the infection was released. Antibiotics simply subsided the inflammation temporary but by no means was the infection cured because the source of the infection which was the tooth was still present. So it didn't take long for the bacteria to build up again and cause further pain, swelling and damage. The broken area of the tooth was either due to decay that had eaten away that portion of your tooth... which would have been seen on an xray taken prior to the re treatment.... or the instrumentation during the re treatment perforated the tooth and literally broke off a piece. What this could mean is that every chemical that was used during the re treatment went directly into the jaw bone through that opening of the tooth.
I have a couple of questions.... the metal fragments in you neck are visible in all of the images but the final one. Were those fragments from the surgery in your maxilla and were they removed at some point? Did the oral surgeon who removed the tooth give you an explanation as to why he did not debride that area of bone when he removed the tooth?
To be completely truthful with you, I would be surprised if your jaw bone was not still infected. My professional suggestion is to seek an evaluation from an different oral surgeon, one who is not at all associated with any of the dentists you have been treated by. Gather all of your radio graphs and Ct scan images prior to that appointment and ask if the new surgeon wants to see them ahead of time. If he doesn't then bring them all with you with a complete history of this whole ordeal including the maxilla.
Just so you are aware..... Antibiotics cannot cure a bone infection unless the diseased tissue and bone is physically removed first. In some cases, the extent of the infection is so great that even after debridement, oral antibiotics are not adequate and the patient needs to have antibiotics intravenously. You need a competent oral surgeon to evaluate your case and offer you some surgical options.
I feel you have a very serious situation going on and should not wait to consult with someone about it. I'm sorry you have endured all of this.... please use your knowledge, of which you have a lot of, to seek the help that you need.
Check back with us when you can.
Bryanna
Quote:
Originally Posted by jojo23
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.
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