bone loss after periodontis abscess 1month pus

Discussion in 'Periodontics' started by AVM, May 2, 2018.

  1. AVM

    AVM

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    Hello,

    Please help! I stayed with this abscess 1 month, I thought it was gingival...One night I wanted to clean the pockets with a small chopstick but the other day got infected. The doctors here said that this tooth should be extracted. After 5 days of antibiotics the pain is no longer there and the gingival looks much better. Still I feel some bone loss. What do you think from the tomography image. I also have orto braces on it..

    upload_2018-5-2_20-25-18.png
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    upload_2018-5-2_20-27-12.png
    upload_2018-5-2_20-29-41.png
    upload_2018-5-2_20-31-35.png
    upload_2018-5-2_20-31-55.png
     
    AVM, May 2, 2018
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  2. AVM

    MattKW Verified Dentist

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    Great set of Xrays. Well, the tooth (36 FDI) has had some RCT started on it that hasn't been finished. Either stop braces movement immediately, do RCT, and hope bone reheals (minimum 6-9 months) before even thinking about restarting ortho; or extract 36 and look at doing implant at later date. And get rid of the useless 38 while you're at it. When was the RCT started on the 36? The ortho shouldn't've been started with a tooth in that condition.
     
    MattKW, May 5, 2018
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  3. AVM

    AVM

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    Hi Matt,

    Thanks for the feedback. Well 2 days ago I just finished RCT with rotative instrument. Too bad I haven't got the chance to use a laser on also.

    The thing is that last year on june the tooth was ok like this XRAY is showing:

    [​IMG]
    upload_2018-5-6_18-57-37.png
    upload_2018-5-6_18-58-15.png
    upload_2018-5-6_18-58-42.png
    (The 3.5 premolar didn't grow anymore at age 10...)

    But after I've played one day with a chop stick on it after 3 month of orto, it got infected....I blame me here.

    And yes probably I should have done also bone graft for 3.6 and RTC back then.

    As for the 3.8 the tooth is healthy, just shown up two years back. The orto treatment initially was to move all three molars in front. That's why I kept it. Problems is know that I lost because of delaying the RCT treatment and antibiotic treatment...some bone....due to the paradontal abscess triggered. In the worst case the orto said we will probably need to extract 3.6 and move the 3.7 and 3.8 a little in front and do bone graft and implant.

    Today after 9 days of antibiotics I don't feel anymore the conjunctive tissue. Seems that the gum healed and the tooth also has strengthen up a bit.

    On other hand I feel optimistic, hope after stopping the antibiotics will not get again infected. I will stay a couple of month see what happens, due also a laser pocket cleaning on those molars and pray to be ok. Anyway in these time I will have to correct my mouth bite so...for me it's ok waiting. It's better to have a tooth then an implant I guess.

    I'm taking also a very strict hygiene, not eating on that side, cleaning after every soft meal, no sugar, and I have oral irrigator, mouth water, inter dental brash etc.

    Thank you very much for the support!
     
    Last edited: May 6, 2018
    AVM, May 6, 2018
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  4. AVM

    MattKW Verified Dentist

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    The earlier OPG shows a deep filling on distal of 36, which means the abscess is probably endodontic in origin. I don't understand why any perio treatment with laser would even be considered.
     
    MattKW, May 7, 2018
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  5. AVM

    AVM

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    Thanks for the reply, well I lost some bone on the lateral of the tooth because of pus that gattered it's path threw the bone (after the jaw was inflamated I also had a paradontal abscess with pus). And I think it's good if I also clean the gum very well with laser...
     
    AVM, May 7, 2018
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