2 Sinus Tracks, 2 Residual Roots? M

A 64-year-old woman requests extraction of the tooth #23 for lower partial (Fig.1).  Since there are 2 buccal sinus tracks, another residual root is suspected (?).  After shown loss of the buccal plate (Fig.2,3), the patient agrees to have socket preservation with allograft (Fig.5,6 *) and BioXclude (Fig.4 >).  The suspected residual root is not explored considering the 2 sinus tracks being associated with the lesion of #23 (Fig.2,3).  Cytoplast is not used because of time constraint and fear of gingival dehiscence associated with extensive dissection.  In fact the sinus tracks shrink in a week, while the buccal plate remains bulging (Fig.7 *) and the socket heals (Fig.8 >).  The buccal plate is flat (no swelling) 1 month postop (Fig.9).

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Xin Wei, DDS, PhD, MS 1st edition 11/16/2019, last revision 01/19/2020