Need some opinion about tooth fracture. Really appreciate it.

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Posted on By Newuser Newuser In Endodontics

Hi all,
I am very new to this forum. Please help me.
I have right lower jaw burning pain under the ear and side of the neck right side since may. I went to the dentist to check that out. He said, x-rays are normal but he suspect a tooth root fracture in lower first molar and did bite test. I feel little tender and sensitivity to bite on one spot on that tooth. So he said, he suspect a tooth fracture in the lower first molar and that is the reason for my lower jaw pain under ear and neck.

He took CbcT scan and said he is not very certain and suspecting a fracture. I went to Endodontist and he couldn't see any fracture and did cold, bite test. My molar tooth was sensitive to cold spray and to bite on one spot on that tooth. So the Endo said , I needed root canal.

I don't know if I should go with my dentist or endo opinion. My dentist said I need to extract and implant.
I had root canal in September and still same symptoms. My dentist suspect there is a fracture and want me to extract it. Will the crown help in my case?
I don't know if I need to extract tht tooth ? I have taken cbct scan at dentist office. But my Endo didn't take a look at this scan. Dentist sa saw it and said he suspect a tooth root fracture in lower first molar and want me to extract and immediately implant.
My physician said, it could be tmjd or some neuralgic pain too. So I don't know what's the reason for my pain. Constant burning pain in the lower jaw under ear and side of the neck. Please help me. Can anyone in this forum take a look at my scan and let me know if I have fracture. I trust this group. I don't know how this forum works. Do I need to post it somewhere else? How to post it in the correct category?
Appreciate your help in my case.

This is my cbct scan images link.

https://drive.google.com/file/d/17vk_t-yMsFCGVYXU9t1DVOJZAD2hDdDF/view?usp=drivesdk




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4 Comments

I do not see a fracture nor do I think that could account for the burning you describe. I think your physician has advised you well as far as possible neuralgia. You should be evaluated by a neurologist.


Reply

Thank you so much for the response @gregg bobier. I did consult a neurologist few days back. He checked and said my area of pain and symptoms doesn't look like neuralgia. He want me to take mri brain with contrast to check if the nerve is ok. He said, he doesn't think I have neurological issue. He said, if the mri is normal , then you have to consider this as muscle issue and do the tmj treatment or extract the tooth. I didn't take the mri yet. I had the permanent crown on the root canal tooth #46. Lower first molar. My tooth and gum is very sore constantly after the crown. Sometime it gives sharp pain. My dentist told me to wait for 2 weeks and see if it improves. If not, told me to extract the tooth as he suspect that root fracture is the reason for my pain and symptoms. He took a CBCT scan and suspect a fracture from it. I don't know if the fracture cause so much pain for more than 6 months. My Endo didn't see this cbct scan. He saw only the x-ray. He missed to see this cbct scan. He didn't take any cbct scan too. I don't know if I did this root canal and crown unnecessarily if I needed extraction. Do I need to go for extraction? Please help. Can someone take a look at my cbct images and let me know if I have a tooth root fracture. Please help. I have 600+ dicom images in the below google drive link. https://drive.google.com/file/d/17vk_t-yMsFCGVYXU9t1DVOJZAD2hDdDF/view?usp=drivesdk


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It is hard to determine the cause of the problem with the limited information, But before any irreversible treatment is done I will suggest the following if you answer yes to any of the next questions.
Do you wake up with pain?
Do you sleep on the side of your face that you are experiencing pain ?
Are you under a lot of stress?

If is yes.
Ask you dentist or Physicians to prescribe you a muscle relaxer for 3 to 5 days, and If this help you. You are probably experiencing tmj’s disorders due to bruxism ( cleaning and grinding).


Reply

Thank you so much for the response @Cristian Fernandez. I really appreciate it. Yes, I do wake up with pain and I have pain during sleep too. I have already tried muscle relaxers for more than a month. Been on muscle relaxers for a month and doesn't help much. It just make me sleep through tht night. I have tried NSAIDs too. Taken so much of NSAIDs in the last 6 months. Tried pain medicine, steroid pack. Nothing helps. I did see a tmj specialist. He took CbcT scan for the jaw and said I have the muscle tightness, myofacial pain and jaw joint issues. He said it's muscular. He want me to try his mouth guard day and night ones. It's very expensive and not covered under insurance. It's around 4.5k$. But he wants me to finish the dental work before I start his treatment. I did the permanent crown on that tooth#46 lower first molar last week. My tooth and gum is very sore since the core and crown work done. My dentist suspect that tooth fracture is the reason for my pain and he wants me to extract it. He told me to see if this crown helps and asked me to come back after 2 weeks for extraction. I don't know if I need to do extraction. My Endodontist didn't see the cbct scan though. Only my dentist saw the cbct scan and he suspect a tooth root fracture from it. I don't know if I did the root canal unnecessarily when I needed extraction. Please take a look at my cbct scan and let me know if you see any fracture. No one saw the cbct scan other than my dentist. Please take a look at cbct dicom images and let me know if I need extraction. I have this constant pain since the month of May. It's going to be 7months now and same pain. Does the tooth fracture cause pain for so long? I am not chewing on that tooth side at all since 6 months. Using only the opposite side and mostly on soft diet. This tooth sometimes hurt when I bite down after this crown. Does it indicates fracture? How to know if I have a tooth root fracture?please help. Kindly requesting you to take a look at cbct images. This is the google drive link for dicom cbct images. https://drive.google.com/file/d/17vk_t-yMsFCGVYXU9t1DVOJZAD2hDdDF/view?usp=drivesdk


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