Are resorbed roots painful?

by Dee
(Lehigh Valley, PA USA)


In recent imaging, resorbed root was noted on tooth that is anchor to a Maryland bridge (#9 and #11 hold the #10 pontic) and endo "thinks" he could do root canal and somehow arrest the situation with an apico type access. Have had pain in this area since root canal/failed implant/etc., so likely a neuropathic component. Can the resorption be stopped? Can it cause pain? Is the endo procedure a reasonable "try" for some resolution or is this tooth fatal?

Reply:

Hi Dee, I'm sorry you are having pain. I'm not a dentist but I have seen a few cases of resorption.

Most likely the tooth is resorbing because of the extra biting force that comes from there being a Maryland bridge. (assuming you have lower teeth and are using these teeth when you chew) I'm sure you know that this type of bridge is not ideal because it stresses the anchor tooth/teeth, but probably was your only non-removable option
if your implant failed. With some of your other teeth missing this area is used more than it should be and stressed even further.

I'm not knowledgeable enough to give you an opinion but here are some questions to ask your dentist or endodontist.

Is the resorption is stable or is it progressing? You would need a previous X-ray to know that. That should be available given the history.

Resorption doesn't always cause pain. The cases I've seen have not been painful and were only noticed because they were seen on an X-ray. They are often asymptomatic in the early stages.

Is your pain caused by trauma (from chewing) and the extra torque from the bridge?

If you have a root canal and apico, the pain could be cured but the tooth would still be under too much chewing stress. The root would be weaker and more brittle after a root canal and more likely to crack and the tooth would be lost.

If the Maryland bridge is stressing the tooth and causing resorption, should the pontic be removed and replaced with a partial? Partials are not anyone's first choice but in some cases make sense and in your case might help to ease the chewing load on your from teeth.

A root canal and apicoectomy are quite an investment of time and money if you are not sure of the outcome.

If you feel unsure a second opinion is worthwhile. Maybe a consult with a restorative dentist would be good as well.
Thanks for writing,
Shelly

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