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Dr. Behere
Dr. Behere, Dentist
Category: Dental
Satisfied Customers: 2844
Experience:  Masters degree, years of experience with all kinds of dental problems.
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I'm a 23 year old male from India. I have been going through

Customer Question

Hi,
I'm a 23 year old male from India. I have been going through a periapical cyst nightmare for past 7 years, possibly longer.
I've been told its cause is the trauma (suffered severe blows to the mouth as kid of 6-10 years, twice).
Back in 2008, first time, i went under root canals involving few lower teeth and right 1 & 2 in upper jaw. Eventually surgery was performed to remove a cyst above right 1 & 2.
Post that by 2009, we noticed an reoccurrence and saw a different dentist this time, who informed that previously RC's had not been done properly, which has resulted forming of infection again. However, due to negligence on my part, nothing was done about it until 2013 December. By then infection had spread significantly and had involved right 1 & 2 and left 1 & 2 in lower jaw, and right 1 & 2 in upper jaw. Root canals was formed in the aforementioned teeths and two cysts of 3mm and 1mm were removed from lower and upper jaw respectively.
However, by next year, Jan 2015, an abscess was seen again in the gum region above 1 & 2 right upper jaw and it thought to be a minor infection in the huge healing area and it was drained through a minor procedure on LA, in-vainly, as within next few months an abscess was noticed again in the same region. X-ray confirms formation of infection again in the upper jaw. Since there is no abscess, we did not investigate yet, if there's reoccurrence in the lower jaw also.
Now, my current dentist, who was involved in the past two procedures suggest we eliminate the problem by extracting right 2 from upper jaw and see if that helps, before taking a call on extracting right 1 from upper jaw. Second opinion from a different dentist was to perform episiotomy again in the upper jaw.
Your thoughts?
Should you require, i can upload screenshots of by CBCT and X-rays for your reference.
My general health is decent, with no conditions.
Submitted: 2 years ago.
Category: Dental
Customer: replied 2 years ago.
Something to add more, a biopsy was also performed on cysts after the big surgery last year and no malignant elements were found
Expert:  Dr. Phil, MD replied 2 years ago.
any other medical issues?
Customer: replied 2 years ago.
Nope
Expert:  Dr. Phil, MD replied 2 years ago.
This is out of my knowledge base. I will opt out
Customer: replied 2 years ago.
what about the fees i paid?
Expert:  Dr. Behere replied 2 years ago.

Hello,

Thanks for putting up your question on Just Answer.

First of all, please don't worry about your fees. This is a genuine site, no scam. The expert who has opted out, is not a dentist. Seeing that your question was beyond the scope of his knowledge base, he has simply opted out, leaving your question open for other experts to answer.

I will attempt to answer your question (I am a dentist).

Ive read your question completely, and as I understand , you have been given two choices:

  • Extraction
  • Apicoectomy

In any other tooth, I would always recommend attempting to save the tooth (conservative approach) by apicoectomy. However, based on your history, the tooth has already undergone one cyst removal procedure and one root canal. Yet, there have been repeated re-infections. I would therefore peg the prognosis of this tooth as "poor".

Moreover, your original dentist who had been involved with both the earlier procedures is recommending the extraction. He would know the local factors related to that tooth better than the new dentist.

Even without looking at the images, based on my personal experience with such cases, I would prefer going with the extraction.

Hope this answers your question. Feel free to contact me again for more information. Please leave a positive rating for me if this answer has helped you. I do not get credit for it otherwise.

Good Luck !

Regards,
Dr. Behere