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Remove the tooth or can we save it
I had done Root canal 10 years ago. All was good. Last few months pimple type bump come out on the Gum. Few days it stays and then blood comes out and it goes away. No pain no issue. I checked with Dentist who did RCT. She did x ray. It came good. So she said to do this CTscan. Please can anyone guide me what to do? Dentist said to remove all 3 tooths. As I will be flying back in 2 weeks please help me
Based on the history and the CBCT findings, the recurrent gum “pimple” (sinus tract) indicates a persistent chronic infection associated with the root canal-treated upper first molar (#16). The CBCT report mentions:
* Periapical lesion extending into the furcation
* Possible root microcrack/vertical root fracture
* Buccal cortical plate perforation
* Close relation to the maxillary sinus
These findings make the long-term prognosis of the tooth guarded to poor, especially if a crack is confirmed. A fractured root usually cannot be successfully treated with re-RCT.
However, I would not recommend removing all three teeth solely based on this report unless there are separate problems affecting the adjacent teeth. Only the involved tooth appears to be the concern from the information provided.
Next Steps
If the diagnosis is uncertain, consult an Endodontist for a clinical examination (sinus tract tracing, periodontal probing, bite test, CBCT correlation). If a vertical root fracture or non-restorable crack is confirmed, extraction followed by implant or bridge is generally the most predictable option.
Since you are flying in 2 weeks and there is currently no pain or swelling, this is usually not an emergency, but it should not be ignored because the infection is active and can flare up unexpectedly.
Health Tips
* Most likely diagnosis: Chronic apical abscess with draining sinus secondary to a vertical root fracture/root crack.
* Treatment of choice if fracture confirmed: Extraction of #16 only, followed by rehabilitation (implant/bridge).
* If no fracture is present: Consider nonsurgical or surgical endodontic retreatment after evaluation by an endodontist.
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