Originally Posted by Bryanna

Hi Johnbull,

Glad to hear that he took a 3D scan as that gives a multi dimensional view of the bone, sinus, etc than a routine dental xray.

The outcome of your implant surgery is dependent upon several factors but perhaps the most significant are:

1) The health of the mouth overall, teeth, gums, etc and also the reason for the teeth needing extraction is important because any long standing infection will leave a less then ideal, foot print (so to speak) in the bone. Tooth infections occur from decay, root canal therapy, abscess, periodontal disease, and certain trauma that cause the nerves to die in a tooth. When any of those circumstances become long term, meaning are able to brew for months or years, the integrity and health of the jaw bone will be affected.

2) When an infected tooth is extracted, if the dentist does not perform a thorough surgical debridement of the socket and remove all of the tooth, as well as the diseased ligament and diseased bone, the area will continue to carry some degree of the infection. Typically resulting in post operative complications when a bone graft and/or a dental implant is placed. The same goes for someone with active periodontal disease. If the disease has not been arrested, any invasive oral surgery may result in post operative complications.

3) The health of the patient is critical as well as their nutritional health and other lifestyle habits. A smoker, drug user legal or otherwise, alcohol consumption and poor eating habits all affect the oral health. There is also an increased frequency of gum disease among those with Diabetes as research shows that gum disease has the potential to affect blood glucose control. It also works the other way around in that someone with gum disease is more prone to develop Diabetes and for the same reason.

3) The oral surgery itself needs to be performed in a very sterilized manner with minimum contamination of any kind.

The bottom line is that there are many reasons for there to be post operative complications after any dental procedure including oral surgery. Most often there are combined reasons and until all of these details are discussed and a conclusion is derived, the situation will remain similar or worsen over time. It is never a good idea to ignore an oddity, like prolonged numbness, after any dental procedure.

Regarding the current bone grafted area.... whether or not it is infected, I don't know as that depends on how healthy the bone was when the implant was placed. There also has to be enough of your own healthy bone present to place bone graft material into. The holes surgically drilled into the existing bone need to be deep enough to hold the graft as the graft itself is meant to stimulate your own bone cells to grow new bone and take over the graft material. It is not something that can just be placed in shallow areas or laid on top of existing bone as it will have nothing to integrate with. Extraction sites that are 10 years old generally have receded quite a bit. Some people have thicker, denser bone than others and in those cases the loss of bone may be less than in someone who has thinner, less dense bone. Perhaps your bone is in the positive category rather than the negative..?? Did your dentist explain any of this to you at all?

The health of the opposing teeth on the lower arch can affect the fit, durability and comfort of any restorations on the upper teeth. The occlusion (bite) needs to be fitting properly to avoid excessive wear on either the top or the bottom. Sometimes this can be difficult to achieve if the opposing teeth have old worn down restorations or are compromised due to periodontal disease.

If the upper site is infected then in most cases the graft would need to be removed and the site would need to be surgically debrided. It is not an easy diagnosis to make unless there is a blatant abscess. So it is important to discuss these issues in detail with your dentist. Make sure that he is very aware of your symptoms and also aware of any other medical, nutritional or lifestyle issues that you feel can be relevant in your case.

I'm sorry I cannot help pinpoint the problem with you but the history and other factors are big issues to take into consideration. I hope I have given you enough important information to be able to discuss this situation with your dentist.

Please let us know how things are going.
Bryanna