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This question is more than six months old, so the information in the answer may no longer be accurate.
Visitor asks:
Hello!
About three years ago, my dentist removed the nerve from my upper central incisor, which had been sensitive to cold and heat. Even after removal of the nerve, the condition of this tooth did not improve, except that it no longer hurts with cold, heat or sweets.
Because I still feel the tooth as painful, especially when my immune system is weakened or in bad weather, I had an apicoectomy. Less than a year later I went back to the surgeon who had performed the apicoectomy and told him that the tooth still hurt in the same way and also hurt when I pressed on it or tapped it. He performed another apicoectomy, and it is still no better. The tooth is painful and I constantly feel as though there is pressure on it. The X-ray showed no inflammation and that from the surgeon's side everything was fine. Over the last year the tooth has moved slightly backwards and this is already quite noticeable aesthetically. The surgeon mentioned that my problems could be due to the incorrect position (completely straight and already slightly backwards) and that because of my bite I probably keep wearing the tooth down.
I then went to an orthodontist, who told me that he could not guarantee that a dead tooth could be aligned in the way I would like, and I was advised that both dead upper central incisors should be extracted, that I should wait 2 months for the wounds to heal, then have two implants placed and, after 6 months of healing, receive fixed orthodontic braces.
I am very sad and would kindly ask for your opinion!
Thank you for your answer!
Dentist Tomaž Rotar answers:
Dear Sir/Madam!
Apicoectomy is a procedure that statistically does not have the highest success rate (70%). Repeating the procedure at the same site has an even considerably poorer prognosis. The profession recommends prior revision of the root canal filling, thereby increasing the chance of success. If the tooth still causes problems after the procedures described (pain, swelling, fistulation...), repeating them is usually pointless and a different solution must be chosen: removal of the tooth and its replacement. It can be replaced with a classical bridge construction or by placement of an implant.
For a more precise answer, I need to see the X-ray and perform a clinical examination.
Have a nice day!
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