Cbct scan of tooth#30

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Posted on By Newuser Newuser In Endodontics

I am concerned about this tooth#30 issue. I have lower jaw pain under ear and neck for 9 months now. I went to dentist for that. He checked and told me that I might have a tooth root fracture in #30.he took CbcT scan. I have been told I might have a tooth root fracture and that might be the reason for my symptoms.

I went to Endodontist. He tapped on that tooth and that hurts. He gave me bite paper to bite on and that hurts. He said I needed root canal. It was hurting a little only for taping and Biting. He said can try rct or crown can help. He also said if he can open the tooth for rct, he can view the fracture if it's present or not.

I did rct in September and crown in november. I have sore pain on that tooth and gum since crown placed. I still have that lower jaw pain under ear and neck.

It hurts for tapping and biting on that tooth. I have taken 2 cone beam CT scans on that tooth. Before and after the root canal. But the dentist said, we can't see the fracture in the cbct and want me to go with symptoms and try redo the root canal with wider canal fillings. If that doesn't help, trying the extraction. I didn't do the root canal retreatment yet.

Can we see the root fracture in the cone beam CT scan?

I am attaching the copy of those cone beam CT scan of tooth#30. I would appreciate if you can take a look at it and please let me know your inputs. I have placed as zipped folder since it has large number of files. You can view the images by extracting all the files after downloading. You have to extract all the files after downloading the folder.

1.Cone beam CT scan of tooth #30, dec 2020. Taken after the root canal.


2. Cone beam CT scan of tooth #30, june 2020. Taken before root canal.


I went to an oral surgeon for my jaw pain. He said it looks like Myofascial pain dysfunction Syndrome. But he was not sure about this tooth issue. He want me to check this tooth issue before I do further treatment for tmjd /MPDS. He didn't give any night guard. He want me to try PT. He said this jaw pain might be from bruxism. He is not sure about tooth fracture.
Do I need to extract #30? Can anyone see any fracture in the given CBCT? Please let me know your inputs.

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Any thoughts anyone? Attaching few x-rays.


I think one more option you have is surgery. https://www.zamadclinics.in/surgeries


If a look to the symptom in the ear e neck areas I believe little to the dental cause,
In so long time of the history the dental fracture can be excluded.
I see the rx on internet and I don't see any signs of fractures.
I don't se the cone beam..(NO found) . the axial section can prove fracture o other radicular canal.
The pain during check or bite can be the expression of inflammatory reaction at pulp (inside the canal,
In so long time the fracture will be given other symptom as abscess or gingival probing


I see now in other view the CBT scan. I DONT SEE ANY ROOT FRACTURE.
The lesion at the distal root have a particular aspect and the question is it was vial before endo treatment?
The presence of an other canal is the probability cause.
A new scan can be excluded the hypothetis.
I believe that the diagnosis is complicated, the surgery treatment is not ideal without diagnosis for the bone loss after failure.
The extraction is the ideal therapy, but I don't make implants restoration before health (any pain)


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