Fistula after retreatment of molar. Root cracked? Do I need an implant?

Question from Anonymous:

I had a root canal retreatment on tooth #3. About 2-3 weeks after that, a bump developed  on the gum above the treated tooth (there was no bump  pre-op). The endodontist suspects the MB root is cracked and suggests  root amputation. But he
said there is chance it is not cracked and only  apicoectomy will be needed.
There is deep pocket on the gum in question,  therefore my dentist said a crack
is very likely. Please see the  radiography  attached. (I also wonder if the RC
retreatment was too  aggressive since the roots became much wider than pre-op,
and as the result the RC retreatment caused  the crack?)


Dear Anonymous:
I will try to give you my opinion, but I hope that you ask all these questions to your treating dentist which has the advantage of clinical information obtained by examining you in person.
I cannot see very much detail in the xrays you sent, other than the canals being enlarged a lot, which sometimes is necessary, but tends to weaken the tooth more.
If  the tooth also has a deep pocket, you can have a successful endodontic treatment and still the molar could have periodontally related problems in the future, so it depends on whether you want to save the tooth realizing it may not last long term, or you want a strong restoration with good long term prognosis.
The bone graft is also highly indicated in your situation after an extraction because the holes left by the 3 roots of the molar would not allow easy placement of an implant at the time of the extraction.
Hope this helps.
Carlos Boudet, DDS, DICOI

About Carlos Boudet, DDS, DICOI

Dr. Boudet is a graduate of the Medical College of Virginia. After graduating with a DDS degree in 1980, he became a commissioned officer for the United States Public Health Service. When his tour of duty ended in 1982 he received an award for outstanding service. He was asked to serve as Dental Director for Florida Community Heath Centers, supervise the operation of four dental clinics around lake Okeechobee. He established his dental practice in West Palm Beach in 1983 and has been in the same location for 30 years. He is a Diplomate of the International Congress of Oral Implantologists, a member of the Central Palm Beach County Dental Society and a chairman of the Advanced Crown and Bridge course of the Atlantic Coast Dental Research Clinic. His articles on prosthodontics and implants have been published in several popular dental magazines.

Leave a Reply

Your email address will not be published. Required fields are marked *