Hello everyone. Our patient desrcribes pain at right upper premolar area when chewing and with cold and she says it started after the implant prosthesis delivered about 6 months ago. Can the thin bone at the apex area be main reason of it? Or do you see anytihing else wrong? I also referred to endodontist about suspicious second premolar because of the deep filling and endodontist said second premolar is indicated to have root canal therapy. And we are waiting for the treatment(endo) day
usually if implant has pain, its usually soft tissue related. such as mostly mucosal tissue and not enough keratinized tissue around the implant (assuming implant is stable). did you perform vitality/sensitivity test of adjacent teeth? the CT looks fine. i think you will probably have to rely on clinical exam to resolve pt’s symptoms. good luck.
2nd premolar is the problem, requires endo.
I think it is just a coincidence that an implant happens to be adjacent to the affected tooth. Endo on the second premolar should solve the problem.