I had a maxillofacial cyst removed from my upper left jaw above a root canaled tooth about 3 months back. The oral surgeon performing the procedure filled the area with a bone grafting and I was sent on my way for recovery.

About a month after the procedure, I returned to the oral surgeon as there was a growth on the side of my gums directly outside of where the surgery to remove the maxillofacial cyst was performed. The oral surgeon advised that a few lose pieces of the bone grafting most likely broke free and were trying to push their way out. She put me on 7 days of antibiotics if there was any infection and then went in for a second procedure to remove the pieces of bone grafting that had pushed out, cleaned the area up, and stitched everything back together.

It is now a month and a half later and I'm having the same issue. There is a very large growth on the outside of my gum area.

I chose to go to another oral surgeon for a second opinion; he didn't do x-rays or anything other than look at the x-rays and a CT Scan from before the cyst removal took place. This surgeon told me my only option is to remove the tooth and have an implant put it as there must be a fracture to the root of the tooth. I asked if there was any way to confirm a fracture and was told no. I then advised that prior to the removal of the maxillofacial cyst there had never been a growth on the outside and it had already had issues once with small pieces of the bone grafting being pushed out. An apicoectomy was performed on the tooth during the surgery. I then presented the idea to him that perhaps the bone graft was rejecting fully. He pretty much brushed my concern under the rug and stated my only option was removal of the tooth, another bone graft, and an implant.

I didn't trust this second opinion and thought that my only option being removal and implant was a bit extreme so I contacted my dentist, whom I trust greatly, and made an appointment to see him that afternoon. He did, in fact, have multiple pressure type tests that he performed that ruled out a fractured root. During x-rays performed, he pointed out the root canaled tooth and advised if there was a fracture, the entire surrounding area would have a black line and none was present. There would also be sensitivity in the tooth, gums, and surrounding teeth; again, none was present. He then did an x-ray higher up at an angle to see the area in which the cyst was removed. He pointed out the exact area of the bone graft, including a distinct line surrounding the bone grafting to show that it wasn't, in fact, integrating with the bone in my jaw. He has contacted the original oral surgeon to advise that there is a bone integration failure and that my jaw is rejecting the bone grafting and it needs to be removed.

I'm terrified to have this procedure done again. I'm going for a consult with my original oral surgeon on Tuesday and the woman I spoke with in the office havsadvised that she has never heard of a bone graft failing with a maxillofacial cyst. She has however had it happen with dental implants.

My dentist has already advised that I need to have the bone grafting removed. I asked the woman at my oral surgeon's office what they would do after the removal. If they would fill it with another type of bone grafting or if they would leave it empty and just stitch up the area and let it grow in naturally. I don't know which option is worse, chancing another bone graft rejecting and having to have the surgery a 4th time or chancing an infection without a bone graft.

I don't even know where to go from here and the office staff can't advise me what the normal procedure for something like this is as they haven't encountered it before.