Expert: Frederick R. Liewehr DDS, MS, FICD - 11/28/2008

Question
My front tooth was root treated by expert a year ago, it was sensitive for 6 months then started to feel on fire, it was re root treated 2 months ago and temp. dressing still in. Endo says Xray looks good. Tooth has low grade ache , wakes me up at night as sore, hurts to bite on and throbs if I have a hot drink. ndo suggests putting in root fill and taking ct scan to see if it shows anything. I don't want apisect. as would compromise implant if it did not work ( true?) My question is is it worth doing the final root fill , is there any chance that would settle the tooth that is painful with temp dressing in? Would a CT scan of tooth be likely to help? Am I just delaying the inevitable or does it sound as if tooth has a chance?
(Was booked in for bone graft/sinus lift but surgeon thought I might have root tip infection in this front tooth and did not operate and instead gave me antibiotics which did help for couple of weeks to calm front tooth although not completely eliminate its symptoms)

Answer
I can't tell you what is wrong with your tooth without seeing you. The final fill will not help if something is wrong. Tooth may be fractured. A CT scan might or might not reveal something. I would simply perform the surgery, and I would get a lot more information than from the CT scan, which is costly. I can't understand why your periodontist or oral surgeon was concerned about the infection, as a sinus lift is done on teeth further back in your mouth. Your front tooth does not communicate with them. Antibiotics are useless if you don't have a diagnosis, and you don't. You need to consult a competent endodontist.