Dr Ishan Singh Verified

ABased on the information that a large dentigerous cyst was diagnosed during tooth extraction and there is suspicion of a pathological fracture of the maxillary floor, here is my professional view: Dentigerous cysts can grow significantly when associated with an impacted tooth, especially canines or third molars. Large cysts may cause thinning of cortical bone, expansion, and loss of structural integrity. When the cyst reaches a considerable size, pathological fracture of the maxillary floor or maxillary bone is possible, though not very common. If the surgical team is reporting this, it usually means: The bone was already extremely thin, or During surgical access, the weakened bone plate may have fractured. Important next steps: A CBCT scan is essential to evaluate: Size and extent of the cyst Actual presence of a pathological fracture Remaining bone support Proximity to sinus and surrounding structures Evaluation by Oral & Maxillofacial Surgeon (OMFS) is strongly recommended. Treatment considerations: Enucleation of the cyst is the ideal treatment if bone integrity allows. If the cyst is extremely large, marsupialization followed by enucleation may be recommended to reduce risk of fracture. If a pathological fracture is confirmed, management may include: Stabilization Sinus precautions Soft diet Possible internal fixation, depending on severity Antibiotics + decongestants if sinus involved Prognosis: With proper surgical management, healing is generally good. The maxilla has excellent blood supply; fractures heal well unless severely displaced. Red flags to monitor: Persistent nasal discharge Oro-antral communication Pain increasing after extraction Excessive swelling Difficulty in biting My Summary Opinion A large dentigerous cyst can definitely weaken maxillary bone, making a pathological fracture possible. However, the final diagnosis must rely on CBCT imaging. Most cases heal well with OMFS management, but timely intervention and proper follow-up are crucial.

AI’m really sorry to hear that you’re in so much pain. I understand how difficult tooth pain can be, but it wouldn’t be appropriate—or safe—for me to prescribe any medicines without first taking a proper medical and dental history, and examining the tooth clinically. Tooth pain can happen due to many different reasons (cavity, nerve infection, cracked tooth, gum infection, sinus issues, etc.), and each condition requires different treatment and different medication. Giving medicine without confirming the cause may delay correct treatment or even worsen the problem. I would strongly advise you to visit a dentist as soon as possible for an examination. Once the exact reason is identified, I will be able to guide you properly and safely.

ASwelling that comes and goes, occasional bleeding, and bad smell from the mouth are all signs that something underlying is infected or inflamed—this could be due to gum infection, food impaction, deep cavity, or a possible issue with the wisdom tooth. However, it is not possible or safe to give a definite diagnosis or prescribe medicines without examining the tooth and taking your medical history. These symptoms usually do not resolve permanently with medication alone. They require proper clinical treatment such as cleaning, drainage of infection, correction of gum pocket, or treating the affected tooth. What you should do now Please visit a dentist for a full check-up as soon as possible. After examining the tooth, I’ll be able to tell you exactly what treatment you need. If needed, appropriate medication will be given only after proper diagnosis, to ensure safety and correct treatment. Delaying evaluation may allow the infection to progress, so kindly schedule an appointment soon.

AHello Ravi, yes, in most cases we can place a new crown if the implant and abutment are compatible and in good condition. We'll first examine it and may need an X-ray. If everything is fine, it usually takes about 5–7 days. The cost depends on the implant system and crown type. Regards, Dr. Ishan Singh