Hi sbbi,
To answer the question about preserving the socket after an extraction....
For proper healing purposes with all tooth extractions, the socket should always be thoroughly debrided/scraped and irrigated with saline after an extraction to remove the periodontal ligament and any necrotic infected bone. This is also the first step to socket preservation.
If the bone looks healthy after all of that debridement and there is no sinus perforation, then the second step would be to pack in bone graft material and place a collagen plug over that to protect and encourage the formation of a healthy blood clot. Then the area is sutured to keep debris out as well as to help hold the graft and plug in.
Some issues that can occur with some root canaled teeth when they are extracted which may not make it favorable to do bone grafting at that same appointment......
The jawbone surrounding a root canaled tooth is typically necrotic due to the chronic infection in the tooth. It can also have some residual pieces of gutta percha, filling material, or debris in the bone that was pushed out of the apex during the root canal procedure which creates some inflammation and irritation that sometimes needs to heal before placing the graft.
If the site is not favorable to receive the graft, then the socket is debrided thoroughly and a second surgery is done a few weeks or so later to place the graft and collagen.
If the graft is placed in necrotic bone, it will become infected and/or fail. So it can only be determined at the time of the extraction as to whether or not the graft can be done at that time.
It is wise to be on an antibiotic before, during and after the extraction of this tooth because it is infected and the antibiotic will help to reduce the inflammation from the infection and then help to heal the surgical site.
With regard to a sinus exposure....
The dentist will not know how close to the sinus it is until he extracts the tooth. There is nothing you can do to minimize the exposure... your anatomy is what it is. I would ask him to tell you if there is an exposure, how large it is, how or if he plans on closing it and make sure you follow the post operative protocol given to you to the "T".
I'm here if you have other questions....
Bryanna
Quote:
Originally Posted by sbbi
Hi Bryanna,
To be fair, my periodontist suggested extraction. And we did plan to have socket preservation right after extraction in order for future implant. (because he did not see crack, he did not extract the tooth.) Do you think socket preservation is required for my case? If so, I read you said socket preservation should be done after the infection is gone. But I was also told I can start taking antibiotics several days before the extraction so dentist can do the socket preservation right after extraction.
What should I ask my periodontist about sinus exposure? What should I do to minimize its risks?
Thank you a lot!
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