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Thursday, July 31, 2014
Face and Jaw Surgery
Root canals after oral surgery
15 years ago I had orthanathic surgery. Since that time, I`ve had 7 teeth that have died as a result of having the root clipped and root canals performed by my general dentist. 3 years ago, I had to have an apicoectomy for one of them because it was not adequately treated (the first 2 times!). Now today, I find out that another tooth has a repeat abcess because it was not adequately treated. My questions are this - 1) Does the surgery change the bone character such that it makes it difficult to treat? 2) Should I ever consider letting a general dentist do another root canal on one of my top teeth (where the surgery was)? 3) Should I continue to expect to have problems like this?
Without seeing you and your xrays it is difficult to give specific exact answers to your questions and I have forwarded the surgical portion of your question to an oral surgeon and the root canal portion to an endodontist for further explanations. In general, any bone surgery could decrease the blood and/or nerve supply to the jaw but the long term effects especially on future root canals would usually be minor and minimal. Many general dentists perform root canals especially on front teeth. Some general dentists even do more complicated back molars. It is very difficult to try to predict possible future problems and I would recommend that you consult with your local dentist, oral surgeon, +/- endodontist.
(Oral Surgeon) - I would agree with answer from the general dentist expert. In most cases there is not a significant change in the bone around the tops of the roots and typical endodontic therapy would be successful. Your history suggests that it might be worth closer evaluation by an oral and maxillofacial surgeon if, in the future, another upper tooth needs endodontic treatment.
Gregory M Ness, DDS
Clinical Professor of Oral & Maxillofacial Surgery
College of Dentistry
The Ohio State University