Hi annanut,
I understand the dilemma that you have. Is he a Biological Dentist or Holistic Dentist? Generally these dentists are well versed in the need to thoroughly debride the oral socket after the tooth is removed. However, I do have some concern that he may have been too conservative with the debridement as his priority may have been to preserve the bone..... which is okay in many circumstances but at the very same time diseased bone cannot be preserved. He may have rushed into placing the graft and again some dentists do that so the patient does not have to come back for a second surgery. The problem again lies with the fact that a bone graft cannot integrate with diseased bone. So the real priority is to be as certain as possible that the bone was scraped clear of visible disease.
If you developed a dry socket with the bone graft in place then that indicates that the blood clot was either dislodged or did not form properly. Again indicating that the socket may not have been "ready" to receive the graft. The bone graft will not heal the socket if it is infected and the graft will not integrate with diseased bone.
So you need to have the site clinically evaluated along with an xray to see if the graft is still present. A healthy bony socket with a bone graft takes months to heal and up to one full year for the graft to integrate completely with your own bone. If infection in present then the site will not heal properly, new bone will not grow enough to allow the graft to integrate with the jaw bone.
Bryanna
Quote:
Originally Posted by annanut
Thanks so much for your thoughts. MY dentist, I sought out soecifically for his surgical experience and holisimtic knowledge of these situations. He ensures me he debrided all the infection, (as I asked about waiting on the bone graft). Yet he also mentioned "preserving as much bone as possible" which makes me wonder if he realllllly got it all.
Its going to be my concerns vs his certainty I think. I think this is infection, maybe with a dash of dry socket. My concern is he'll just treat dry socket and send me off to have an infection explode as aoon as my ammox run is over (two days left).
Should I insist on removing the graft? Is there a way to locally treat the graft
For infection without removal? Ugh. He is two hours away, I guess I might have to settle for someone closer but without holistic angle if Ill need more and nore appts. (There are non around here)
Ugh, Ill keep you posted. Thanks so much for your reply. Are there any "key" differences that coukd prove infe tion vs just dry socket?
QUOTE=Bryanna;1132797]Hi annanut,
Thank you for posting the picture.
Yes, it appears that you have an infection. Based on your description of the history of these teeth, the infection that was brewing in your jaw bone was severe. Therefore, removing the teeth was the first step in a process of removing the infection and healing. The jaw bone area needed to be thoroughly debrided of all visibly diseased tissue and bone once the teeth were removed. The bone graft should have only been placed if after the debridement the existing bone was found to be healthy. Otherwise, the sites should have been debrided, irrigated with saline, sutured and left to heal for a few weeks or so before a second surgery was done to place graft material.
When a surgical site of an infected root canaled tooth is not thoroughly debrided and the bone graft is placed too soon, the infectious bacteria still residing in the jaw bone and tissue will take over the graft and the infection will become more virulent. This may be what is happening with your case.
Did you see a general dentist or an oral surgeon for the extractions?
FYI... Your oral surgery should have been done by an oral surgeon due to the longevity and severity of the infection because these are the dentists who are the most knowledgeable and experienced in dealing with cases such as yours. If you went to a general dentist for the extractions, it is still best to see an oral surgeon for the existing situation. If you choose to see the oral surgeon, it is important to bring your pre operative xrays to that appointment.
I'm sorry you are enduring such pain and complications. I really hope you get the proper help you need to take care of this. Please keep us posted.
Bryanna
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