A sixty year old lady complaining of pain on her upper right second molar, was referred to me for RCT/retreatment . After dismantling the crown, the missed disto-buccal canal was negotiated. Cleaning and shaping were carried out and dressed with CaOH for two weeks. During her second visit, a small perforation near the MB canal orifice was discovered and repaired with mineral trioxide, and canals obturated.
However, the patient still complained of the tingling sensation. I was suspecting other teeth on quadrant one and four. Three months later, the upper second molar showed normal probings, normal responses to palpation and percussion. Peri-apical radiograph showed periapical lesion at palatal root has disappeared. A month later, her facial pain became more intense. She described the pain to be like "fire-burning" that lasted less than two minutes when she washed her face in the morning and when she drank soup. I also realised that she was partially edentulous on quadrant one and four, whereas all her teeth were still intact at quadrant two and three. I diagnosed trigeminal neuralgia.
She went to a maxillofacial surgeon for a second opinion and started her on Tegretol. Her pain is gone since then!
