HI Bryanna,
As always your quick responses and opinion are appreciated. My gut agrees with you, I don't like the idea of doing the implant giving the way the area feels but also think sitting around and waiting for something to change won't help matters. I am wanting to go see someone for a 3rd opinion.
For sure the site was infected when the graft went in, the perio admitted they can only hope to get out 95-99% of the bacteria when they debribe and I didn't know at the time that it is best to wait to put the graft in. I am also aware that the bone will start to resorb after a while so what are my options?
Is it best to get the graft removed and the area debrided again using the CT scan as a guide to remove the dark areas? I can't see another option at this point. Do I choose another perio or an oral surgeon or does it matter? Should I be looking for a biological dentist, not knowing if they specialize in implants or not. I trust my perios surgical skills, he is highly ranked and respected but can't comprehend how he refuses to acknowledge the possibility of infection persisiting in the area. Here are my x-rays, 4month, 7 month and 10 month. I sadly don't have the CT scan slices but to me these really show the dark area more clearly than the x-rays.
Quote:
Originally Posted by Bryanna
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
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