Dr. Muzaffer Hussain Parray
Dentistry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
Today I had three dental implants fixed, and I feel one is close to the natural teeth. If I develop sensitivity in another one to three weeks, the doctor said a root canal has to be done to that natural tooth. I am attaching my X-ray here. Kindly let me know whether I have to undergo root canal treatment.
Thanks.
Hi,
Welcome to icliniq.com.
I had gone through your reports (attachments removed to protect the patient's identity). It is very close to the natural tooth, and it may need root canal treatment. As per the OPG (orthopantomogram), the tooth near to implant shows PDL (periodontal ligament) widening, that means the periodontal ligament is compromised in the adjacent tooth. Also, the natural tooth already shows apical periodontitis, that is, inflammation at the tip of the root of the natural tooth. If the sensitivity or pain remains there for more than a week, I suggest RCT (root canal treatment) of this tooth.
Regards.
Patient's Query
Hi doctor,
Thanks for the reply.
If there is no sensitivity or pain after one week, does it mean that RCT is not required? As the implant is too close to the natural tooth, will there be enough space for the bone to form around the implant? Will it be a failure after going through all this pain and suffering? Kindly reply.
Thanks.
Hi,
Welcome back to icliniq.com.
If there is no pain, sensitivity, or mobility of the tooth, there is no need for root canal treatment. As you know, implants are bio-compatible, and there will be bone formation around them even if it is very close to the root of the natural tooth. Root canal treatment is the only option for pain and apical pathology management. If there is no issue, it is unlikely to happen in the future.
Regards.
Patient's Query
Hi doctor,
Thank you for the reply.
How long do I have to monitor my symptoms?
Hi,
Welcome back to icliniq.com.
I suggest you take care for at least two weeks and monitor for any symptoms like the mobility of the adjacent tooth. The bone formation gets completed within four to six months around the implant, so for at least two weeks to four months you should be careful.
Patient's Query
Thank you doctor,
Yesterday I got the crowns fixed. After the trial, I got severe throbbing pain while rinsing with water before fixing the permanent crowns. Even today, whenever I rinse with water, I am experiencing this throbbing pain. At other times, it seems to be a dull pain. What could be the reason? I am worried whether it would become a failure.
Hi,
Welcome back to icliniq.com.
Because the luting or cementing agent contains weak acids, which can irritate dentin and cause pain, but the pain should not be there for more than a week or too. Please check whether the fit is proper, means, if there is any gap, let me know, or if there is associated foul smell, let me know that too. If everything is fine, and the pain is mild and not throbbing, it is fine.
Patient's Query
Thank you doctor,
The doctor checked and told me that there were no gaps after fixing the crown. I cannot check by myself because of poor visibility. As of now, I get mild and dull pain. But if I rinse with water around the implanted area, I am getting throbbing pain. The last wisdom natural tooth adjacent to the implant has little mobility. The doctor showed it to me last time while fixing the crown. He said better to get it removed in my next visit. Do you think the pain is also because of that mobility?
Hi,
Welcome back to icliniq.com.
Yes, it could be because of it. Sometimes mobile tooth exposes dentin and cementum, which are sensitive to hot and cold. You need to give it two weeks and avoid too hot, too cold fluids and highly concentrated mouthwashes. Follow your implantologist. The second throbbing pain is always from the natural tooth. Therefore, it will not harm your implant. I hope you should get well soon.
Patient's Query
Thank you doctor,
So, for now, I guess that I should avoid rinsing on the implanted area so that I will not experience pain, and I have to give some time to heal. I hope the pain goes down slowly if I follow this tip. Please confirm.
Hi,
Welcome back to icliniq.com.
You can do rinsing if your doctor has prescribed it. But make sure the concentration is not too high. Add half of lukewarm water to the mouth wash and rinse gently.
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Dentistry
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