Hi Bryanna,
I started a new thread cause the other one was getting too confusing. I have the results of my Maxillofacial CT/with contrast.
It looks as though everything is normal (which I can't believe) but one question I have for you. It says:

"status post removal of left maxillary tooth crowns with remnants of the molar roots within the maxillary alveolus. No adjacent cortical irregularity or erosion"

Is that normal? I think it means that tooth roots are still in my sinus? Could that be causing my problems?

There is something definitely not right and I am starting to look like a crazy person because every ct comes out normal! The only other thing I can think of is it is the Pseudomonas and maybe it doesn't show up on the ct?

Thank you

Angels,

The maxillary alveolus is the bony socket that holds the roots of the tooth. It is not the sinus. The description of the report is not clear the way it is written here. Could you re-post it with the exact wording and punctuation?

Thanks,
Bryanna

That is exactly how it is written in the conclusion. In the findings, it says "no bony defect of the left maxillary alveolus. Status post removal of left maxillary molar crowns with remnant of the roots within the maxillary alveolus."

Is it normal to have roots left like that? The oral surgeon told me the roots were infected and in my sinus. He is at a dental conference all next week. Ugh!
Thanks

Angels,

This statement the way you say it is written appears to be an incomplete statement. However, it could be just the way the radiologist wrote the report in response to what was written on the prescription for the scan... "Status post removal of left maxillary molar crowns with remnant of the roots within the maxillary alveolus."

One) If the script read something like..... Scan area of the upper left quadrant post removal of teeth and root remnants. It could mean the "current" status post removal of such and such was found to be normal.

Two) If the script read something like .... Scan area of upper left quadrant post removal of teeth for retained root remnants, etc. It could mean the current status shows root remnants were found in the maxillary alveolus.

At least that is my interpretation of it. Do you see what I mean?
Bryanna

Yes, I do. I think it was a finding? Is that normal to have roots left after an extraction?

Angels,

When a tooth is extracted, it is imperative to remove the tooth in its entirety.... this includes every bit of tooth structure including the roots. It is also imperative to remove the periodontal ligament that surrounds the root structure as this ligament is a chronic source of infection if it is left in the bone. And it is also imperative to remove all other diseased tissue and diseased bone as they too will be a chronic source of infection if they are left behind.

Ninety nine+ percent of the time, there is no reason not to perform a complete and thorough tooth extraction.

Bryanna

Aha, maybe that is my problem! This sinus problem is not going away. If the roots were infected and they are still there couldn't that be it? There is no reason for this to hang on. Also, if there are roots left in there, how do you get them out? Is this an involved procedure? Is it performed by an oral surgeon?
Thank you for your help, I am very unsettled right now and I really appreciate your posts! Also, this makes sense with the roots because when I move my head certain ways I get a nerve twinge in the area where the teeth were removed. Also, when I do my sinus wash it happens also, in fact after I do the sinus wash that area will hurt and bother me for a while. I still feel like I did before the teeth were taken out.like I have an infection.

Angels,

If the roots of the extracted teeth are still in the bone and/or they moved or were pushed up into the sinus during the extraction, then that could explain a chronic infection that antibiotics are not able to cure.

Retained roots from extracted teeth need to be surgically removed. The type of the surgery depends on their location but they are generally retrieved from an entry of the oral cavity. Most often an oral surgeon will perform this surgery. However, if there is extensive damage, infection or other sinus complications have arose, then the os and an ENT will frequently collaborate on the surgery.

Your oral surgeon needs to inform you if the roots are still retained and if so, where are they exactly.

Root canaled teeth have so many things wrong with them and so many possible complications can arise when these teeth are not extracted before they become badly infected. Sometimes the rc tooth is so ridden with bacteria that the roots separate from the rest of the tooth due to deterioration or decay. When that occurs, it may nor may not be clearly evident on the dental xray. In those cases, the dentist only becomes aware of the problem when he goes in to extract the tooth and there's no root or roots attached to the tooth. Sometimes in attempting to retrieve the infected roots, they end up getting pushed up further into the bone or the sinus. It's hard to retrieve roots from the jaw bone that are mushy and decayed as they just keep breaking apart.

I don't know what is going on in your particular case but it is imperative that the oral surgeon explain in detail what is going on and offer you some options as to what to do about it.

I'm sorry you are going through this. I hope you can see the os on monday and get some answers.

Bryanna

The bad news is the oral surgeon is out of town until Feb 2nd. I have already gone back twice and he said nothing is wrong. He did an X-ray but I can't remember if he did the CT scan around my head. I know he did it after he removed both teeth though. How come he couldn't see the roots? I am trying to get a hold of the Endodontist that has so desperately tried to help me through this whole thing. He seems to be the only one who cares. He also referred me to the oral surgeon. I am wondering if I should go to a different oral surgeon? What do you think? I am suffering terribly with this sinus thing and to think of going another week with it is killing me. Also, I was just reading that leaving root remnants can cause heart problems. Also, what happens if the reason he left the roots are because it is too close to sinus or a nerve? Will someone be able to successfully get them out without damaging my sinus or nerve? This whole thing makes me nervous!

Angels,

Ironically, the endodontist is a strong promoter of root canal therapy which is the very thing that has contributed to the severity of your infection. Is this the same endodontist that did both root canals on 14 and 15? Did he also do the root canals on the other two upper teeth that resulted in a sinus infection? How long ago was the problem with the other side and what transpired during that situation? Was that sinus infection ever completely resolved?

By any chance has this endodontist and the oral surgeon that he referred you to communicated with each other about your case?

I think it would be wise to insist and expect the oral surgeon, the endodontist and the ENT doctor to confer on your case. If they are reluctant to do that, then something is weird because these discussions are done routinely especially in cases such as yours. It would be difficult to try and find another oral surgeon, etc to take on your case at this stage because it's complicated and no one really wants to end up being wrongly blamed for what someone else did or didn't do. So you have to try to get these guys to collaborate with each other.

I know you are suffering with this infection and I know the stress of all of this is becoming unbearable. However, before you jump out the window, you have to be truthfully informed of the status of the situation. Are there retained roots of #14 and/or #15, is so why and where are they?.... Is there still an apical lesion in the sinus from prior to the extraction of #14, if so why wasn't it removed?.... Is the bone graft causing further problems, if so should it be removed immediately and how involved will that be? These are the pertinent things you need to be informed about so that you know what is worrisome and what isn't. Those 3 doctors need to collaborate on your case, figure out what is going on and then truthfully inform you of whatever that is. Otherwise, you will keep stressing about possibilities and making assumptions that may or may not have any relevance.

I really cannot stress enough that before you try to get other dentists involved, those 3 practitioners need to collaborate. In most cases, it is the oral surgeon who ends up being the one who presents the outcome of that collaboration and treatment options to you.

Bryanna