Hi N2L3,
I do have a 3rd opinion for you..... think twice before putting an implant in bone that shows a radiographic "void or pathology" in the bone. That void is most likely bacteria and/or the result of the bone graft material that was lost early on. I REMEMBER you stating "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." Now "oddly" enough.... almost a year later you still have odd sensations in that area and there is a "void" in the bone.
To say that this "undiagnosed" area of missing bone would be removed during the placement of the implant does not mean that the surrounding bone is healthy. Also, you should know that as time goes on your natural bone as well as the bone graft will recede in that area. So you do not have unlimited amount of time to have the implant placed. However, placing the implant in questionable bone is risky.
Your situation is commonly seen in cases where the extracted tooth had been chronically ill for many years. There is no way to know for certain if the bone will ever become healthy again.
The choice to wait and see or do the implant is yours. Perhaps an oral surgeon unaffiliated with either of those other dentists could give you some further insight. By any chance could you post the recent x-ray of that area?
Bryanna
Quote:
Originally Posted by N2LE
Hi Bryanna,
Checking back with an update and still very troubled by this tooth (or lack thereof to be precise). It has now been 11 months since I had it pulled and bone grafted. As I reported earlier, ever since the 4 month followup I have been plagued by sensitivity in the area of the missing tooth, to me it feels like a cavity in a tooth that isn't there. I just had my 10-month followup and x-ray and mentioned this to my perio again. The problem is the pain/sensitivity ebbs and flows, sometimes it is fine for weeks or months at a time and then it comes back. It is not pain in the sense that it is a big problem for me but rather I am concerned it is indicative of an ongoing infection and hence a sign of a bigger problem to come. At my 10-month followup I told the perio I felt it was about 99% as it hadn't bothered me in a while and sure enough 4 days later it came back unmistakeably. The perio is adamant that what I am experiencing is not due to an infection because there are no outward signs of one (no swelling/pus, gums look normal, etc). But I feel it took 10 years for my root canalled tooth to finally show symptoms of an infection so to me this is the only thing that it could be.
He (along with my regular dentist) agrees that the bone density is now sufficient to do the implant yet he won't proceed while I am experiencing these issues and is not offering me answers or solutions. I could wait another year with this big hole in my mouth and nothing could change. My regular dentist who also does implants agrees that nothing is likely to change by sitting and waiting and said he thinks the implant should be done. I am torn because I want something to happen either way and don't see how waiting could change anything but I also worry about trying to do an implant if the site is infected and having it fail.
I had a CT scan done of the area which shows a small dark area in the graft zone. My regular dentist thinks this could be the infection I am feeling but that most of that region would likely be removed during placement of the implant and that along with a course of antibiotics would clear everything up.
The perio refuses to believe this could be infection and thinks its just an area of less dense bone in that region. He says the rest of the bone would not have grown in as well if there was an infection in that area.
I feel like I am in limbo with no clear answers in sight, hoping you have a 3rd opinion to offer?
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