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Oral Surgery/3 teeth with tooth pain, one a repeat RC and Apico

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Teeth xrays
Teeth xrays  

Teeth xrays
Teeth xrays  
Hello.  I would like to get your opinion on these 3 xrays if possible.  My upper right molar (#3) has been root canaled 2x and Apicoectomy 1X.  I have intermittent pain up in the area of my gums above that tooth and have for several years, although most recently it feels like there may be an infection.  

Tooth #21 has receded gum line exposing what I thought was a pit or cavity.  Severe sensitivity to cold and air.  Endodontist looked at xray and says something should be done immediately with that tooth, and that there is possible cervical interior absorbtion of the tooth.

Upper left molar #14 I think, had an old large filling removed and replaced about a year ago.  Has started to hurt.  Endodontist says looks like filling is close to nerve and possible crack in distal part of tooth.  

I had severe pain and troubles with my last root canal of the upper right molar, and thinking if possible I might opt for implants if necessary for these issues.  Any suggestions and thoughts after looking at these xrays?  Your input would be greatly appreciated! can't fit third picture of #3, so I will just appreciate input on what you can see.  Thanks!

Answer
Hello Nicole

I would certainly NOT go for implants  as a first choice. You seem to be taking good care of your teeth and you will need a good endodontic treatment achieved with microscope. Your surrounding bone is pretty good too so I suspect implants will not come unless you have a major fracture of one of the teeth.

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Dr.MANNAI

Oral Surgery

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Chawket MANNAI, DDS,Ph.D Diplomate ABOMS

Expertise

I am a US board certified Oral & Maxillofacial Surgeon trained at UCLA and Parkland Memorial Hospital (Dallas) with more than 25 years of experience and will provide answers to all questions pertaining to the Oral& Maxillofacial Surgery region including Orthognathic Surgery, Trauma,TMJ, Implantology, tumour surgery (excluding cancer and Oral Dermatology),reconstructive surgery...

Experience

Extensive in all fields for the past 25 years hospital and office based.

Organizations
American Association of Oral & Maxillofacial Surgeons American College of Oral & Maxillofacial Surgeons British Association of Oral & Maxillofacial Surgeons

Publications
2006: Mannai Chawket Early implant loading in severely resorbed maxilla using xenograft, autograft, and platelet-rich plasma in 97 patients. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2006;64(9):1420-6. Bayonne, France. c.mannai@surgical.net 1998: Bell W H; Mannai C [An interview with Dr. W.H. Bell and Dr. C. Mannai. Interview by Colette Orival-Demange.] L' Orthodontie franšaise 1998;69(1):225-9. 1988: Abemayor E; Zemplenyi J; Mannai C; Webb D J; Canalis R F The fixation of malar fractures with the transnasal Kirschner wire. The Journal of otolaryngology 1988;17(4):179-82. Division of Head and Neck Surgery, Harbor-UCLA Medical Center, Torrance 90509. 1988: Wald R M; Abemayor E; Zemplenyi J; Mannai C; Lesavoy M A The transoral treatment of mandibular fractures using noncompression miniplates: a prospective study. Annals of plastic surgery 1988;20(5):409-13. Division of Plastic Surgery, Harbor/UCLA Medical Center. 1988: Di S; Bell W H; Mannai C; Seale N S; Hurt W C; Taylor J; Waite D E Long-term evaluation of human teeth after Le Fort I osteotomy: a histologic and developmental study. Oral surgery, oral medicine, and oral pathology 1988;65(4):379-86. Division of Oral and Maxillofacial Surgery, University of Texas Health Science Center, Dallas. 1988: Bell W H; Mannai C; Luhr H G Art and science of the Le Fort I down fracture. The International journal of adult orthodontics and orthognathic surgery 1988;3(1):23-52. 1986: Mannai C; Schwartz H C Juvenile nasopharyngeal angiofibroma presenting as a facial swelling. A case report. Journal of maxillofacial surgery 1986;14(6):329-31. 1986: Mannai C; Leake D; Pizzoferrato A; Ciapetti G; Sangiorgi C Histologic evaluation of purified bovine tendon collagen sponge in tooth extraction sites in dogs. Oral surgery, oral medicine, and oral pathology 1986;61(4):315-23.

Education/Credentials
DDS,Ph.D Fellow and Diplomate American Board of Oral & Maxillofacial Surgery Residency training:Harbor-UCLA MedicalCenter 1982-1985 Fellow OMFS Parkland Memorial Hospital Dallas Texas with William H.BELL

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