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Different Endo opinions. Do I need RCT?
My symptoms are,severe burning sore pain in the lower jaw under earlobe and on the side of the neck since may. Mild Swelling in the lower jaw and neck. I have small pea size lump on the neck along with mild swelling. Sore ear pain with mild swelling.i went to ENT and no Infection in ear and sinus. I went to dentist and no infection in any tooth. He told me to extract upper wisdom tooth and I did that 2 months back and same symptoms still. dentist said I might have tooth fracture on lower first molar and told me to RCT or extract it. But crack is not visible on x-ray and cbct scan. I went to the Endodontist. He said no fracture, but tooth is little cold sensitive. I had sore pain for 20secs after cold spray test. Tender and sensitivity to bite on one spot on that tooth.so he said to do RCT. I went for second Endo opinion. He said tooth is healthy and not RCT required. It's kind of confusing if I need RCT or not. How to know if I have a crack, fracture or root fracture? should I try RCT?
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Based on your tooth radiograph, there seems to be radiolucency (decay) in the the back most tooth.  It has some radiolucency reaching pulpal horn of the tooth indicative of your symptoms.  Still a clinical examination needed to be affirmative. If you are confused about going ahead with RCT, I would suggest to go for direct pulp capping of the tooth under LA. Basically the decayed exposed part of the pulp horn is lined with a base to protect against any temperature change and on that tooth filling is done.  Then this filling is reviewed and followed up over a period of time like one to two weeks.  If no pain, you are safe and happy with filling.  If pain, you will know you require Root canal treatment for that tooth.
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I can understand the confusion you are going through as different people will have different opinions.  the best judgement is your symptoms and discomfort.  if the pain and sensitivity is too high even to normal water, then surely go with RCT.  if there is tenderness on tapping the tooth, again RCT.  If not, the above mentioned filling and then follow up can be line of treatment.
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don't delay treatment.
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It appears from the medical and dental history that you have shared, that there is some infection in the mouth or neck. The radiograph that you have shared shows almost normal features. In such a situation a thorough review is required. A cracked tooth may not be visible on a radiograph / CBCT always.
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Please consult once again with proper physical examination. online consultation may be futile.
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If the symptoms are reducing, just keep a watch. In case there is no let up in the swelling, plz consult a well reviewed dentist.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.