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.

Attached Images

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