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Q. I have a pus pimple at the area of flap surgery. Please guide me.

Answered by
Dr. Naveen Thomas
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 11, 2017

Hello doctor,

I am a 35 year old male. I had a root canal treatment done on the lower left side second molar about four to five years back by an endodontist. Two years after the treatment, the ceramic crown came off and was replaced by a metallic crown. Recently, I had a pus pimple under that tooth from the last three to four months, which would appear and then fade away on its own. One periodontist at the same clinic, saw my case and advised a flap surgery and subsequently removed the infection during this process. PRF was also placed during this process. Within 15 days of this surgery, the pus pimple again reappeared. On consulting the periodontist again, he advised that the bone under the teeth is growing as the PRF was placed and the infection is draining out and causing this pus pimple. This would continue for three to four months until the bone grows completely. However I am not convinced with this theory and wish to seek a second opinion to save my tooth. I am attaching the periodontist prescription and a few X-ray images. I request you to please advise what could be the correct route of treatment and help me save my tooth as I do not want to go for an extraction or implant.

Dr. Naveen Thomas

Dentistry Endodontist Paediatric Dentistry Periodontist


Welcome to

  • The infection is due to the improperly done root canal of the mesial root of that tooth. Flap surgery was done needlessly.
  • The treatments possible are:
  1. Frequently, what the dentist would do after such a problem is to extract that tooth.
  2. Go to an Endodontist and request re-RCT of that tooth. He will open the root again and do a root canal treatment. Then, take an X-ray after three months.
  3. The other 50-50 chance is to remove the cap and then surgically remove the mesial root alone, leaving the distal root. Then wait for three months and take an X-ray to check if the area is healed and the bone is formed. Then place a new cap or bridge including the front molar also.

Hope you understood the treatment plan possible.

For more information consult a periodontist online -->

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