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Tooth and Zygomatic pain
Rct done 9 years back.
Left upper 1st molar.
Intermittent pain in that tooth from over one year but not all times.
Zygomatic area pain sometime.
Sometime in morning beside nose.(recently)
OPG done
Findings:
• Endodontically restored 26.
• Bilateral condylar and coronoid process appear normal.
• Generalised bone mineralisation and trabecular pattern appear normal.
If re rct done - same problem can persist internally?
extraction will be teer for this case?
What should my next steps?
Hello,
Thank you for sharing your history and OPG. Based on your report and symptoms (intermittent pain in upper left first molar and occasional zygomatic/facial discomfort):
𦷠Clinical Insight:
Tooth 26 (upper left first molar) appears root canal treated.
Intermittent pain and radiating discomfort in the zygomatic and paranasal region may indicate:
A chronic periapical lesion
A missed/untreated canal
Or a microleakage/failure of the previous RCT.
Next Steps
CBCT scan is highly recommended for 3D evaluation â helps detect: Hidden periapical pathology Missed MB2 canals (very common in maxillary molars) Extent of bone involvement near the sinus Re-RCT (retreatment) is a good first-line approach if the tooth is restorable and firm. If there's structural loss or persistent infection, extraction followed by implant may be considered.
Health Tips
Do not extract the tooth hastily. Re-RCT has a good success rate with proper technique and modern tools. Delaying treatment may lead to sinus involvement or chronic facial pain. âï¸ Suggested Plan: Visit an endodontist for CBCT and clinical re-evaluation. If re-RCT is advised, follow through with crown replacement afterward. Avoid chewing hard on that side until treatment is complete.
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Hi! Your OPG shows an old RCT in tooth 26. Since you're having recurring pain and zygomatic discomfort, a CBCT scan is advised to check for any hidden infection or lesion. Based on findings, either re-RCT or extraction with replacement (like implant) can be planned!
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