I'm from Argentina, and as regards to the numbering, I was using the FDI Dental Federation notation (I would link an image but I cant due to my number of posts). My bad I didnt clarified it.

I'm not sure, but I got the sensation that my surgeon didn't have that much experience on bone grafting, though he is known as one of the most experienced and best surgeons on my area, if not the best. Still this doesnt make him good at bone grafting. Btw he gave me ketorolac ome hour before the surgery and I was bleeding a lot during the op.

Both 8 and 9 were root canale due to an accident I had 9 years ago, thankfully only one of them got inffected and had to be removed (had a cyst). I first tried an apicoectomy with the same surgeon but it failed (1 year ago).

As regards to the bridge, I didn't wear it for the first 4 days, and the exposure was there on day 4 (probably even before, but never looked to it).

I'm on day 25 since the surgery and I tend to avoid wearing the bridge, just when I go out. I don't feel the temporary bridge rubs the exposure site (plus since there is no gum tissue, it feels like there is gap between the bone graft and the crown).

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capsula,

Thanks again for the pictures. They are a little blurry, but I know what I'm looking at so they are okay

Just wanted to clarify the tooth number, thanks for helping me with that.

It concerns me that your surgeon may have been inexperienced with doing the bone graft. To be honest, that is what I thought when I first saw it. I honestly don't see how this site can be prepared properly for a dental implant. Is there anyone else (who is competent) that would give you a second opinion?

Yes, Ketorolac is an NSAID and one of the side effects of that type of drug is bleeding. In the US, we don't use that drug prior to oral surgery if we can avoid it.

To properly inform you... all root canaled teeth are chronically infected because it is not possible to remove all of the infected nerve material from the microscopic canals inside of the tooth. Because of the chronic infection and inflammation, the jaw bone surrounding the root canaled tooth is never healthy. So there are additional risks associated with any surgery that is done next to a root canaled tooth.

I am sorry to say that I would be concerned about both areas, # 8 and 9, as neither one looks healthy from your photos. If you can, please seek a second opinion before you allow this dentist to do any further work on you.

Please keep us informed along the way....thanks!

Bryanna

Sorry for the blur in the pictures, I took several and couldn't make it better. It's hard taking pictures by myself.

I'm not sure about someone else who might be competent thought I'll try to locate some other surgeon and ask for another opinion. I'm pretty aware "my" surgeon is a good implantologist, not sure about bone grafting.. I'm defintely not happy with the results, plus it's autologous bone graft and that costed me a lot from myself.

I have read some posts (here) about the root canals and came to know that nice things! I have that root canal on #9 and two more in lower molars, and thats not a good prognosis. Better late than never! I won't go for extraction but I will watch them out.

I have a screw on the bone graft, so I'm pretty sure I will go with another surgery with the same surgeon. I'd like to think he can't actually do anything wrong in removing dead bone and the screw!

After 5 weeks of the procedure, I went back to my surgeon for a revision.

He told me the exposed bone remains the same, it doesn't have supuration nor a rare color, so he thinks it's alright.

He knows I will lose the exposed part, but in one month more (2months +1week from surgery) he will mill the bone until he finds bleeding bone and will take out the screw. He is pretty positive that the bone will be okay for a dental implant.

I guess that on the next surgery he will have a great outlook on the bone graft, and if its really prepared for an implant. I'll let you know.

Hi capsula,

What does he plan on using to cover up the exposed bony area once that bone is lost?

Seriously, I urge you to get a second surgical opinion before proceeding with this dentist. What could it hurt??

Bryanna

He said that once he find bleeding bone, that will cover up the exposed bone. Plus I think that if the bone is milled, there will be less bone to cover up and probably the soft tissue is enough to cover all or pretty much of the bone. What do you think about this?

Anyway I'm making an appointment with another surgeon, just wanted to know what you thought about the last opinion from my surgeon.

capsula,

I'm finding this hard to believe! That exposed bone is large and if there wasn't enough tissue originally to cover it up... how will there be enough once that is removed and more bone is exposed? He talks about drilling into bone until it bleeds simply because the blood indicates live bone. That's all well and good, but it doesn't reduce or eliminate the problems with this exposed area of bone.

Glad to hear you are consulting with someone new.... hopefully he will be more knowledgeable and forthright with you.

Keep us posted..
Bryanna

I guess he will just remove some bone, not the soft tissue, through a flap. Then if the bone is shorter (smaller vertically), probably the tissue may cover it up.

Who do you think it may be better to consult, another oral surgeon or a periodontist?

See an oral surgeon.

Bryanna

Just in case you wonder, here are some actual pics where you can see the situation hasn't changed much.

I just noticed today the gum tissue is a lil bit more reddish near the exposed bone (bottom.jpg). The surgeon told me yesterday that it seemed that the bone graft had started to get vascularized, not sure if that redness has something to do with the vasculization process.

PS: I already made an appointment to consult another surgeon, I'll keep you informed.

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