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Bone Graft Immediately Post Implant Removal
The tooth #30 was extracted in other office 1 month ago. The socket appears to heal normally. A tissue-level implant is placed as planned and smoothly. No antibiotic is prescribed pre- or post-op. The patient reports mild pain 1 week postop. There is a sign of infection. Amoxicillin is prescribed. One week later, the symptom improves, but the infection signs are present (Fig.1). The implant has mobility and is removed (Fig.2). The osteotomy is thoroughly debrided, followed by copious irrigation with normal saline and Clindamycin soaking. Irradiated cancellous bone graft (.5 mg) is placed (Fig.3,4). The wound is covered by collagen plug (Fig.5) and sutured with Chromic gut (Fig.6). Amoxicilin is prescribed postop. One week follow up reveals normal wound healing (Fig.7 (buccal view), 8 (lingual)).
To reduce infection associated with the 2nd placement, an antibiotic is taken pre- and post-op. An incision is made and a submerged implant is placed, three months post bone graf.
Xin Wei, DDS, PhD, MS 1st edition 10/20/2013, last revision 07/26/2014