Hi Ori,,
Thanks for posting the xrays.
Inflammation yes...but both of these molars are infected.
Tooth #2, the last molar, is decayed/diseased inside of the tooth where the post has perforated the furcation. Tooth #3, the first molar, two out of the three roots have areas of pathology at the apex... the center root has a large post and appears to be decayed/diseased at the furcation.
Apicos will not alter or cure the infection in either of these teeth. An apico is not really a less invasive procedure than an extraction when you think about how it causes additional inflammation and infection in that already compromised area of bone. Making the extractions and replacement of these teeth more complicated. Bone grafting may or may not be advisable at the time of extractions if the bone cannot be cleaned up completely. The surgeon would have to determine that at that time.
Regarding the bone graft material... depends on whether you want to use a synthetic graft or one that was derived from an animal or cadaver.
Regarding replacement of these teeth... you are not a candidate for a permanent bridge because you would have no anchor tooth in the back. Implants are risky when replacing root canaled teeth.. so it would depend on the health and thickness of the bone after the site healed. You may be a candidate for a removable partial denture... are you missing any teeth on the upper left side?
Bryanna
Quote:
Originally Posted by Ori1
Dear Bryanna,
You asked me about my background... I have a good teacher, YOU!!! Almost everything that I have learned up to now is from you, thanxs!!! I read a lot of your answers and advice to people that where or are in a similar situation as myself.
I hope you are here for me because I still need your help.
This is where I am holding. I went and saw two oral surgeons. 0ne was a #8 on a scale of 1 to 10 and the other ??? The 8 is a maybe. he said that I have inflammation and it is not an active infection??? I told him I really want to extract the tooth. He feels that that is way too evasive and think that the best thing for me to do is apicoectomy. He said for him extraction and cleaning out the socket is much easier for him to do and his price for that is 1/3 the price of an apico if I do not need a bone Graft and double the appt. time. He says his concentration for the apico is really intense. He goes in through the gum and cleans it out and cut the top of the apex and seals it. He said if he go in and he feels it needs to be pulled he will do it on the spot. His opinion is, less evasive is the key. Bridges or implants also have pros and cons. At the end of the day he says it is my call. he e-mailed me what types of bone grafting material he uses and his price, collagen based bone filling augmentation material and or collagen of spongious bone granulate and 10% porcine collagen fibres. What are your thoughts on these materials and also his price for the grafting at the time of either procedures if it is needed is a little less then double the cost of the extraction, it seem a little high, what are your thoughts???
I am going to attach a x-ray from around 2 weeks ago. Maybe you could tell me your thoughts???
Sincerely Yours,
Ori
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