David,
Glad you got in to see the oral surgeon and they took a ct scan.
The term fistula and sinus tract can be interchangeable. In that case it means, yes, there is a definitive opening into the sinus from the extraction site. A fistula of 6.6 mm in diameter is a good size opening. Hopefully it will heal on its own. Did he give you at home instructions of what to do and what not to do between now and next week to try an promote healing of the membrane and reduce the inflammation?
The debridement that I refer to on many posts is correlated with the actual extraction. Every time a tooth is extracted, the dentist is suppose to thoroughly debride the bone socket, remove the periodontal ligament and any disease tissue or bone that is visible clinically or radio graphically. If that debridement is not done immediately and thoroughly after the tooth is extracted, then the dead ligament can prevent or prolong complete healing. Not debriding is like leaving debris in a surgical wound.
When a sinus communication is repaired, the surgeon will debride the surgical site, the sinus and the surrounding area. The degree of that debridement depends on how well the site was debrided at the time of the extraction and if there is infection present.
The hope is that the sinus communication will close on its own. The extraction site, the gum tissue, may or may not close before the sinus opening closes. The bone will not fill in at the area of an open sinus. The sinus needs to be closed for the bone to fill in there.
With or without a sinus opening, the jaw bone normally takes up to one year after a tooth is extracted to solidify. The gum tissue closes over long before the bone solidifies.
The actual surgical repair is of the sinus membrane. However, the gum tissue and bone are involved during the repair surgery.
Bryanna
Quote:
Originally Posted by skywayd
Thank you,
I norrowed down my search for an oral surgeon to go to see today and decided on this young Portugese oral surgeon. They have a 3D CT Scanner. They were able to book me in 2 hours after I made the phone call.
He was so nice and friendly, very understanding, and gave me so much time.
Down to the nitty gritty.....He had a look in mouth and confirmed the fistula. He said no sign of infection. (relief).
CT Scan showed about one quarter sinus inflammation
Fistula is size 6.6mm x 1.9mm
His opinion to me was to give it 2 weeks to see if it heals itself. If it has not by then to go ahead with procedure to close it. He suggested using PRGF. I am reseaching this right now. Other procedure that he could do is the buccal fat flap, but he preferred the PRGF.
If I need to get it closed, something I read on one of your posts, was debridement to clean up area. Is this something they do anyway or should I ask for it?
I asked him if I do not get any improvement next week to arrange procedure to be done when I return in 2 weeks. I can sometimes be such a worryer.
Am I guessing right that its the repairing of sinus membraine that I am hoping to achieve naturally to stop communication, as it cant be the bone or the gum?
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