Failed root canal extraction and the periodontal ligament

[Acheygirl]

Thanks for reading.

I had a visit with an implant specialist today and one question I forgot to ask him was, do you remove the periodontal ligament? I will follow up with him on this but I was just curious is it customary for a surgeon who is performing an extraction and implant on a tooth that had a failed root canal to remove the periodontal ligament? I had read it should come out but wondered if this is standard procedure in this situation? I am told I have no infection "yet" however there is tooth pain and pressure on biting. The endo wanted to do an apioectomy but my heart tells me to pull the troubled tooth.

I see some holistic doctors urge removal of the ligament. Is this a standard train of thought in dentistry across the board? Is it difficult to remove the ligament or does it just come out easy? Thank you again for reading.

 

[Gordon]

I think you need to back away from the "holistic doctors" they're spouting a load of crap

During the extraction the periodontal ligaments will be torn apart, it's kind of what you have to do to remove a tooth Anything left attached to the boney socket will be swiftly dealt with by the bone remodelling cells when they start clearing up the socket.

 

[Mike]

Couldn’t have said it any more eloquently than Gordon!

 

[Acheygirl]

Thank you so much Gordon. My doc is not a holistic doc but I read about how the holistic community feels the need to remove the ligament. I did not understand why? My doc did not mention the ligament nor did I ask. They think inflammation is brewing up top of the apex of the root canal tooth The Endo wants to do that procedure where they cut of the root tip. I just can't see myself going that route I feel extraction is my best solution.


I really appreciate all your time here and answering questions it means a lot to me!

 

[Mike]

I’m guessing they feel the need to do it so they can scrape about for a few seconds then charge you much $$ for a ligamentectomy or similar. I can’t think of any other reason for it!

 

[Acheygirl]

Hey Gordon if you don't mind me asking, what are your thoughts on an apioectomy? My endo suggested this procedure and said it had a 97% success rate. I have had this tooth root canaled and re treated twice and it's still giving me trouble. My gut tells me to have it pulled. I would love your thoughts. For the record, this is tooth #12.

 

[Gordon]

Apicectomy has a decent success rate, especially nearer the front, so it is likely to work. Depends if you want to throw more money at this tooth or not? It's a fairly easy one to replace with something like a Maryland bridge too, assuming the next door teeth are in good shape?

 

[Acheygirl]

Thank you Gordon. I am just not sure what to do. I was thinking if I do extract I probably might go towards an implant however I am not to understanding of how close the sinus is to these teeth. The tooth next to this one #13 had a root canal and still has the temp crown on. I bet you often get this question and I hate to ask you but - what would you do if you were me based on the two failed root canal retreats?

Also in the back of my mind I am wondering if at this stage there is any possibility the tooth could still miraculously calm down for good?

Thank you again Gordon.

 

[Gordon]

Be nice to see some x-rays...
The closeness of the sinus isn't really an issue for an implant, although I'd check with Lincoln or Comfort Dentist who actually place implants.
I guess the question is are you sure it's this tooth that's causing the issues and not the next door one?

 

[Acheygirl]

I will ask for a copy of my xrays and post a pic for you. So as for which tooth, 12 feels pain when tapping and biting but they don't think it's cracked because upon release of bite there is no pain. I also feel odd pain when I push up top of 12. 13 may be slightly sensitive but nothing like 12. Also, 12 has some strange situation where one of the roots he says grows outward towards the cheek side he said it's got no bony coverage hence I can feel the root area as a bony bump under my upper gum line.