Parminindes,
I think you definitely have something going on there. Whether it is bone and/or tissue related... that is hard to tell. It is a good sign that the bone appears to have filled in since the removal of the tooth. However, dental xrays are only 2 dimensional so if the film were angled differently the area may or may not take on the same radio-graphic appearance.
I would not opt for an open flap procedure there as that could compromise the integrity of the oral tissue and cause severe gum line recession. What you might look into is a laser procedure called LANAP. This requires no cutting of the tissue with a scalpel so there is no trauma to the oral tissue. The laser is used in the sulcus between the tooth and the gum. It is so precise as it kills the bad bacteria and restores the health of the good tissue.
Do you have periodontal disease? Have you consulted with a periodontist about this area or others? Have you had any form of periodontal treatment?
You mentioned getting a denture to replace tooth #8. Are you missing other teeth in your maxillary arch that you are hoping to replace with this denture?
I would like to see those xrays so keep posting
)
Bryanna
Quote:
Originally Posted by parminides
Thank you for your quick reply.
As for #8, I'll probably get a denture! One reason is the pre-existing bone loss makes it a very questionable candidate for an implant. I don't want to spend all that money if there's very little chance of success.
I wish that I could have attached the xray from the endodontist and the panorex from the second dentist. I would love to see what you think. But I'm brand new to this forum, and I apparently must have 10 posts before I can attach files or put links in my message. (Only 8 more to go after this one!)
You might not want to spend much time on my case since it seems resolved. I can understand that. You seem to be on the forum to help people. When I said I was fine, it's not quite so simple. I meant that all the infection seems to be out of the bone. But I'm still draining slightly from the buccal gums, almost a year and a half after the extraction.
For many months I would have bet a lot of money that I had osteomyelitis. Not anymore. I had my teeth cleaned in August, and an xray showed that the root channels had completetly filled in. That image convinced me that this remant drainage must be confined to the gums. So that's the long version of "I seem to be fine now."
I think I have a small, chronic, periodontal abscess. The place that cleaned my teeth in August didn't get the full history, because I've found that no one wants to jump into someone else's medical error, followed by unending complications.
The dentist I saw in August said that this kind of thing could take years to resolve or might never go away. He didn't call it a periodontal abscess or anything. He said he could do a gingival curettage or an open flap debridement that might help.
I was reluctant to go through with either procedure since he might have recommended something completely different if he'd known about the root tip. All he knew was that the tooth had been pulled almost a year and a half ago, and I still have drainage.
You don't know the full history either, but you know about the root tip that lurked in my jaw for four months. Something else that might be pertinent is that I've been on antibiotics five different times since the tooth was pulled. Three times before the root tip was removed and two times afterward (the last course was in January).
Do you think a gingival curettage and/or an open flap debridement would be the best thing to try to finally knock out the lingering drainage? If not, what would you recommend?
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