Root canal + crown sensitive

[thefifthbeatle]

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I've always learned having a root canal (done correctly, and not missing accessory canals) essentially makes the tooth "inert" and leaves it with no feeling.

Can a RCT tooth (with no periapical activity) with a PFM crown (with open margins and caries detected with an explorer) give a patient sensitivity, similar to irreversible pulpitis? Is a re-treat the next step? Remember, no PA activity. Or just a REM-DEC procedure, re-prep, provisionalize and new PFM crown.

I'm very interested in knowing this....thanks!

 

[puncho]

Could have missed a canal or tooth could be cracked.

 

[omaralt]

was the RCT done recently? if so, many teeth remain sensitive for a few days, maybe even weeks. sometimes you may instrument past the canal, and the PDL is inflammed. if the RCT was done recently Rx motrin 800 and re-schedule in 1-2 weeks. if it wasnt done recently, there is either missed anatomy, cracked tooth, or referred pain from another area. good luck

 

[sokrman14]

It could be referred pain, cracked tooth, or PDL inflammation. Any of those could cause pain/discomfort if the RCT was properly done.

 

[Mackchops]

Sensitivity to...??? Perc? Palp? Cold? Heat?

If the crown is new I'd check the occlusion. Then I'd consider a fracture. Then I'd consider retreat -- prob missed a canal.

 

[shwan]

but why would an endodontically treated tooth with a crack cause symptoms similar to irreversible pulpitis ?

 

[Mackchops]

but why would an endodontically treated tooth with a crack cause symptoms similar to irreversible pulpitis ?

RCT removes vitality from the PULP but not the PDL. A fracture causes inflammation to the PDL which causes discomfort, pain, deep probe depths... etc...

 

[shwan]

RCT removes vitality from the PULP but not the PDL. A fracture causes inflammation to the PDL which causes discomfort, pain, deep probe depths... etc...

I understand that. But still it will not be sensitive to heat and cold which the most important feature of pulpitis.