Meera Dasi,

Thanks for posting the pan.

The adjacent teeth next to all of your extraction sites have moved a bit towards the opening. This could make the restoration portion of a dental implant complicated as there needs to be adequate space between the teeth to place the implant crown that fits onto the dental implant. The areas would have to be measured carefully prior to any proceedings with implants. Sometimes orthodontia is suggested to help widen the spaces allowing the final restorations to be better functioning, easier to clean and esthetic-ally pleasing.

Pertaining to the jaw bone... it looks like you have maintained a good level and solidity of bone on your left side in both areas of the extracted teeth. On the right side in the area of tooth #5, the height of the ridge is a bit higher compared to that on the left and it has not healed as smooth as those on the right. Given your symptoms with that area and tooth #4, I think site #5 should be looked at more closely to rule out if there is anything lingering in that site at the ridge.

Pertaining to the jaw bone on your lower right in tooth #29 site. When was that tooth extracted? If it was more than several months ago, then it needs further evaluation as it appears "on the pan" to still contain the periodontal ligament or remnants of it. You can see that by the clearly defined outline of the tooth that was removed. That bone should look solid without any hint of a tooth ever being there. Placing a dental implant in the jaw bone where the perio ligament from an extracted tooth is still intact and where the bone has not healed properly can be problematic. Perhaps a periapical xray would be helpful. But ideally a 3D scan may be necessary if you want to proceed with an implant in that area.

Bryanna