Hi Bryanna,

I had a root canal retreatment at the end of last year on tooth #3. About 2-3 weeks after that, a fistula (bump) developed on the gum above the treated tooth. The endodontist thought the MB root is cracked and suggests root amputation. Please see the x-ray attached.

I decided to seek 2nd opinion. About 2 weeks ago, my periodontist did an exploratory surgery but he did not find crack on the root. he told me there was significant bone loss so he did the bone regeneration with graft material.

however my periodontist was not clear where the source of the infection was. He said he did not know the whole history of the tooth and there might be crack inside the root.. he does not think apicoectomy is needed since he thinks the RC retreatment has reached to the end of the root. And since he has done the exploratory surgery I believe he should have cleaned up the gum (I need to check with him). My endodontist did tell me that he saw infection inside the root but he did not see crack inside the root. So I do not know what to do now..

Also, the situation has not got any better after the surgery. I feel tooth #3 "sticks" out, meaning it feels longer than other teeth so when i clench my teeth, the teeth at the right side (or tooth #3) touch the bottom teeth first. The symptom is slight in the morning and gets worse during the day. so in the PM, I will feel some slight pain at the root end when I clench the outer part of tooth 3 (the area which I think corresponds to the MB root?) I actually had this problem before the surgery, but the symptom went away when i took antibiotics. However, after the surgery the symptom resurfaced even when i was still taking antibiotics post-procedure. The fistula has gone, but my gum in that area is still swollen since the surgery. According to what I read online and it seems that it is the membrane surrounding the roots is infected.. what do you think? Can this be viewed as the cause of the whole problem (Fistulas..)? how should dentist treat this?

I tend to lose hope on this and I guess i should just have the periodontist extract the tooth.. BTW if tooth #3 is extracted, do I need to worry about sinus perforation?

Thank you so much!

Attached Images

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