Dentistry/Tooth abscess after a bridge and RCT
QUESTION: I have got a recent new ceramic bridge on my upper 6 front teeth about a month ago because my lateral incisors are missing, and my central incisors have gone under RCT, and one of central incisor feels sensitive on biting pressure so I got an Xray done and it shows that it developed a small infection, a really small black circle at the apex of the root but the rest of the bridge are fine, my dentist prescribed Ornidazole and told me to take it for 3-4 days and she'll check about the improvement after a week, but if it doesn't get better after 2 months observation then I might need an apectomy.
I just want to know if the antibiotics will really cure the infection? Is it a serious problem? because I don't want to get an apectomy operation.
ANSWER: Hi Sunisa,
I'm sorry to hear you have this going on especially after just getting your new bridge. I'm afraid I have some bad AND good news for you. First the bad news.....when w tooth has had a previous root canal and an abscess develops, that is cause by some issues with the root canal that allow material, inside the tooth, to leak out. This causes a reaction in the tissues at the end of the tooth and the dark spot develops. Unless this source of leakage is fixed, the problem will remain. Antibiotics will not cure the problem.
Now the good news....apicoectomies, especially on front teeth, are VERY easy to do, don't take a lot of time, pain is minimal afterwards and healing is fast. Many of our patients don't even need pain medication and do fine with just Ibuprofen or aspirin. I would suggest that you have an endodontist do the procedure as we do more of this in one month than most dentists do in a year or two. We you would like to know about apicoectomies, I would refer you to www.aae.org, which is the USA website for endodontists and there is a lot of information there for patients.
Hope this helps. Write back if you need further information.
Gary Backlund DMD, MSD
---------- FOLLOW-UP ----------
QUESTION: thank you so much for the answer, is it possible to do root canal re-treatment by removing the bridge and put it back? my bridge was fixed with resin cement which is very strong right? and if removing it is not possible without damaging it then is it possible to do rct through the bridge without damaging it?
Hi again Sunisa,
It is very risky to try to remove the bridge. The cement is very strong and it would be possible to break off one or more of the teeth underneath the bridge. That would cause HUGE problems since the bridge would then need to be remade and if the break was below the gum line, it could also require the tooth to be extracted. Drilling through the bridge is a better option, but that could also damage the bridge. If this were my tooth, an apicoectomy would be my choice of treatment.
Sorry for the bad news.
Gary Backlund DMD, MSD