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Suggest Treatment For Cyst In Gums After Unsuccessful Root Canal Treatment
Question: I asked a question few months back about a cyst forming around the root of 2 of my teeth after bad canal treatment. (found out long time after the treatment)..
I went for a second consult (teeth nerve specialist), whom I explained my situation to,he re-treated my teeth roots again after draining the puss out, then and asked me to check again in 3 months.during the treatment, he was able to extract excess needles\root-canal-blocking thingy (I don't know what it is called), all of them except for one root which was too far in (about 3mm he said) , he also added that in 3 months if the puss is still there we will have to remove the tooth, the other one is fine and no need to worry...
Now 3 months have passed, I went to another dentist, he took another panoramic x-ray, and said that the cyst -not puss- have expanded and is already going through my sinuses bones, "it needs a surgery ASAP" he said, "you will not be able to transplant any teeth, there is no bones left to support it".... as he explained, he will remove both teeth, remove the cyst and block the hole to my sinus with a special material, he then added that if I don't do it ASAP the cyst will expand more and eat through my jaw bones which will lead to my teeth falling off! he added that I should've not re-treated my canals again and instead, should've removed my teeth and did the operation.
* Do I really need the surgery to clean up the cyst?
* How Critical this is?
* Is it true I can't do transplants where there was a cyst?
* What are the expected complications of such a procedure? (my dentist didn't give any)
* Is there a way to save the teeth?
Attached, the x-ray
I went for a second consult (teeth nerve specialist), whom I explained my situation to,he re-treated my teeth roots again after draining the puss out, then and asked me to check again in 3 months.during the treatment, he was able to extract excess needles\root-canal-blocking thingy (I don't know what it is called), all of them except for one root which was too far in (about 3mm he said) , he also added that in 3 months if the puss is still there we will have to remove the tooth, the other one is fine and no need to worry...
Now 3 months have passed, I went to another dentist, he took another panoramic x-ray, and said that the cyst -not puss- have expanded and is already going through my sinuses bones, "it needs a surgery ASAP" he said, "you will not be able to transplant any teeth, there is no bones left to support it".... as he explained, he will remove both teeth, remove the cyst and block the hole to my sinus with a special material, he then added that if I don't do it ASAP the cyst will expand more and eat through my jaw bones which will lead to my teeth falling off! he added that I should've not re-treated my canals again and instead, should've removed my teeth and did the operation.
* Do I really need the surgery to clean up the cyst?
* How Critical this is?
* Is it true I can't do transplants where there was a cyst?
* What are the expected complications of such a procedure? (my dentist didn't give any)
* Is there a way to save the teeth?
Attached, the x-ray
Brief Answer:
Detailed below.
Detailed Answer:
Hello XXXX,
Thanks for consulting Healthcare magic .
This is Dr. Priyanka Tiwari answering your query .
I have read your query and gone through the xray (opg) you have attached as far as I have observed there is radiolucency seen at apex of RCT treated tooth. Your OPG xray is not very clear . Based on detail provided and what I see it look like small abscess or cyst formation at apex of root of rct treated tooth . See XXXX what happened is periapical cyst arise from periapical infection of infected tooth .
I will answer all your questions there is nothing to be worried so much :
- Treatment for cyst is surgery . Once cyst is formed you have to remove through surgery .
- cyst in jaw expands and occupy space in jaw causing bone loss . Surgery for cyst removal is simple as extraction of tooth . Surgery is done under local anesthesia .
- for transplantation of tooth you can consult prosthodontist for clinical examination and treatment . If there is more amount of vertical bone loss then implant might not be possible but you can go for fixed partial denture (bridge).
- No expected complication . After removal of cyst follow post operative instruction and take proper course of antibiotic and visit dentist for follow up.
- Other option for save the teeth is Re-Root canal treatment . Drainage of cystic fluid if possible .
Hope I have answered your query .
If you have further query I will be happy to help.
Detailed below.
Detailed Answer:
Hello XXXX,
Thanks for consulting Healthcare magic .
This is Dr. Priyanka Tiwari answering your query .
I have read your query and gone through the xray (opg) you have attached as far as I have observed there is radiolucency seen at apex of RCT treated tooth. Your OPG xray is not very clear . Based on detail provided and what I see it look like small abscess or cyst formation at apex of root of rct treated tooth . See XXXX what happened is periapical cyst arise from periapical infection of infected tooth .
I will answer all your questions there is nothing to be worried so much :
- Treatment for cyst is surgery . Once cyst is formed you have to remove through surgery .
- cyst in jaw expands and occupy space in jaw causing bone loss . Surgery for cyst removal is simple as extraction of tooth . Surgery is done under local anesthesia .
- for transplantation of tooth you can consult prosthodontist for clinical examination and treatment . If there is more amount of vertical bone loss then implant might not be possible but you can go for fixed partial denture (bridge).
- No expected complication . After removal of cyst follow post operative instruction and take proper course of antibiotic and visit dentist for follow up.
- Other option for save the teeth is Re-Root canal treatment . Drainage of cystic fluid if possible .
Hope I have answered your query .
If you have further query I will be happy to help.
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you for your reply Dr. ;
*Can you please specify which tooth of the two should go under surgical treatment? or should I do both?
*Can a fixed partial denture hold on the right given that there will be 2 extracted teeth next to each other? I heard that the "bridge" is not a good solution, it can't take stress like normal teeth and it causes a lot of issues...
* Should I raise a complaint against the dentist who did the rct on the left tooth? -the procedure is expensive and is not covered by any insurance here-
* If I undergo the procedure, will the bone grow back as it should be? meaning can it take its normal shape again to support a transplant??
*Can you please specify which tooth of the two should go under surgical treatment? or should I do both?
*Can a fixed partial denture hold on the right given that there will be 2 extracted teeth next to each other? I heard that the "bridge" is not a good solution, it can't take stress like normal teeth and it causes a lot of issues...
* Should I raise a complaint against the dentist who did the rct on the left tooth? -the procedure is expensive and is not covered by any insurance here-
* If I undergo the procedure, will the bone grow back as it should be? meaning can it take its normal shape again to support a transplant??
Brief Answer:
A few points below .
Detailed Answer:
Hello XXXX,
Welcome again .
I have read your query and understand your concern . I will answer all your question nothing to be worried :
1- As your pic (opg x ray ) is not very clear . Based on what i see . Radiolucency (cyst) is seen at one tooth (molar tooth) . So if cyst is not envolving the adjacent premolar or second molar tooth then you should go for removal of infected tooth .
2-Fixed partial denture (bridge) is given after healing of extraction socket (approx after 20 days). See what happened is bridge is good solution in cases when implant is not possible . In FPD tooth preperation is done on abutment (adjacent) teeth and crown placement is done . Clinicaly bridge look like Natural teeth . Metal ceramic bridge has good strength, durability and indicated for replacing posterior maxillary and mandibular teeth . As far as issues related to fixed partial denture is concerned No as such issues are related but you have to maintain good hygiene after placement of bridge .
3- Dont raise a complaint againt your dentist . I am sure your doctor has tried best in your treatment . I know procedure is also expensive but XXXX what happened is in Root canal treatment we try to save the tooth when tooth is infected or decayed . As Cyst usualy caused infection , periapical inflamation leads to formation of scar resulting in periapical cyst . So if infection persists after root canal treatment then for this I will suggest you to go for Enucleation of cyst.
4- For procedure I will suggest you to consult good oral surgeon and discuss the treatment . I would suggest placement of bone graft was probably help the bone area to heal faster and support a transplant.
Hope I have answered your query .
If you have further query I will be happy to help.
A few points below .
Detailed Answer:
Hello XXXX,
Welcome again .
I have read your query and understand your concern . I will answer all your question nothing to be worried :
1- As your pic (opg x ray ) is not very clear . Based on what i see . Radiolucency (cyst) is seen at one tooth (molar tooth) . So if cyst is not envolving the adjacent premolar or second molar tooth then you should go for removal of infected tooth .
2-Fixed partial denture (bridge) is given after healing of extraction socket (approx after 20 days). See what happened is bridge is good solution in cases when implant is not possible . In FPD tooth preperation is done on abutment (adjacent) teeth and crown placement is done . Clinicaly bridge look like Natural teeth . Metal ceramic bridge has good strength, durability and indicated for replacing posterior maxillary and mandibular teeth . As far as issues related to fixed partial denture is concerned No as such issues are related but you have to maintain good hygiene after placement of bridge .
3- Dont raise a complaint againt your dentist . I am sure your doctor has tried best in your treatment . I know procedure is also expensive but XXXX what happened is in Root canal treatment we try to save the tooth when tooth is infected or decayed . As Cyst usualy caused infection , periapical inflamation leads to formation of scar resulting in periapical cyst . So if infection persists after root canal treatment then for this I will suggest you to go for Enucleation of cyst.
4- For procedure I will suggest you to consult good oral surgeon and discuss the treatment . I would suggest placement of bone graft was probably help the bone area to heal faster and support a transplant.
Hope I have answered your query .
If you have further query I will be happy to help.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Thank you for your reply dr.
I see you are talking about the molar on the right side, which is very clear in the xray, however; there is a bigger similar issue on the left.... I've attached 2 files one is named (old) that is my teeth before RCT retreatment 3months ago.
(new) is after the retreatment, the problem is clear in the old xray as the dentist already drew arrows pointing to it in both teeth, kindly check the old and the new xrays and maybe the difference will become clearer. (its better not to inlarge the image so that the contrast is better)
one more thing, can you please explain what is bone graft? who can place it? and what is the benefit of it?
I see you are talking about the molar on the right side, which is very clear in the xray, however; there is a bigger similar issue on the left.... I've attached 2 files one is named (old) that is my teeth before RCT retreatment 3months ago.
(new) is after the retreatment, the problem is clear in the old xray as the dentist already drew arrows pointing to it in both teeth, kindly check the old and the new xrays and maybe the difference will become clearer. (its better not to inlarge the image so that the contrast is better)
one more thing, can you please explain what is bone graft? who can place it? and what is the benefit of it?
Brief Answer:
Detailed below .
Detailed Answer:
Hello ,
Welcome again .
I have read your quey and gone through the OPG xray both (old and new ) you have attached . Thanks for attaching both the xrays it is more helpful for me to observe the changes . As far as I have observed cyst is involving only Root canal treated tooth . There is no need to go for extraction of tooth if adjacent tooth is not infected or XXXXXXX .
As you are asking about bone graft see bone grafting is a surgical procedure that replaces the missing bone with material called bone graft. Benefit - Loss of bone that occur in gum problems (periodontal disease ) , Extraction , trauma , cyst or tumor bone grafting replaces missing bone .. Bone graft can be taken from human own body (hip bone or chin) . Other graft can be used are synthetic material also. For bone grafting you should consult good oral maxillofacial surgeon or Periodontist . The procedure is usually done in dental office under local anaesthesia .
Hope I have answered your query .
If you have further query I will be happy to help.
Detailed below .
Detailed Answer:
Hello ,
Welcome again .
I have read your quey and gone through the OPG xray both (old and new ) you have attached . Thanks for attaching both the xrays it is more helpful for me to observe the changes . As far as I have observed cyst is involving only Root canal treated tooth . There is no need to go for extraction of tooth if adjacent tooth is not infected or XXXXXXX .
As you are asking about bone graft see bone grafting is a surgical procedure that replaces the missing bone with material called bone graft. Benefit - Loss of bone that occur in gum problems (periodontal disease ) , Extraction , trauma , cyst or tumor bone grafting replaces missing bone .. Bone graft can be taken from human own body (hip bone or chin) . Other graft can be used are synthetic material also. For bone grafting you should consult good oral maxillofacial surgeon or Periodontist . The procedure is usually done in dental office under local anaesthesia .
Hope I have answered your query .
If you have further query I will be happy to help.
Note: Find out which dental treatment will work best for your teeth. Ask here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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