Hi, I have an infected root canal tooth(molar) with jaw involvement that will be removed next week. The surgeon gave me the option of having cadaver bone graft placed for an x-tra $500. He left it up to me and didn't recommend one way or the other what I do. Do I need to do this, will it heal better? I do have ms/lyme so am concerned putting a foreign substance inn there might set things off. He didn't know about that aspect of it.

thanks

Hi diaba,

Good to hear that you are having that infected tooth removed.... your immune system will thank you for that :-)

With regard to having a bone graft after the removal of that tooth...

One.. bone graft should not be placed in an extraction site if the jawbone is infected. Ideally in that case, a small second surgery would be done in the surgical site about 2-4 weeks after the extraction of the tooth. Bone graft material and infected bone do not mingle well together. Sometimes, the infected bone is able to be debrided at the time of the extraction and so long as there is a good solid bone remaining with a good blood flow, the graft can be placed with much success.

Two... Bone graft material is placed in the socket of the extracted tooth to stimulate new growth of bone. The body eventually resorbs the graft material and replaces it with your own bone.... which helps to keep a fuller more natural curvature of the bone instead of a hollow depression where the tooth use to be.

Three.. There is some concern and controversy about placing bone graft material in patients who have any chronic medical condition such as lymes or any autoimmune disorder. The pros and cons should be discussed with your dentist and possibly your physician as well. It is an individual decision based on your overall health history and present well being.

Please let us know how everything goes... I'm sure you will be just fine

Bryanna

Thanks bryanna, he does plan to debride the jaw infection before placing the cement. Does the bone graft help it heal faster or make it take longer?

thanks again, diana

Hi diana,

If the jawbone is healthy and there is no residual infection prior to placing the bone graft material, then the bone graft helps with the healing process because it stimulates your own bone to grow into the graft which ultimately creates a higher, thicker bone level. Similar to what was there before the tooth was removed.

When you have a tooth removed, there is a large hole in the bone where the tooth use to be. The bone on the sides of the hole collapse down to partially fill that hole but the end result is a thinner, flatter, level of jawbone. All extractions cause 50% or more bone loss at the site of the extraction if bone graft material is not placed in the hole.

Hope this information is helpful. Please keep us posted on how you're doing!
Bryanna




bone.

Thanks again for your help. It doesn't appear my bio dentist is going to get ahold of me to give me any advice before I have this done, so very happy to have this info from you. I'll let you know how it goes.

Also, am I supposed to be on antibiotics after this, if so who gives them to me?

thanks again, diana

Hi Diana,

The dentist will determine if antibiotics are necessary.... sometimes they are, sometimes not. It depends on what he finds when he removes the tooth. He will also be the one to prescribe them to you if needed.

.......You are very welcome.... I am happy to be of help

Bryanna

this is a classic example of dentristry profitering he knows exacly what hes doing and wants to make as much money as he can.his work might well be good but he wants as much out of it that he can

Especially since you have MS you need to be ultra careful when it comes to nerve damage. If you even suspect your dentist isn't being ultra careful or is doing any procedures that are unnecessary or risky, get another dentist or at least a second opinion.

I just had my molar #14 extracted yesterday and the surgeon didn't do a bone graft. I had planned to talk with him about getting one done at the time of the extraction and mentioned it to his staff when I called to set up an appointment but I forgot. Then the procedure began and I only focussed on the crunching and grinding sounds of bone and hoping to god that I would get out of the procedure safely.

I was going to call his office on monday and find out what my options are. Is it more risky to do now because it wasn't done during the extraction? What things should I be concerned about?

My initial reason to do this is in case I want to get an implant or bridge in that spot later. Or I think even with a flipper it won't sit right because of the bone loss because I didn't get it done with the extraction. Now I bet that spot will be all squishy and if I put a flipper or a bridge on it I won't even be able to chew food on it.

How soon should I go back to get the bone graft if it's even possible at this point? And now I'm freaking because I'm going to have to go through more grinding and crunching...I think. If someone could give me some advice it would be really appreciated. I feel like an idiot for not bringing this up right away. I think even if I had wanted a bone graft he couldnt have done it because he had someone on deck after me and was kind of backed up. Plus, I'm not sure how much more work it would have been to put the graft in. maybe only a few more minutes. I have no idea. Sorry for rambling.

Hi asquirrel,

Bone grafting is generally recommended at the time of the extraction providing there is no infection in the bone. However, not every extraction requires a bone graft. It all depends on the size and quality of the bone after the extraction. I am surprised that he didn't discuss this with you himself??
Was it a root canaled tooth that was removed?

It is not too late to do a bone graft. Some surgeons wait 2 weeks post op the extraction some a bit longer. It depends on the health of the bone at the time of the extraction.

To place a bone graft using synthetic bone material is not a big surgery. It only takes a few minutes. Just so you know....

Call the surgeons office and ask to speak to the surgeon (preferable) or have someone there speak to them about doing the graft. Better to do that than wonder about it.....

Bryanna