Junior Member
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Join Date: Mar 2016
Posts: 9
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Junior Member
Join Date: Mar 2016
Posts: 9
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To Bryanna: persistent pain problem around #19
Hello Bryanna,
Perhaps you would be so kind to comment on this (I have posted before but have had no success in getting a reply).
I had a periodontist extract #19 in June 2015. #19 was badly compromised (apicoectomy in 1991, May 2015 fistulous tract.) Equimatrix bone graft with optimatrix barrier membrane placed over BG and undel F/L mucogingival flaps.
Eventful recovery with sutures falling out 3-4 days post-op, and loss of some BG material. Ultimately, the site healed over a period of 5 weeks but with numerous complaints about deep seated, gripping pain (not acute) in the LL area, as if a stake had been placed in the area.
Checked for bone regeneration with an OMFS (periodontist retired) in Novermber. The extraction site was well healed with a broad alveolar ridge. A Noble implant with a healing abutment was placed in #19, slighlty more mesial than septal area. Site healed nicely but after 3 weeks, the deep seated, gripping ache that builds up during the day and subsides at night, started again. OMFS checked the site 2 and 4 weeks post-op. There is no pathology, edema, exudate, etc. Referred to a TMJ specialist who thinks it's peripheral neuralgia and suggests anti-convulsants.
I am at a loss, speculating on the following:
#18 (RTC in 2008) is failing..but no tenderness, or pain on biting...fractured root, 3rd root not seen on saggital x-ray view...?
#20 vital tooth, but with a crown, with some biologic width violation..and a ledge on DL side...?
IAN or lingual nerve injury duing the blocks? (left side of tounge is affected, a bit sensitive but not numb, etc...hard to tell if this is referred pain from around 18-19 area..?
I have excluded other causes (ENT related, acoustic neromas, etc.).
Any hints, ideas on how to pin this down would be much appeciated. Antinflammatories are a hit and miss on this. Would a cone beam CT reveal any issues, residual infection, etc?
Best regards and thanks in advance --jr
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