Hi Johnbull,

Thank you for answering those questions and sharing more of your dental history.

A few more if you don't mind...

Did the dentist take a 3D scan prior to doing any of this dentistry or is he working off of 2D dental xrays only?

Regarding the recent dental implant and crown in the adjacent area to the surgical site....
When was that tooth extracted? Had that tooth been root canaled or infected? Was there any sinus involvement with that tooth or the extraction of it? How long after the extraction was the dental implant put in? How long after the implant placement was the crown put on? Has it felt numb since the extraction or since the implant placement or since the crown was put on?

Regarding the the two teeth that were extracted 10+ years ago...
What was the reason they were removed?

When a tooth is extracted there is going to be some degree of bone loss as the tooth socket does not fill up with bone to it's original height. If nothing is put into that bone to hold the height of the bone, the level of bone will continue to decline as time goes on. If there was chronic long term infection in that area of bone from an infected tooth, then it creates an even more fragile situation.

Placing a bone graft in an area of healthy jaw bone where teeth have been removed 10 years prior is a risky undertaking because there is not much if any existing bone for the graft to integrate into. There are measures that can be taken to encourage the graft to be stable but the existing bone has to be healthy, the person has to be healthy and the surgery has to be impeccable for an optimal outcome.

Placing a bone graft in an area of unhealthy jaw bone under the same (above) circumstances has very little chance of success.

The history of the teeth that were extracted is pertinent because chronic, long standing tooth infections, either from root canaled teeth ... badly decayed teeth ... or injured or fractured teeth, are capable of causing unfavorable and sometimes resistant or even permanent changes to occur in the jaw bone. These changes can result in significant bone loss ... a bone disease called Osteonecrosis in which the body is unable to rebuild new bone due to a history of reduced blood flow in that area of the bone .... or a chronic bone infection referred to as Osteomyelitis in which the long standing infection from the tooth traveled to the bone and continues to reside there.

Anytime there is extended post operative complications.... pain, numbness, swelling, etc..... the root cause of those problems need to be sought to avoid further complications. Sometimes the pre operative history gives clues to what the problems may be.

Have you informed the dentist about the numb feeling with the dental implant? What is his response?

In the lower quadrant on this same side ... what is the health of the teeth that are biting against this crowned dental implant? Are those lower teeth restored with fillings or crowns?

Bryanna