Hi N2LE,

Nice to hear from you!

Something you wrote is very concerning to me. You wrote:
"I know I lost a good chunk of graft material post-op with the infection causing it to ooze out, but because of the sensitivity I sometimes feel in the area I am convinced the infection is still present."

1) If the bone was visibly infected much beyond the tooth itself at the time the tooth was removed, the bone graft should not have been put in. The surgical site should have been debrided (scraped) very thoroughly, irrigated with copious amounts of saline and then sutured closed. Antibiotics would be prescribed for a minimum of 10 days and perhaps another course or two after that. The reason being is that the graft material would not be able to integrate properly with bone that has an active infection. The antibiotic would not be as effective in killing the bacteria in the bone as it would be if the graft were not there to interfere. The site would be monitored for several weeks to a few months and if the infection appeared to be gone, then a second surgery would be done to add the graft material.

2) When a bone graft is done, excess material is placed in the socket to allow for some normal leakage as the site heals closed. However, the leakage should be minimal at best. If infection is the reason the graft was coming out, that indicates that the site was not healthy enough to receive it.

Your questions.... my answers in bold type.

<<<1. If the area is still infected (even though no obvious outward signs) will taking MORE antibiotics fix this or is it unlikely? I already took 2 back to back courses post-extraction which should have done the job>>>

IT IS UNLIKELY THAT ANTIBIOTICS WILL CURE THIS SITE IF THE INFECTION IS FROM THE ORIGINAL PROBLEM THAT WAS NOT TAKEN CARE OF PRIOR TO THE PLACEMENT OF THE GRAFT. TAKING SEVERAL COURSES OF ANTIBIOTICS POST OP WOULD BE EFFECTIVE IF THE GRAFT HAD NOT BEEN PLACED. THIS IS ALL CONTINGENT UPON THE NOTION THAT THE SURGICAL SITE WAS UNHEALTHY AND THE GRAFT INTERFERED WITH THE HEALING.

2. If the bine density isn't sufficeinet in 10 months time what are my options then?

THE OPTIONS REALLY DEPEND ON WHAT THE RADIO GRAPHS SHOW. IF THE BONE APPEARS LESS THAN IDEAL MEANING IT HAS NOT FILLED IN SOLID OR ADEQUATELY FROM THE GRAFT.... THEN PLACING AN IMPLANT INTO THAT BONE IS VERY RISKY BECAUSE YOU COULD BE LEFT WITH RECESSION AROUND THE IMPLANT LEADING TO POCKETING AND THE DEVELOPMENT OF INFECTION AND/OR IMPLANT FAILURE. PLACING GRAFT MATERIAL AROUND THE IMPLANT DURING THE IMPLANT SURGERY WOULD ONLY BE BENEFICIAL IF THE BONE WERE HEALTHY ENOUGH TO ACCEPT IT.

IN A HEALTHY SCENARIO AT 1O MONTHS POST OP, THE BONE WOULD LOOK SOLID AND 90%+ HEALED. PLACING THE IMPLANT WOULD BE SIMILAR TO PLACING IT IN HEALTHY VIRGIN BONE. SOMETIMES A "LITTLE" GRAFT MATERIAL IS PLACED ALONG WITH THE IMPLANT WHICH IS OKAY SO LONG AS THE BONE IS HEALTHY.

I'm sorry the options are what they are....... I think the issue here is whether or not the bone is healthy.

Please check back with us....
Bryanna