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tooth extraction when root is in sinus cavity

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Unread 06-16-2007, 10:25 AM   #1
Chemar
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Question tooth extraction when root is in sinus cavity

title says it all eh

Bryanna, what can one expect when this is the case?

thanks
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Unread 06-16-2007, 11:32 AM   #2
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oh no!!!

please don't tell me you have this?

i had one taken out. do want to im me about it? or pm? ( i think my extra might give you a hint )
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Unread 06-16-2007, 12:22 PM   #3
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yeppers

it is me who has it
this is the one that was so outchy

gotta decide what to do
PM, IM, post here or whatever will help me decide on this
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Unread 06-16-2007, 01:34 PM   #4
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i had mine surgicaly removed...through the roof of my mouth.

serious pain. all i could eat was baby food for weeks.

to this day i still have sinus issues. all the migrains i get...go up my nose into my eyeball. nice visual huh? getting ice...ice cream..anything real cold on my pallette...is a no no. very sensitive.

i'm sure things have changed. i was 12 when i had the surgery. i wasn't even told that this was going to happen. was just told that i was going to the dentist. being put under without my consent or knowledge was very tramatic. oh...mine was done on dec 22...i slept through christmas. had pinapple baby food food for dinner.

are they going to put in a bridge? for me...it was done to make room for my teeth. i had 4 baby..and 4 permanent teeth taken out at the same time before i got braces.
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Unread 06-16-2007, 01:46 PM   #5
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Hi Chemar,
First, don't panic. This situation is far more common than people realize. Even if a root of a tooth were not in the sinus cavity, but an infection from a tooth had spread to the sinus, there would be a perforation in the sinus membrane. A sinus infection can also perforate the sinus membrane and infect the oral cavity.

A radiograph only shows a two dimensional picture of the tooth and a skewed version of it's location near or in the sinus. The only way to tell how far it actually is into the sinus, is during the extraction.

I emphasize this heavily............ The main thing here is to have a dentist who is comfortable and very familiar with extracting teeth like this. Do not hesitate to ask how often your particular dentist deals with this situation. When it is done by someone who has alot of experience with sinus exposures and you faithfully follow their post operative instructions.... the chances of post op complications are bascially non existent.

During all extractions (especially if the tooth is infected or previously had a root canal) ........ it is imperative that the surgeon thoroughly debride the tooth socket removing the periodontal ligament and then irrigate the area with copious amounts of saline. Depending on the size and location of the sinus perforation, sometimes the sinus needs to be closed surgically and sometimes it doesn't.

Again........ an experienced surgeon and your strict compliance with post operative instructions will minimize post op complications drastically!

I hope this information was helpful to you. Feel free to ask any questions that are concerning you and I'll see if I can help. Keep us posted on how you're doing!

Bryanna

ps....... just a gentle word of advice...... be careful not to let anyone's negative experience influence your already heightened anxiety. Most people who have post op complications following this type of dental surgery: either had an incompetent surgeon; had not prepared themselves for the surgery and/or did not follow post op instructions. ~'.'~
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Unread 06-16-2007, 01:56 PM   #6
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Curious,
From what you have described, your situation is completely different than Chemar's. At 12 years old, you had either "retained" premolar baby or adult teeth that had either never come down through the gum or due to overcrowding, those teeth were coming through the palate as there was no room for them to fit into your small upper jaw.

Since Chemar is an adult, my interpretation of her post is that her tooth is fully erupted, but the root(s) may be located in or near her sinus cavity. A truly different situation and surgery altogether.

Chemar, please correct me if I have misinterpreted you ~'.'~

Bryanna
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Unread 06-16-2007, 02:51 PM   #7
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thanks Bryanna and Curious

yes, I remember you telling me that now Curious ...just didnt equate it with this so heeding all cautions and also of course your words of wisdom and experience too Bryanna

Ok, I am middle aged and this tooth broke a while ago. When I went to have it removed (I never ever ever will have a root canal again ever ever never )..........anyways, the dentist (a couple of them in a row in fact) refused to extract and all wanted to do more of the kind of work that has left my teeth in the state they are but that is another story!!
There primary reasons for not extracting was that they felt it could be "saved" (yeah right! ) and that it was "rooted in the sinus cavity"
So, as it wasnt bothering me, I have lived with it. A month ago it began to have like an itchy/burny pain and I found what I hope is a good dentist willing to extract it and others back there that should go. He has treated infection (clindamycin) and we need to start a plan of extraction now. No root canals needing out...front teeth are all fine as are some back ones

sooooooooo

there's the story
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Unread 06-16-2007, 04:38 PM   #8
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ACK. Yikes. All the best with this problem, Chemar. I'll be thinking of you.
I have a similar problem going on with one of my old molars.
can I say this here on the dental thread???........ I HATE teeth.
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Unread 06-16-2007, 05:54 PM   #9
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Chemar,
I know this is not what anyone wants to hear. Believe me, I address this very issue every day with people and I see the disappointment and fear in their expressions.

Literally, 9 out of 10 people can relate to your story. Dentists are taught to convince the patient that teeth should be "saved" irrelevant of how infected or broken down they may be. However, that word "save" simply means "retain". Root canals, apicoectomies, amputated roots do nothing to "cure" an infected tooth. Teeth start out as live body parts and once the nerve becomes infected, it rapidly spreads to other parts of the tooth called the dentin tubules which are also filled with nerve material. These tubules are microscopic, therefore, they cannot be cleaned out and antibiotics cannot kill the various strains of bacteria that develop because there is no way to culture it to know what's growing in there. The nerve material inside the tubules becomes necrotic and remains infectious. In addition to that, our teeth get their nutrition from the blood supply that circulates through the nerves, just like it does in every other part of our body. Once the nerves are severed, as they are when they are removed from the inside of the roots, the circulation stops. It is very common for people to end up with 2, 3, 4 root canaled teeth in a row as the infection has spread through the bone. Depending on the persons immune system, the infection can spread rapidly or take months to years before it shows up radiographically.

Chemar, never hesitate to question your dentist about his experience extracting teeth near or in the sinus cavity. He may be the nicest guy in the world.............. but he needs to know how to deal with a sinus perforation irrelevant of how small or large it may be. Most general dentists DO NOT know how to repair a sinus perf, nor do they have the material to repair it. It takes special training and experience to know what to do. Oral surgeons see sinus perfs all of the time, so they are ready and able to repair it.

I have seen so many "mistakes" because the patient didn't question the dentist and because the dentist didn't want to offer to refer them out for fear of losing the patient for restorative work. Please make sure you ask what his experience is with sinus perforations and how he would handle it.

I know this is scary........ I realy do. But in the right hands, you will be fine!!

Bryanna
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Unread 06-16-2007, 06:10 PM   #10
shiney sue
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I'm going through this now i'm 60,have Micro Valve Prolapse,and
Sjogren's Syndrone,so all infection must be taken care of before
anything can be decided. And i'm in fear of Dentist's in a big way.
Lot's of dental problems with Sjogren's indeed. Sue
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