Hi asmitty,
First let me clarify that irrelevant of how well or how poorly done the original root canal was done on tooth #14... the tooth has been ill for at least 4 years. Root canal therapy cannot cure an infection or make a tooth healthy again. The procedure is done to allow the patient to retain their tooth.... not cure the infection. I just thought you should know that because it means that you have had a chronic infection in your tooth and jawbone for at least 4 years. So this may correlate with your ill health. Check out this tooth and meridian chart... it's been around for centuries. See if anything rings a bell...
http://toothbody.com/wp-content/uplo...v2.1_rehme.swf
You stated...
<<<Last year, the gum above the tooth was found to be abscessed and a fistula had formed and periodically drained. Eight months ago I had the root canal retreated and it was found that two roots had not been properly removed the first time around.>>>
The gum above the tooth was infected but only because the infection had spread through the bone to the gum and the fistula is the point of exit or relief from the pressure of the infection. Just so you understand, it was not a gum infection.. it was an abscessed tooth. The infection had been present for 4 yrs but the abscess was draining for 8 months so it is not surprising that you have a systemic infection as indicative of your blood work.
It may not be wise to do a bone graft at this point simply because you are dealing with systemic issues and the graft could exacerbate those problems. You should speak to the oral surgeon about this and he should confer with your physician. Possibly even an infectious disease specialist would be helpful.
Regarding dental implants... it is my understanding that titanium implants are not considered to be as bio compatible as zirconium implants. Different types of bacteria encase the implants as they integrate with the bone. Some people will have a problem with one type more than the other for various reasons. It is very individualized. One way to see what type of implant may be best for you is to have a blood test to see if you are reactive or sensitive to either material. The other thing to know is that the tooth or crown portion of the dental implant has many little parts that hold the crown onto the implant which are combined of various metals. So you may want to be tested for those materials as well.
Regarding the vascularity around the dental implant... sure the implant is in direct contact with the vessel system and nerves, just like the root of a tooth would be. So yes, that is very different from something that does not go into the jawbone which would be a pontic (fake tooth) attached to a bridge of some sort that lies against the gum tissue.
Regarding a bridge vs an implant..... it is a shame to cut down healthy teeth to make a bridge. However in your case you may be a good candidate for a porcelain onlay bridge which requires less removal of the adjacent teeth. A porcelain pontic (fake tooth) is fused to two porcelain onlays. One onlay would be cemented to #13 and the other to #15. You could speak to your dentist about that. Sometimes it is best to see a Prosthodontist (dental specialist in the replacement of teeth) for this type of bridge as they tend to do more of them than general dentists.
I also agree with you and I do believe that oral infections, especially a long standing one can and will affect our systemic health. They can cause, contribute or worsen an existing infection, inflammation or an auto immune disorder.
Thanks for posting the picture and the xrays... it does help tell the story more clearly. I hope I have given you some helpful information. Please feel free to continue this discussion...
Bryanna
Quote:
Originally Posted by asmitty
Hi,
Sorry for the lengthy post but this issue is a bit complicated. I had an ill-informed root canal on tooth #14 nearly 4 years ago. A few months after the procedure I developed a neuro-immune disease which was initially thought to be multiple sclerosis, but may be closer to ME/CFIDS or neurological Lyme disease. Looking back I have had neurological symptoms since before the root canal, but this may have triggered the acute symptom that finally led to diagnosis.
Last year, the gum above the tooth was found to be abscessed and a fistula had formed and periodically drained. Eight months ago I had the root canal retreated and it was found that two roots had not been properly removed the first time around. I was concerned that the infection was an additional insult to my immune system, my oral surgeon agreed, and I had the tooth removed a week and a half ago. The oral surgeon who removed the tooth wants to put in an allograft (Mineross) this coming Tuesday (exactly two weeks from the extraction date). Additionally, I have recently had blood-work that indicated immune dysfunction due to a depressed white blood cell count and NK cell count as well as potentially active infections. I have the following concerns.
1. The gum-line superior to the tooth has a white bump where the fistula was located and remains a bit swollen. As well, the molar behind it is a bit sensitive now. Should I be concerned, or does the area look sufficiently debrided to accept an allograft? It would be nice to avoid a sinus lift in the future, but I also don’t want to receive a bone graft that will become infected and fail. See attached picture as well as X-rays of #14 that preceded the extraction by one month.
2. I understand an implant is preferable to a bridge, however, I am concerned about an implant in the future because I have read Pubmed articles that state the area surrounding the implant will inevitably be colonized by microbiota….I would attach the articles but my post count is insufficient. The article is entitled "Early colonization of dental implants by putative periodontal pathogens in partially edentulous patients."
In my cause I am worried my immune system cannot handle the potential insult. Specifically Fusobacterium Nucleatum has been shown to make cells in blood vessels more permeable and allow several bacteria to enter the bloodstream and become pathogenic. The blog is called "how bacteria sneak into your blood through your mouth"
I have considered Zirconium Oxide implants, but even then bacteria will grow around a foreign body. Is it your expert opinion that bacteria surrounding a post have increased access to blood vessels versus the normal microbiota that colonizes the mouth? Given the issues I’m having I want to err towards caution regarding microbial insults to my immune system.
I sincerely appreciate the consideration and time.
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