intermittent instense sinus pain since front tooth removed
 

About 6 months ago, after suffering an impact I had my front tooth removed. It was cracked horizontally and the dentist performed an extraction of the lower part of the tooth and then the root.

An implant was attempted, but I was found to have too big a hole after the root had been removed i.e there was no bone to implant into. I was given a temporary bridge and told to come back 3 months later when the bone should have grown back.

3 months later I returned, and oral surgery was performed by dentist to attempt the implant a second time. The gum was cut open , but this time I was found to have a 'cleft in the bone' that prevented him from implanting. The procedure was aborted half way through, the cavity of the cleft was filled with artificial bone and I was stitched back up. I was told to wait another 6 months for the artificial bone to fuse. I am now 5 out of the 6 months down the line. After 2 failed attempts at the implant I told my dentist I was going to have it done by an implantologist, which is still my intention.

Ever since the initial extraction I have been experiencing sinus pain between my left eye and teh bridge of my nose. It happens as often as 3 or 4 times a day to once every few days. Normally I feel it coming on, and over a period of 10 mins or so it intensifies and reaches its peak , where it stays almost unbearable from anything between 10 mins and an hour.. the then starts to fade away..

My dentist says that the pain is not connected with the extraction. I have been to see my doctor many times, and have been prescribed steroids, nasal sprays (avamys) , and most recently Gabapentin in case it could be trigeminal neuralgia.The latter just makes me sleepy and I have stopped taking it. What makes things more complicated is that I actually had a F.E.S.S. operation about 5 years ago to remove nasal polyps, and so doctor is tempted to think that it could be related to that procedure. recently my gut feeling is that it is connected with this extraction, and maybe a sinus was perforated.

Do you think this is possible, any ideas what I should do / say / next? I am still suffering..

Hi cheekybloke,

From your description it sounds like the tooth AND the buccal bone (this is the bony area under your gum that faces the inside of your lip) were both broken at the time of the accident. During the extraction, the dentist would have seen this right away and should not have attempted to place an implant at that time. Generally it is difficult to place a graft in this area when the buccal bone is broken, so after about 3 months of healing, a second surgery is done to place the graft. Then 6 months later a third surgery is done to place the implant.

I tend to think that your pain is related to your dental situation. I think more of the jaw bone was broken than perhaps you were told... the extraction was injurious to some degree because there was alot of bone manipulation to remove the root from the broken buccal plate. This all needed time to heal before anything further was attempted. It also needed to be monitored with xrays to follow the healing process prior to attempting an implant.

Jaw bone takes a full year to fill in completely from any extraction. So imagine that bone also being injured and broken....what was the rush to place this implant?

I would be concerned that you could have some residual bone fragments irritating that area, perhaps up as far as your sinus membrane. And/or a sinus perforation or an infection.

Your pain is real.... it is intense ....and if it wasn't present after the FESS surgery or anytime prior to the event with this tooth.... then I'm with you and guessing it is dental related.

Have you been to an ENT doctor?

Bryanna