Dear Sir/Madam! After reviewing my panoramic X-ray, my dentist confirmed a granuloma around lower tooth 6 (around both roots). The tooth had already undergone endodontic treatment about 4 years ago, but, judging by the image, the root filling at that time (or perhaps even earlier, I no longer remember) was poorly performed because part of the root remained unfilled. Over the last few years of normal oral-hygiene maintenance I did not have any X-rays taken. Over time an inflammation developed, but I do not know how long it has been present because I had no pain in the meantime. My dentist therefore attempted to access the canals through retreatment, but unfortunately he could not reach them at all because the filling material (iodoform) was too hard. He suggested two options: either to return to the doctor who originally treated the tooth and filled it with iodoform (perhaps he would know a better solution) or to undergo an apicoectomy. Although I am leaning more toward the apicoectomy, I am afraid because at the age of 35 this would be my first such procedure. At the same time, after reading the experiences of some patients on forums, I am not sure whether such a procedure permanently eliminates the possibility of a granuloma recurring. Thank you for your answer! Kind regards.

Dear Sir/Madam!It is very difficult to determine from an X-ray alone whether the root filling was performed well or not. Often a root canal cannot be treated and filled "well" because of many factors that cannot be identified on an X-ray. Based on the problem you describe, I recommend the following:-X-ray follow-up-repeat root canal treatment (statistics show that an apicoectomy is also much more successful after prior revision of the canals)-apicoectomy if the follow-up X-ray and symptoms after the revision indicate it.Have a nice day!

Dentist - Your questions

Visitor asks:

Hello! I am 22 years old and I am already missing an upper second premolar, a lower first molar, an upper second molar and 2 wisdom teeth. During extraction of the lower wisdom tooth my bone was damaged; I had severe pain, took Amoksiklav 1000 antibiotics three times and had a high fever, but the problems have now sett

Dentist Tomaž Rotar answers:

Dear Sir/Madam! I would certainly first try root canal treatment of the problematic tooth you describe. There are different methods of locating the entrances to root canals and also different methods of preparing them, so do not give up immediately. I recommend that you make an a

Visitor asks:

First of all, kind regards! I have one short question: I am scheduled for an apicoectomy on Tuesday. Today my tooth was filled. Until Tuesday I have to take Amoksiklav preventively. The following concerns me: another tooth has started to hurt. Not so much that I would have to take a painkiller, but I can feel it. I thi

Dentist Tomaž Rotar answers:

Dear Sir/Madam! The question is relevant if the painful tooth is the immediate neighbour of the tooth that will undergo apicoectomy. In that case it would be sensible to perform root canal treatment on that tooth beforehand as well and then, if necessary, perform apicoectomy on b

Visitor asks:

My daughter broke off half of her upper central incisor and chipped the lateral incisor slightly. Since these are permanent teeth, I would like to know how this can be repaired. The roots are not damaged. Can it be repaired nicely and how? Are any further complications possible? Thank you for your answer. Špela

Dentist Tomaž Rotar answers:

Dear Sir/Madam! If there is only a fracture of dentine and enamel, with the dental pulp not exposed to the outside and the tooth showing no pathological symptoms (apart from sensitivity), the tooth crown can simply be rebuilt with composite materials. If this build-up is not suff

Visitor asks:

Dear Sir/Madam, Please give me some advice and reassurance. I had a bridge on my front teeth (1 and 2). Months ago a swelling developed above the central incisor; it was very hard to the touch, and from time to time I felt a kind of pressure and slight tingling in it. I visit my dentist regularly because I constantly h

Dentist Tomaž Rotar answers:

Dear Sir/Madam! In the case you describe, a postoperative complication has occurred. Infection of the wound is the cause of pain, swelling, discharge, an unpleasant smell from the wound, ... The treatment described is usual and appropriate, but despite this the problem may contin

Visitor asks:

Hello, I would like to ask whether monitoring, in other words monitoring of vital functions, is used in maxillofacial surgery (and also in dentistry in general) during a procedure under local anaesthesia... during wisdom-tooth extraction... I know the question is a little unusual, but still...

Dentist Tomaž Rotar answers:

Dear Sir/Madam! Monitoring of vital functions during local anaesthesia is of course present throughout, since we continuously observe the basic signs of life. No special equipment is needed for this type of monitoring. Instrument-based monitoring of vital functions (ECG, ventilat

Visitor asks:

Dear Sir/Madam!!! My dentist treated my lower left first molar. The X-ray showed that all four canals are nicely filled, but a large pus-filled bump has formed on my gum. I am taking Amoksiklav and my dentist promised that on Thursday she would open this pus-filled bump. How is this done? What does she use to open it?

Dentist Tomaž Rotar answers:

Dear Sir/Madam! A pus-filled bump, or submucosal abscess, is incised with a scalpel, which is a painless procedure. A drainage strip soaked in a special liquid is inserted into the drainage wound. Because this is a minor procedure, taking Marivarin should not be problematic. Acco

Visitor asks:

Hello!!! I am missing the upper left canine and first premolar. I am interested in a metal-free bridge: how much would a complete porcelain bridge cost, and what would you recommend most? Thank you very much for your answer.

Dentist Tomaž Rotar answers:

Dear Sir/Madam! The best solution would be implant treatment, which would allow us to avoid preparing healthy and intact neighbouring teeth (in your case the central incisor, lateral incisor and second premolar). This is the solution we recommend most. The price would be: implant

Visitor asks:

Dear Sir/Madam! I am 77 years old and need a lower denture. At the front I still have five teeth (on the left 1, 2, 3 and on the right 1, 2), but no teeth at the back. I would like to know whether I would also need implants for retention of the denture (and how many). Please also let me know the price for the procedure

Dentist Tomaž Rotar answers:

Dear Sir/Madam! In your case, implants are not necessary for denture retention, since five teeth should in principle be sufficient to retain the denture. There are many different ways of retaining it (clasps, attachments, ...) and the choice depends on the patient’s functional an

Visitor asks:

Hello, because I am afraid of the dentist, my teeth are in a terrible condition. The lower right first and second premolars have chipped so badly that it seems only the roots are left. A bump has formed on the gum from which blood and pus are coming out. Until now it did not hurt, but the day before yesterday it starte

Dentist Tomaž Rotar answers:

Dear Sir/Madam! If the matter is urgent, you would not have to wait for treatment at an emergency dental clinic. If it is not urgent, is chronic in nature and is the consequence of a longer-lasting disease process, make an appointment with your dentist (if that is us, the waiting

Visitor asks:

Dear Sir/Madam! After reviewing my panoramic X-ray, my dentist confirmed a granuloma around lower tooth 6 (around both roots). The tooth had already undergone endodontic treatment about 4 years ago, but, judging by the image, the root filling at that time (or perhaps even earlier, I no longer remember) was poorly perfo

Dentist Tomaž Rotar answers:

Dear Sir/Madam! It is very difficult to determine from an X-ray alone whether the root filling was performed well or not. Often a root canal cannot be treated and filled "well" because of many factors that cannot be identified on an X-ray. Based on the problem you describe, I rec

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