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Surgery or extraction to remove cyst
During my childhood, my front tooth (21) got cracked due to a fall. Later, because of an infection, that tooth had to be extracted. Many years later, the adjacent teeth (11 and 22) also became infected. The doctor performed surgery on the upper gums to remove the infection, and after performing Root Canal Treatment (RCT) on teeth 11 and 22, a bridge and crowns were placed to replace the missing tooth (21)."Now after 16 or 17 years ,i have pain on left side by pressing nose but normally there is no pain.Doctor told me for xray and cbct . In arepoer of cbct it's showing that a redicular cyst on left side on tooth root 22 and on tooth 11 there is black area which dont know what it is? It can be either surgery defect or cyst.. but i dont gave oain on right side on tooth 11 . Doctor suggested to do surgery on front upper side abd remove the cyst without doing any re -rct on tooth 11&22 .i want 2nd opinion -what to do? surgery or removing tooth 22 will automatically remove cyst within it.
Answers (10)
•If teeth 11 and 22 are clinically stable and RCT is adequate, the preferred option is surgical cyst removal (apicoectomy/cyst enucleation) while preserving the teeth.
•Extracting tooth 22 alone does not guarantee complete cyst removal, as cyst lining can remain.
•Re-RCT is usually not needed unless there is clear failure of the existing root canal.
Proceed with surgery only after correlating CBCT findings clinically and plan histopathology of the removed tissue.
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There is definite radiolucency associated with 11 and 22 ,it looks like a radicular cyst irt 22 but irt 11 it is massive and needs débridement and excisional biopsy ,it could be cystic but histopathology will tell definitive diagnosis,it doesn’t look like a surgical defect as you mentioned 16 years have lapsed since it was first treated,in this long time bone healing should have taken place .
Re root canal is not required if tooth first root canal is good enough which is not very clear from X-rays provided.
Apicectomy can be done at the time of surgery.
Prognosis of 11 will depend upon the nature of the associated radiolucency ,if anything aggressive,tooth will need to be extracted.
Next Steps
Visit an Oral & Maxillofacial Surgeon for detailed treatment planning
Health Tips
Always better to see doctor/ dentist in person even for second opinion
Hope that helps !!
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Your scan shows a cyst near the root of the tooth caused by an old infection. Such cysts can stay for many years without pain. Pain can appear when pressure is applied or infection increases. If the previous root canal is still good and there is no active infection, repeat root canal may not be needed. Surgery is done to remove the cyst and clean the area while saving the tooth. Removing the tooth will also remove the cyst, but the tooth will be lost permanently. Doctors usually try to save the tooth first if possible.
For the best and proper treatment plan, it is advised to visit an Oral and Maxillofacial Surgeon .
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Well sometimes its well corrected by surgery and in some cases extraction is the only way . Considering your case , as you said you went for surgery many years back , it's best to consult a maxillofacial surgeon and let him decide weather it can be corrected by surgery once again or not .
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Hey
Surgery over extraction will be a preferred option ( if you can save the natural tooth).
Enucleation ( surgical removal of cyst) is appropriate for confirmed radicular cyst.
Success rate is 80-99%
If you extract tooth after sometime you need to place implant over there as itâs your aesthetic zone with bone grafting
Which is also a costly procedure
With surgery you can save money as well a your natural tooth
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