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Originally posted by deportes
Very nice of you to answer all this questions. I've had a root canal done 10 years ago on number 19. Once in a while the tooth aches and I went to the oral surgeon and he said that it may be broken under the crown. I have a very small infection on the root tip. I haven't had it pulled but I'm wondering how long and what damage is causing to have the low level infction going on, it's not going away.
I don't want to loose a tooth,
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Like your oral surgeon said, it's possib;e that the tooth is cracked under the crown. This can cause lingering pain that really won't go away (especially seeing that having a crown on top hasn't stopped it). If you want to go all out to save the tooth, you could try removing the crown to see how big the crack is and if it can be fixed.
But since you say that there is a chronic infection going on at the tip, the pain could easily be related to that and not a crack. The question is whether it is really an infection or scar tissue left over from the original root canal.
Looking at X-rays from a year or 2 or more ago will tell you if the "infection" at the end of the root is worsening or if it hasn't changed. If worsening, it's robably causing the pain. If not, could be a crack.
If it is an infection that's reappeared then you have 2 options: 1) have a surgical root canal where they go in from the gums directly to the root tip. 2) extract the tooth and get an implant. Believe it or not, most of the literature shows that implants have a higher rate of success. The conservative (and potentially costly) way to go would be to see if the root canal surgery works and have the implant as a backup plan.