NeuroTalk Support Groups - Orthodontics, implant and a constant, dull pressure

Hi again,

Instead of updating my previous thread (can't link: thread ID is 162436 "Constant crown awareness"), I'm making a new one as the situation developed in a semi-unrelated fashion.

Recap:

Quote:

I've had a molar extracted about two years ago. I've had two titanium implants inserted 3 months ago, one for a premolar that never grew and another for the [upper] molar that got extracted. At the beginning of this week, I've had two temporary crowns fitted on my implants until my orthodontic treatment gets completed.

Ever since, I've been acutely aware of the molar crown. At first, I thought it was only a matter of adapting to the new objects in my mouth but I realized that the crown overlaps the gum. In comparison, a regular tooth "erupts" from the bone and gums and is a perfect fit with the surrounding tissues. This molar crown instead creates a little "pocket" between itself and the gums, as if it were too large even though its proportions seems kind of in line with the rest of the teeth. Furthermore, during suction, my cheek gets sucked in that little space and has now formed a small bulge; it doesn't hurt but since it's innervated, I'm constantly aware of that small defect and it makes for a rather annoying (and constant!) feeling.

Fast forward a few weeks later, I still have the temporary upper molar crown but the crown awareness diminished on the vestibular side (cheek) as I sort of grew accustomed to the small fleshy protuberance. Unfortunately, as the stress caused by a new foreign object in my mouth diminished, I then started noticing a dull, constant pressure on the lingual side (tongue).

This pressure is somewhat hard to describe. While both teeth surrounding the crown and implant are uncomfortable due to the orthodontics work, the pressure doesn't seem centered on a particular tooth nor can I affirm that it's due to the implant/crown. Instead, it feels slightly off-center compared to the maxillary arc, seemingly radiates from the gums, goes upwards on a very short distance and "sits" at an angle between the teeth and the palate itself, in the lingual part of the mouth.

While the intensity of this odd pressure varies slightly, depending on my level of activity for instance, it never dissipates and isn't affected by painkillers. I've likened the sensation to the aching pressure one can get from a very congested nose while fighting off a cold, except in a different part of the body.

Meanwhile, I've consulted a few health professionals in a short time-frame who didn't find anything out of the ordinary, much to my dismay.

1) First my dentist/oral surgeon. I've had about 3-4 appointments where he banged on my implant, first to remove the crown, then to check for pain. I even had the crown removed for close to a week without feeling any relief. He forwarded me to an otorhinolaryngologist (ear-nose-throat doctor, ORL).

2) The ORL checked my ears, throat and nose and found nothing using primary diagnostic measures. He had me do a CT scan (dentascan).

3) The radiologist didn't find anything of consequence. Here's a translated excerpt of the CT report.
"The mandibula is healthy with no sign of bone loss or granuloma. Maxillary osteopenia [lower than normal bone density] around the implant with no sign of osteolysis. No bone resorption around the roots of teeth nor periapical granuloma. Posterior molars intrude slightly in the maxillary sinuses as well as for the maxillary implant. Slight polypoidal mucosa thickening with no sign of acute infection. No fracture. No notable swelling of soft tissues. Normal ventilation of the sphenoidal sinus, the ethmoid cells, the inner ear and the visible portion of the mastoid cells."

[For anyone who stumbled upon my thread looking for answers about molar extraction when the end of the roots are inside the sinus, I did have one upper molar extracted a few years ago with absolutely no side-effects.]

4) I've also had the maxillary orthodontic arc temporarily removed in a attempt to identify the cause of the pressure. No dice.

So I'm left in this awkward position where nothing seems abnormal, no one knows what's causing that dull pressure and I fear that without an identified cause for it, this situation will last indefinitely. The "plan" is to finish the orthodontic treatment and see if it goes away... then possibly have the implant itself removed as a last resort, with all the possible heavy consequences that might follow (sinus lift, repair of sinus fistula, bone graft and finally, new implant...).

Basically what I'm asking is for a possible cause of that dull pressure.

- Did the temporary crown get fitted too soon, somehow damaging or causing a shift of the implant?
- Is the temporary crown applying undue pressure on my gums or the surrounding structures?
- Is the pressure linked to the orthodontic treatment?
- Could the tip of the implant in my maxillary sinus be an issue?

I know that a thread on a forum is no substitute for a live medical appointment but since I've ran out of ideas as to who I could ask for advice, I'm open to any suggestion at this point.

PS: I've added a few slides from the CT scan to illustrate the situation.
PPS: My apologies for the "wall-of-text". =p