Patient's Query
Hi doctor,
I had an accident, and tooth 21 got broken. The root canal was done with gutta-percha filling in this year. I had persistent pain for two months after gutta-percha filling because it was overfilled above the apex. Gutta-percha was removed, but an X-ray after one month showed that a small piece of gutta-percha was still above the apex in the tissue. The dentist tried to dissolve it with chloroform, and it damaged all surrounding tissues and nerves, and the left part of my nose till the upper left was numb, and it had been three weeks already since it happened. The tooth is still in pain. All surrounding bone is inflamed, and I now have only temporary calcium filling. Two dentists now have different opinions on how to handle this. One is suggesting closing the tooth permanently with ATM even though it is still very painful and waiting for the inflammation to reduce over time. He says I cannot do apicoectomy because of nerve and tissue damage and that local anesthetics or operation can make it worse. The maxillofacial surgeon says I need to keep my tooth open for one to two weeks and do an apicoectomy with permanent filling, and local anesthetics should not influence the damaged nerves in my upper lip. He says the inflamed tissue with possible gutta percha debris has to be removed. Please help.
Hi,
Welcome to icliniq.com.
I have gone through your question, and I can understand your concern.
With this much gutta-percha, we can allow it to be left there if it is not causing you pain even after two to three weeks and also if it does not initiate any apical granuloma or cyst formation. The second opinion seems better. I suggest you get an apicoectomy done and get it removed; that will reduce your stress burden too. My suggestion is to wait for three to four weeks to keep the tooth open. If you do not feel any pain get it filled with gutta-percha; otherwise, go for the second oral surgeon's opinion.
Hope this helps.
Regards.
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Answered byDr. Muzaffer Hussain Parray
Medically reviewed byiCliniq medical review team
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