Vertical root fracture symptoms after 4 months

[iartemch]

Hello,

I’ve had pain and pressure in the gum and in my #9 tooth with root canal for the last 4 months. The tooth is covered by a veneer. The root canal was done because of pain after veneer replacement - It was done 6 months before my current symptoms began.
Nothing showed up on the X-ray taken 3.5 months ago. 2 dentists and 1 endodontist say root canal looks good. I have had 4 bite adjustments with some relief after that. The dentist who replaced my veneers and did crown lengthening said I needed to come for another adjustment. She also suggested it might be vertical root fracture. Another dentist suggested to see ENT since my sinus infection might be causing it ( I also developed pain and pressure in gums in teeth #10, 11 and even 12).
I have no pain in tooth #9 when biting. In fact, pain and pressure disappear when I bite while eating. Also, no pain or pressure while wearing a night guard.

Given the fact that it has been 4 months since my symptoms started, shouldn’t I have developed a periodontal pocket or bone loss visible on the X-ray ? Since my veneer felt weird from the beginning (no problems with temporaries), is it possible that it did not fit right to the tooth under it? Can my sinus infection mess up my tooth since I am congested and feel pressure and pain in maxillary sinus mostly on that side?

Please, any advice is greatly appreciated. I don’t want to extract my upper front tooth if there is no need for it. Thank you!

 

[MattKW]

1. I would've expected a periodontal swelling to have developed as you say. Bone loss may not be visible on a standard dental Xray. You might see a fracture on a CBCT, but I would've expected the perio to be the first sign. Also, there should be pain on biting with a fracture.
2, Can't see why a veneer would've caused much change in your bite unless there was significant incisal adjustment. Normally you still have to keep the length of a single veneer within the movement envelope consistent with adjacent teeth, unless you do a lot at the same time.
3. Nothing to do with sinus issues. Maxillary sinus issues only affect back teeth, say 2nd premolar and backwards and would manifest as a dull ache, exacerbated when chewing, and not easily located to a single tooth.

Yeah, can't say for sure. A crack seems the most likely out a poor choice of possibilities. Maybe consider a simple ortho retainer for a few months rather than risk something more aggressive. Pls write back here when you find a diagnosis and effective solution.

 

[iartemch]

Thank you for your reply. I am planning to get CBCT to see what goes on with the tooth and the bone.
I will write if/when I get a diagnosis.

 

[iartemch]

Hi.
This is an update to my post regarding pressure and pain in gum after a new veneer was bonded. After several consultations, I was finally diagnosed with biological width violation. According to the dentist who removed the veneer, the veneer was sitting way too close to the bone pressing on it and causing chronic inflammation and irritation. In addition to that, there was an access cement under the gum that was not cleaned after the bonding. It is worth mentioning, that while I was waiting for this appointment, my gum became very sensitive and bled when probed.
I spent a lot of money on my 2 veneers and now I have to redo the veneer that was not done properly. It irritated the nerv in my tooth and I had to have a root canal that did not fix the problem. I went to the dentist who did the veneers 3 times and every time she suggested that I clenched my teeth and kept adjusting my bite while in fact she had placed the veneer too high and did not clean the cement properly after bonding. Should I contact her office and ask for my money back? I am really upset.

 

[MattKW]

Sad to hear. Would've thought BWV would've been picked up earlier.
If your symptoms have indeed been resolved, then you may have reason to ask for compensation. I'd suggest you gather any evidence you can, then start initial contact to the dentist - before and after photos would be useful. Do it in writing and be polite; expect only that you may get the cost of any remedial re-treatment (don't try for "pain and suffering" - this wasn't life or death issue). If that fails, seek advice from any local consumer assistance office.