Often times, a fractured tooth is a diagnosis made by excluding other possibilities such as infection. In some cases, the fracture may be identified directly under magnification while the root canal is being completed, by radiograph, or by transillumination whereby a fiberoptic light source is directed thru the tooth.
In my experience, the "crack" cannot always be identified before extraction.
Another possibility is the presence of an infection in the maxillary jaw bone adjacent to the tooth root(s). Antibiotics do not cure these infections in many cases and a procedure called apicoectomy (root surgery) is necessary to attempt to save the tooth.
The decision for Apicoectomy vs. Extraction should be may by you after consulting with a Board Certified Oral and Maxillofacial Surgeon who routinely performs these procedures. They will be able to provide you with realistic expectation and long term success probabilities.
Be advised, the apcioectomy long term success rates for tooth #14 given your history of symptoms is between 50-70%.
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation. This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
I'm sorry that I didn't have the opportunity to reply earlier. I'm not being notified when there are postings to this forum. I agree with Dr Kirsch. If you are seeing evidence of an infection on the x-ray you may be a candidate for an apicoectomy (reverse root canal). I would first check with your endodontist as a lot of them perform apicoectomies routinely. If they aren't comfortable with the procedure you can consult an oral & maxillofacial surgeon to consider that treatment. The decision on undergoing an apicoectomy versus extraction/dental implant should be made after consulting with your dentist and endodontist or oral surgeon. Good luck.
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation. This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
Thank you for your help. I feel better equipped to talk with my endodontist next appointment.