4+ Days After Bone Graft Small Piece of Membrane Came OffI had an infected tooth (bot
 

I had an infected tooth (bottom center, right tooth) that also jeopardized the tooth next to it. After two failed root canals on the infected tooth my endo & DDS determined the following course:

- Root canal on the one tooth that they could do a root canal
- Two weeks later went back and had the infected tooth which was next to it (anti biotics 5 days before & 5 days post surgery) removed, gum opened, membrane put in with bovine granuals (not socket grafting). Goal is to get an eventual implant. He did tell me that I had a significant amount of bone loss from the infection.

Last evening, (Fri, 2/15) I was eating dinner when a small piece of the membrane came off. Dentist is on vacation for the next week, his staff told me this can be normal & a sign of healing. I spoke to another oral surgeon's office over the phone & she said it indeed is possible but to monitor for any infection etc & they wouldn't do anything unless there was a present infection of some sort. Do I need emergency appt somewhere? I'm traveling most of next week.

Is my bone graft doomed? Very healthy/early 40 y/o, doesn't smoke etc.

Hi CG76,

A couple of things.
Number one, all root canaled teeth are chronically infected. It is irrelevant how well or how many times a root canal procedure is performed, the microscopic canals are untouchable and will continue to harbor infected nerve tissue. I will post a diagram of the anatomy of a tooth to show you how many hundreds of microscopic canals every tooth has and how inaccessible they are.

Two... The lower front jaw bone, just like the upper front bone, is very thin. When there is a long term infection such as from a root canaled tooth, the loss of bone in that area is usually severe ... and due to the natural thinning of that bone it is often not able to be rebuilt.

Three... Placing an implant in a thin area of jawbone that had an infection and next to a chronically infected (root canaled) tooth is at high risk for infection and failure. Your dentist should have informed you of that.

Four.... The membrane that was placed was either resorbable or non resorbable. It is placed underneath the flap of gum tissue to help hold the graft material in the socket and to help prevent the gum tissue from infiltrating the open bony socket where the tooth use to be. Depending on what type of membrane was used, some dissolve within a few days while others remain intact for a few months. If the goal is to attempt to preserve the socket while the body builds new bone cells to integrate with the graft material, which takes several months to do, then it is not okay for that membrane to come out too early.

The question is... what type of membrane was used and should it be replaced asap? I would not rely on an office administrator to answer that question. It would also behoove you to have an xray of that area to see what is actually still present in that area.

I hope you are able to get this squared away properly.
Bryanna