My endless dental grief

JasonBat

Dear all,

I had my UR6 tooth root-treated by an Endondontist about 9 years ago (and paid around £750 for this). The pain never settled however the Endodontist would not revisit the tooth as there was no obvious sign of infection.

A few months later a Maxillofacial Surgeon explored the tooth surgically and noted an infection. He then performed apical surgery on the tooth. The pain never settled.

The tooth was fitted with an onlay and not a crown which my dentist should have advised on but did not.

I underwent a cone beam CT scan last year and this revealed a fractured root canal filling.

I recently reverted back to the Endondontist who initially treated the tooth but he now asserts that the tooth may be cracked due to the fact that it was not fitted with a crown.

My questions:

1. Is there another examination that can be carried out to determine if the tooth has a crack?
2. Am I being fobbed off by the Endodontist (again)?

Many thanks.

justme111

1. It is not root filling that has a crack. It is the root. So it is not fault of the endodontist.
2. Onlays are often referred to as "crowns" for simplification. Both are laboratory made indirect restorations. None is better than other. Onlays may be considered more appropriate in case of classic post rct tooth defect.
I obviously do not know for sure but from what you written it does not look like you have been fobbed off in the first place , let alone "again".
Re another investigation for confirmation of fracture - I do not think there is anything beyond CBCT. In any case what is the purpose of confirming it? If the tooth gives you pain and none of the dentists you know can do anything about it then how confirmation of fracture will help you ?

JasonBat

justme111 wrote: »

1. It is not root filling that has a crack. It is the root. So it is not fault of the endodontist.
2. Onlays are often referred to as "crowns" for simplification. Both are laboratory made indirect restorations. None is better than other. Onlays may be considered more appropriate in case of classic post rct tooth defect.
I obviously do not know for sure but from what you written it does not look like you have been fobbed off in the first place , let alone "again".
Re another investigation for confirmation of fracture - I do not think there is anything beyond CBCT. In any case what is the purpose of confirming it? If the tooth gives you pain and none of the dentists you know can do anything about it then how confirmation of fracture will help you ?

Thanks. How can you be so confident that the tooth has a crack? The root filling has a fracture and is defective.

I am not completely sure it is my UR5 or UR6 that is the cause of the pain. Both have been root-treated and subject to apical surgery.

brook2jack

Would this be the same area that you have seen specialists from the Eastman about , neurologists, pain experts , two oral surgeons etc and have extensive investigations over from multiple specialists? The same place where "foreign bodies" were removed and you had MRI investigations?

As said in your thread a couple of years ago when you have complex problems the Internet is not the place to have them diagnosed.

Root fillings do not fracture , they are a rubbery filler and have no structural function, roots do fracture and this was extensively discussed last time.

justme111

Because terminology "crack" and "fracture" is applied to roots and teeth, not root canal treatments. Root fillings don't fracture.
Because there are some classical scenarios that people who know the subject recognise and yours seem to fit it.
How do you know that " root filling has a fracture and is defective "? When you look at cbct report what does it say ?
Re whether it is ur5 or ur6 - I definitely can not tell you that

JasonBat

brook2jack wrote: »

Would this be the same area that you have seen specialists from the Eastman about , neurologists, pain experts , two oral surgeons etc and have extensive investigations over from multiple specialists? The same place where "foreign bodies" were removed and you had MRI investigations?

As said in your thread a couple of years ago when you have complex problems the Internet is not the place to have them diagnosed.

Root fillings do not fracture , they are a rubbery filler and have no structural function, roots do fracture and this was extensively discussed last time.

The same area indeed. Yes, none of them have come up with any concrete answers and I sense that is because none of them are willing to stick their necks out and say "extract the tooth".

It seems the root filling has definitely fracture in my case. I will post the cone beam CT report shortly.

brook2jack

Root canal fillings do not fracture , they are a rubbery material whose only function is to fill the space inside the root canal. There are several methods of placing but mostly they are either several cones of filling cemented in or one large cone cemented in or a paste squirted in.
They do not crack except if the root around them is fractured .

You have seen top specialists in many fields over a period of years.I really do not think you are going to find the answers you seek on an Internet forum.

JasonBat

justme111 wrote: »

Because terminology "crack" and "fracture" is applied to roots and teeth, not root canal treatments. Root fillings don't fracture.
Because there are some classical scenarios that people who know the subject recognise and yours seem to fit it.
How do you know that " root filling has a fracture and is defective "? When you look at cbct report what does it say ?
Re whether it is ur5 or ur6 - I definitely can not tell you that

It definitely seems the root filling has cracked in my case which is worrying based on what you have set out.

Do I understand correctly that my case seems to fit the classic case of a cracked tooth?

Scan results (see point 2):

https://onedrive.live.com/redir?resid=114084C793252AC3!107&authkey=!AKeWH5HCCZwWbL0&ithint=file%2cpdf

JasonBat

brook2jack wrote: »

Root canal fillings do not fracture , they are a rubbery material whose only function is to fill the space inside the root canal. There are several methods of placing but mostly they are either several cones of filling cemented in or one large cone cemented in or a paste squirted in.
They do not crack except if the root around them is fractured .

You have seen top specialists in many fields over a period of years.I really do not think you are going to find the answers you seek on an Internet forum.

Hmmm... How does one make sense of the scan results then?

brook2jack

This is a report from a year ago . The bit about the root should say root filled root not root filling otherwise it's nonsensical.

I'm sure that you must have had multiple discussions over this report from a year ago with people who can actually see you and all the many investigations you've had. I do not intend to comment further as I can see little I can add that the multiple people involved in your case over the years have not already said or done.

JasonBat

brook2jack wrote: »

This is a report from a year ago . The bit about the root should say root filled root not root filling otherwise it's nonsensical.

I'm sure that you must have had multiple discussions over this report from a year ago with people who can actually see you and all the many investigations you've had. I do not intend to comment further as I can see little I can add that the multiple people involved in your case over the years have not already said or done.

The Maxillofacial Surgeon I have seen did not comment on this at all - very worrying.

Are you saying the actual tooth root has definitely cracked?