Hi Parminides,

Thanks for posting the x-rays!!
Sorry for the delay.... I work varied hours throughout the week so I am not able to be here all of the time. A big thank you to Chemar for guiding you through the attachment process

I will re post your questions and answer in bold type.

<<<Besides the root tip, do you see anything worrisome in the panorex, especially around the extraction site, but really anywhere in the image?>>

THE ROOT TIP WAS NOT ACTUALLY AT THE SURFACE. IT WAS CAUGHT IN HIGH UP IN THE OPEN CHANNEL WHERE THE MESIAL ROOT USE TO BE. I'M GLAD IT WAS REMOVED.
I CAN SEE THAT YOU HAVE GENERALIZED BONE LOSS THROUGHOUT YOUR DENTITION. YOU HAVE SOME OVERCROWDING/CROOKED TEETH IN THE FRONT LOWER ARCH WHICH CAUSES AN OVERLAPPING OF TEETH ON THE X-RAY MAKING IT DIFFICULT OF DISTINGUISH ONE TOOTH FROM ANOTHER. HOWEVER IT DOES LOOK LIKE YOU HAVE MODERATE BONE LOSS ASSOCIATED WITH SEVERAL OF THOSE TEETH.
YOU ALSO HAVE SOMETHING IN THE LOWER RIGHT BONE BEHIND YOUR SECOND MOLAR. LOOKS LIKE A SMALL WISDOM TOOTH THAT NEVER FORMED COMPLETELY OR A REMNANT OF A WISDOM TOOTH. HAS ANYONE MENTIONED THAT AREA TO YOU?
THE UPPER FRONT AREA HAS A LOT OF SHADOWING IN PART DUE TO SOME OVERLAPPING/CROWDING OF TEETH THERE ALSO. SO IT IS DIFFICULT TO SEE THE ANATOMY CLEARLY. HOWEVER, TOOTH #7 ...AND POSSIBLY #9 MAY HAVE SOME HEALTH ISSUES DUE TO THE SPREAD OF INFECTION FROM TOOTH #8. IT WOULD BE WISE TO HAVE A FEW PERIAPICAL X-RAYS OF THE UPPER FRONT OF YOUR MOUTH TO SEE THE BONE MORE CLEARLY. HAS ANYONE MENTIONED ANYTHING ABOUT #7 AND 9?

<<Do you see any evidence of a root or crown fracture in the first xray image, which was taken the day before the extraction? Do you see anything worrisome in that image?>>

IT APPEARS TO ME THAT THE MESIAL ROOT (ROOT TO THE LEFT OF BOTH ROOTS) WAS FRACTURED FROM THE CROWN DOWN TO THE ROOT. THERE WAS DEFINITIVE PATHOLOGY IN THE BONE SURROUNDING THE MESIAL ROOT MOVING OVER TO THE DISTAL ROOT. SO IT WAS WISE TO HAVE THAT TOOTH REMOVED.

<<<Comparing the panorex to the last image, which was taken last August, almost a year after the root tip was removed, do you think it's likely that the jawbone is clear of infection?>>>

THE MAJORITY OF THE HEALED EXTRACTION SITE HAS FILLED IN AND LOOKS PRETTY GOOD IN THE LATEST X-RAY. HOWEVER, THERE IS A SMALL DARK AREA SHAPED LIKED A HALF MOON JUST BELOW THE GUM ON THE MESIAL (LEFT) SIDE OF THE EXTRACTION SITE. I WONDER IF THIS IS A RESIDUAL POCKET OF BACTERIA??? YOU SAID YOU WERE STILL GETTING SOME DRAINAGE ON THE BUCCAL AND THAT MIGHT EXPLAIN IT.

Bryanna