Why You Should Not Ignore Inflammation Around a Tooth That Has Had Root Canal Treatment (Implants After Extraction)

Hello.

I am Kim Tae-young, the head doctor of Barun Young Dental Clinic in Geumho-dong, and I personally treat the cases I introduce here.

When teeth that underwent root canal treatment a long time ago are used for many years, inflammation sometimes develops around the root of the treated tooth, causing the bone around the tooth to dissolve and, as a result, the tooth to become mobile.

The root canal treatment we commonly know—also called endodontic treatment—does not allow you to feel temperature stimuli or pain, except for proprioception.

Because of that, unless periodontal disease or cavities progress for a long time, most people do not notice symptoms. When the bone around the tooth is resorbed and extraction becomes necessary, the first treatment option is an implant. At that time, if the surrounding bone where the implant will be placed has been resorbed, bone grafting must be performed together.

Today, let’s look at two similar cases.

I had a toothache for a long time, but I was too scared to come in.

The patient had lost several molars, and several teeth were loose due to periodontitis, but because of fear of dental treatment, they endured it by taking medication until the pain could no longer be controlled, and then came to the clinic. The marked area in the photo had previously undergone root canal treatment, and inflammation had developed around it, resorbing the bone that supports the tooth and causing tooth mobility.

The diagnosis showed that extraction was necessary, but because the patient was afraid of dental treatment, we decided to proceed while controlling pain as much as possible. We began treatment after local anesthesia, using anesthetic cream and a painless anesthesia device to minimize discomfort.

After extraction, an implant should be placed immediately. However, the area indicated by the arrow had been resorbed due to inflammation, so even if an implant were placed, there was no surrounding bone, meaning it would inevitably be exposed.

If the gum in the extraction site is incised and surgery is performed, it can help secure the surgical field. However, when bone grafting is performed, the fixation strength of the graft material at the surgical site weakens, and resorption of the remaining alveolar bone may occur. So, to maximize the success rate of the bone graft, we performed the surgery without making a gum incision.

These are photos after waiting for the graft material to harden sufficiently and completing the prosthetic restoration. Fortunately, about 4 months after surgery, a 3D CT scan confirmed that bone appearing white around the implant had formed. Even in the full photo taken one year later, there do not appear to be any special problems.

Although the patient had to wait a little longer than other patients after implant surgery, they followed through well, and we achieved a good result. The patient also said that the treatment was more manageable than they had feared and regretted not coming to the dentist sooner for care. Still, they overcame their dental phobia, and we decided to proceed with treatment on the opposite side as well. At present, the painful area has been resolved, but because the patient is busy, the timing for treatment on the opposite side has been delayed.^^;

A previously root-canal-treated tooth is loose and inflamed. Here are photos of the second patient.

This is a case similar to the first patient. This time, the patient had received bridge treatment using root-canal-treated teeth. There was an implant nearby with strong chewing force, and because the patient generally had a strong bite, the root of the tooth in front of the implant fractured and inflammation developed inside. In the intraoral photo, the gum around that tooth showed repeated inflammation that would appear and then subside.

Again, on the initial 3D CT scan, the bone forming one wall around the tooth had been resorbed, exposing the tooth root. In this case as well, for immediate implant placement after extraction, bone grafting was performed using the existing gum as a barrier membrane.

This photo was taken 4 months after surgery. White bone formation could be seen around the implant. The fixation evaluation between the bone and implant also showed good values, so prosthetic treatment was completed.

This is a photo from a recent visit. Among the bridge teeth, the front tooth was preserved by remaking the prosthesis without extraction, and implants were placed in the two spaces behind it. In this patient’s case, they have continued to come in for regular checkups and have been using the restoration well for the past two years.

Root-canal-treated teeth are vulnerable to cracks or root inflammation When root canal treatment is performed, the vitality inside the tooth root is lost, making it vulnerable to reinfection and weakening its resistance to fracture. Not all teeth develop these symptoms after root canal treatment, but it can vary depending on chewing habits and the occlusal condition of each tooth.

Even if implant surgery goes well and restores solid bone, you still need to maintain implant care, prevent and manage peri-implantitis, and maintain good oral health.

Today, I explained the symptoms that can occur in root-canal-treated teeth. If you are experiencing similar symptoms or have any discomfort, I recommend visiting a nearby dental clinic for an examination. Thank you.^^

▼Other case studies worth reading together

I believe proper treatment creates proper results. For everyone who visits us with worries, my wish is to create a trustworthy dental clinic where you can leave feeling reassured.

• Barun Young Dental Clinic

Directions

2nd Floor, JYJ Building, 179 Dongho-ro Right in front of Exit 6, Yaksu Station toward Yaksu Market Village Bus No. 5 (Yaksu Station) Village Bus No. 12 (Namsan Town, Yaksu Police Box) Bus stops (Yaksu Heights, Sindang Social Welfare Center, Gaon Library, Geumho Tunnel Entrance) Use the direction from Yoo Yoo Pharmaceutical toward Geumho Station

This post was written directly by Barun Young Dental Clinic in compliance with the purpose of providing medical information and hospital advertising (Article 56, Paragraph 1 of the Medical Service Act). These photos were taken of individual patients, and after treatment/procedure, results may vary by individual, and side effects (loss of prosthetics, pain) may occur. Please consult thoroughly with the medical staff in charge before making a decision.