Dental trauma resulted in root canals . Diagnosed with IDFP but think there is still an issue.

[Sam Williamson]

I have had root canals 15 weeks ago and still have pain. It has reduced with amytriptiline but there is localised pain that responds to codeine. his resulted from a fall and i think the pocket behind the tooth has been damaged by the tooth moving in the fall. I also have a really sore patch palatally behind one of the root canalled teeth. What can be done for the damaged pocket? As inflammation reduces the teeth do not feel totally secure in the gum.

 

[Gordon]

I'd suggest you go back to the dentist for some more investigations.

 

[Sam Williamson]

I did indeed. He thinks leave it a few more months . Given the trauma to the tooth in the fall but he does not feel there is any sign of infection. Will rescan in a few months but it could still improve the pdl and bone may well take significant time to heal. Frustrating having an unusable tooth and being unable to bite with front teeth. This is a long job! Is it possible to take that manu months?

 

[Gordon]

It's possible.
Given your dentist has actually examined you and has presumably had some x-rays, they're much better informed than I am, so I'd defer to their opinion.

 

[Sam Williamson]

There is nothing visible on xray or scan. Endodontist says no evidence tgat is conclusive to extract. Dentist suspects root fracture. Oral surgeon says give it another 4 months. In all frankness can a tooth settle after this length of time. I have days when the tooth pain is minimal unless moved much or days like today when the gum swells and there is more pain. All want to delay any scans for longer. It is now 3 .8 months since the first root canal and week 12 of amytriptiline.

 

[Gordon]

If the dentist is correct and the root is fractured, then the prognosis is pretty hopeless. It's not always easy to see the fracture line on an x-ray.
I'm not seeing any mention of a diagnosis from the OS or Endodontist, what do they think is causing the pain?
You can't say if you think the tooth will settle down if you don't know why it's causing pain in the first place.

 

[Sam Williamson]

@Gordon Endo cannot say what is causing the pain just wants to work through his steps. He says redo root canals although on xray they look good and after that he says his next step would be apicetomy. And he would not recommend extraction until tried everything. Oral surgeon diagnosed Idiopathic facial pain. I was in a huge amount of pain in the left side of my face and sinus. That has improved . Either amytriptiline or healing. He does not think the tiny facial fracture is the cause of pain as says it is likely healed now as it was over 10 weeks since the fall. He has looked at the dentist rct xray and similarly says they look well done. The dentist is recommending invisalign if we have to extract and do implant. No one is really clear what is causing the pain on palpation of UL1. There is a pocket that is slighty inflamed behind UL1 but both dentist and oral surgeon say it is within normal limits.