Post Root Canal Treatment Issues: Can Cracked Roots Be Saved?

Issues After Root Canal Treatment

Hello: Around November last year, I underwent root canal treatment elsewhere.
Three months later, I experienced mild pain when biting down, but there was no pain when I released the bite or when tapping on the tooth.
I later consulted an endodontist who confirmed that there were no abnormalities in the root canal treatment; both X-rays and CT scans showed no issues.
Currently, I have a temporary crown, but the situation remains the same.
The doctor suggested observing for another month, but it is almost confirmed that there is a crack in the tooth root.
Is there still a chance for recovery if there is a crack?

Mu Bai, 30~39 year old female. Ask Date: 2016/03/09

Dr. Zeng Guanghui reply Dentistry

The above situation may indicate that there is already a crack in the tooth itself.
If the crack extends to the root and is a vertical fracture, it may be necessary to extract the tooth.
It is recommended to consult a dentist for further evaluation and treatment.

Reply Date: 2016/03/09

More Info

After undergoing root canal treatment, experiencing symptoms such as mild pain when biting or pressure sensitivity can be concerning, especially if there is a suspicion of a cracked root. The management of cracked roots can be complex and depends on several factors, including the extent of the crack, the overall health of the tooth, and the surrounding bone structure.

When a tooth has undergone root canal treatment, it is devoid of its nerve supply, which means it can no longer feel pain in the traditional sense. However, it can still be sensitive to pressure or temperature changes due to the surrounding tissues and the integrity of the tooth structure. If your dentist has confirmed that the root canal treatment was successful and there are no signs of infection or other complications on X-rays, the next step is to evaluate the condition of the tooth itself.

Cracked roots can sometimes be salvaged, but the prognosis depends on the severity and location of the crack. Minor cracks that do not extend below the gum line or into the root canal can often be treated with a crown or other restorative procedures. However, if the crack is significant and extends into the root, it may compromise the tooth's structural integrity, making it difficult to save.

In cases where a crack is suspected, your dentist may recommend a few approaches:
1. Observation: If the symptoms are mild and manageable, your dentist may suggest monitoring the tooth for a period to see if the symptoms resolve on their own. This is often the first step, especially if there are no signs of infection.

2. Restorative Treatment: If the crack is minor, placing a crown over the tooth may provide the necessary support and protection. This can help prevent further damage and alleviate symptoms.

3. Surgical Intervention: In some cases, if the crack is severe and the tooth is at risk of extraction, a procedure known as apicoectomy may be considered. This involves removing the tip of the root and any infected tissue, which can sometimes save the tooth.

4. Extraction: If the crack is extensive and the tooth cannot be saved, extraction may be the only option. After extraction, options for replacement, such as dental implants or bridges, can be discussed.

It's essential to maintain open communication with your dentist about your symptoms and concerns. If you feel that your current treatment plan is not addressing your issues adequately, seeking a second opinion from an endodontist or a specialist in dental surgery may provide additional insights and options.

In conclusion, while cracked roots can sometimes be saved, the success of treatment largely depends on the crack's severity and the overall condition of the tooth. Regular follow-ups and monitoring are crucial in managing post-root canal treatment issues effectively. If you experience any worsening symptoms, such as increased pain or swelling, it is important to contact your dentist promptly for further evaluation.

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