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Medical Forum / General / Dentistry / December 2005

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Abscess following Implant

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Wendela - 16 Dec 2005 00:45 GMT
A friend of mine has had bone loss and an abscess following a dental
implant after the cap was inserted, and this has even resulted in bone
loss to thew newly done bone graft. We can't figure out how this could
have occurred and how his bozo cap specialist, one of a few in the
city, could have misdiagnosed him and allowed him to be experiencing an
unexplained pain for 6 months, all the while assuring him it was just a
slow recovery.

His Endodontist told him today that it was abscessed. We felt that
because he had some immune and blood issues the gum was healing slowly,
plus the cap doctor (don't know the name of this specialist) reinforced
this by saying that his teeth were putting pressure on the gum area,
and spending an hour sanding the area before sending him home with
sandpaper. Prior to that, the guy kept saying it was a slow healing
recovery.

Tomorrow, he'll return to the oral surgeon but I'm furious. I guess
we're grasping at straws with this because he's bee through so much.

Sequence of events:
-It's in a front tooth, #7, lateral.
-Cap that was on for 40 years had to be removed because of a receding
gum line.
-Cap was removed, and recapped, but he had pain from it (again the
dentist from hell allowed him to be in pain for 4 months)
-Root canal was done with cap on there
-2nd root canal was done when they determined that didn't work, but
only after the Periodonist tried to salvage the cracked root.
-tooth was pulled
-bone graft was done taking bone from the jaw
-implant was done
-abuttment was put on, cap put on, and pain occurred immediately and he
was told the tight fit would relax and he was given dental sandpaper to
alievate the pressure, however, the inflamation continued in his gum
area.

I guess I feel the distress because he has had other health problems
and this is a shame this has occurred. I wonder what could have
happened to cause the abscess? No one seems to level wit him, however,
the cap doctor seems to be really horrible at diagnosing and treating.
Thanks for listening -Wendy
Sue - 16 Dec 2005 01:18 GMT
> A friend of mine has had bone loss and an abscess following a dental
> implant after the cap was inserted, and this has even resulted in bone
[quoted text clipped - 37 lines]
> the cap doctor seems to be really horrible at diagnosing and treating.
> Thanks for listening -Wendy

Hi Wendy,

You mentioned this:

"We felt that because he had some immune and blood issues the gum was
healing slowly"

...and then you asked why did he get an abscess?

I do not know.  Although I am neither a dentist nor a doctor,  I do
know that infection can occur with any implant procedure (as I work for
a medical device company).  Although this is rare,  (generally less
than 2% overall for pts that have our products), the incidence is
higher in patients that have pre-existing health problems that may
compromise the immune system and/or circulation.  It is also higher if
the procedure is a reimplantation procedure.

So I think your husband may have been at higher risk for infection (but
I am only speculating).

Was he given antibiotics prior to the procedure?  What are his
pre-exisitng health problems?

Just curious.

Thanks,

Sue
Peter Jason - 16 Dec 2005 06:30 GMT
>> A friend of mine has had bone loss and an abscess following a dental
>> implant after the cap was inserted, and this has even resulted in bone
[quoted text clipped - 66 lines]
>
> Sue

I had a similar infection just after my gum had been cut away and a screw
inserted into the implant.
It was at night and I awake to find a large abcess growing on my gum near
the implant.
This I lanced with a fingernail and then I swallowed about 10 amoxycillins
(which I allways keep in the refrigerator, just in case) after which I rang
the oral surgeon who said I did the right thing and to stop worrying.
I'm sure glad I had the penicillin because this saved me the trouble of
trolling the town searching for a pharmacist whilst indisposed.
Always keep at hand in a cool place:
1/ Pain killers.
2/ Oral Penicillin.
3/ Nembutals
Especially if you live alone.

I have survived to tell thee!
Wendela - 17 Dec 2005 03:20 GMT
Wow, I'll explain below the outcome of the appt. Please be careful
about taking the medicine. I had a violent reaction to Penicillin and
almost died :( from taking one pill. I previously wasn't allergic to
it, but someone who stored it gave it to me. Now I find out it's one of
the meds most people are allergic to.  I'm glad you are okay though!!
Be careful please. I'm very well familiar with the alone thing. I don'
t live alone now, but did for many years. You need someone to talk you
out of the urge to grab the meds!  Thanks for writing!  -Wendy

> had a similar infection just after my gum had been cut away and a screw
>inserted into the implant.
>It was at night and I awake to find a large abcess growing on my gum near
>the implant.
>This I lanced with a fingernail and then I swallowed about 10 amoxycillins
(>which I allways keep in the refrigerator, just in case) after which I
rang
Peter Jason - 17 Dec 2005 06:34 GMT
> Wow, I'll explain below the outcome of the appt. Please be careful
> about taking the medicine. I had a violent reaction to Penicillin and
[quoted text clipped - 4 lines]
> t live alone now, but did for many years. You need someone to talk you
> out of the urge to grab the meds!  Thanks for writing!  -Wendy

It seems curious why the oral surgeon didn't prescribe penicillin - just in
case - after the procedure.

In all I had 6 implants exposed whilst wedged in a chair, with his
understudy looking on handing him the novocaine (or whatever) and screw-caps
in succession, and it seemed a rushed affair.  I had agreed to this to save
myself yet another boring and disruptive  hospital day-stay with anesthetise
etc.

It was all done in about an hour with a rubber cork wedged between my
(other) teeth through which I grunted for more novocaine (or whatever) when
required.

These newsgroups are rather good for getting feedback from fellow patients,
and now I always consult them before any procedure.

However my six implants went on to become a great success (the surgeon said
I had the jaw of an ape) and I now have a teenager's mouth again with which
I can grind thru the toughest gristle etc.

Alas, the surgeon went a little too deep with one of the implants and I have
a slight loss of feeling in a small part of my lower cheek.

The fellow was a bit of a cowboy, really.
Wendela - 17 Dec 2005 03:14 GMT
He was treated for Hep -C and his red and white blood counts were off.
The Hep was actually a minor amount of liver damage, however, the
medicine you take for it is a killer.

>I think your husband may have been at higher risk for infection (but
>I am only speculating).

>Was he given antibiotics prior to the procedure?

No, he was not. The procedure went well, and it wasn't until the doctor
put the cap on that he started having the pressure.

What are his
>pre-exisitng health problems?

answered above

Thanks for writing. see my explanation below about the appt.
Steven Bornfeld - 16 Dec 2005 20:48 GMT
> A friend of mine has had bone loss and an abscess following a dental
> implant after the cap was inserted, and this has even resulted in bone
[quoted text clipped - 37 lines]
> the cap doctor seems to be really horrible at diagnosing and treating.
> Thanks for listening -Wendy

    Probably the surgeon should have been consulted as soon as something
was clearly wrong.
    Sometimes implants fail to integrate properly.  This happens with any
surgeon, though some surgeons doubtless have better track records than
others.  The patient's medical condition may also have had an influence
on the probabilities of success.

Steve
Whamatus - 17 Dec 2005 00:41 GMT
>> A friend of mine has had bone loss and an abscess following a dental
>> implant after the cap was inserted, and this has even resulted in bone
[quoted text clipped - 46 lines]
>
>Steve

This is one of those 10-foot-pole thingies ain't it ?
/
--

Whamatus Bemoana
wubbabubbazG@RBAGE
at yahoo dot com
Wendela - 17 Dec 2005 03:35 GMT
Don't touch it with a 10 foot pole?
Wendela - 17 Dec 2005 03:34 GMT
I guess I'll write the long reply. I did realize that he probably was
given an antibiotic after the implant, however, he can't recall. He had
an impacted wisdom tooth and they used the bone from it to build the
graft, so I do think the surgeon was great, really great. He now
forgets about the antibiotic. It was the doctor specializing in the
caps that could be at fault because the pain didn't occur until the cap
was inserted. We thought that since he was being treated for HEP C and
his blood levels were off, the gum wasn't healing very well.  He was
pleased because he saw the surgeon today, and the surgeon said he will
not charge him to correct the situation. The X-ray shows the bone loss
and a space around the implant, however, we don't know if the implant
is lose yet, or it's just that the cap is loose. The surgeon feels the
impact of the cap being put on may have caused the bone to be
displaced, cracked or loosened. I dread that he is going back to the
"cap doctor" to have the cap removed because at some point he had to go
through a 2nd root canal through the cap because they'd put the cap on
and couldn't remove it and all the while the root was cracked. I just
don't have any use for that doctor.  But the surgeon said that in 20
years, he's only had one one case where he did a repeat implant and it
didn't work on the 2nd time. I'm glad we found the surgeon. He'll use
synthetic bone packed around the area in lieu of building the bone.
Really, it was a miracle that he got the impacted wisdom tooth out to
borrow the bone from. It was a dangerous operation.

I guess the same doctor from hell wants my niece who is grossly
underweight to have her jaw broken and reset for cosmetic reasons. My
sister went to high school with this jerk and she thinks the world of
him. Now, given what happened with my boyfriend, and also given that
this same cap doctor advised me to get a root canal I never needed and
luckily didn't get, I'm irritated.

Now, he's taking antibiotics and I feel better. I had an aunt die from
a dental infection and I feel skittish about everything :(. Meanwhile,
I'm suffering myself from fibromyalgia/chronic fatigue but it's always
easier to focus on someone's illness other than your own.  I'll keep
you posted.

I just feel bad that when he questioned the cap doctor about the pain,
his response was "there is NO TOOTH it must be pressure from another
tooth, the bite wasn't right, or there is tenderness in the gum due to
his HEP C". He said it wasn't unusual to have 4 -  6 months of pain.
It was unnecessary pain and hopefully the infection didn't spread to
his heart or something horrible.  Thanks for listening. -Wendy
Joel - 17 Dec 2005 22:20 GMT
Sadly, this happens .....

> A friend of mine has had bone loss and an abscess following a dental
> implant after the cap was inserted, and this has even resulted in bone
[quoted text clipped - 37 lines]
> the cap doctor seems to be really horrible at diagnosing and treating.
> Thanks for listening -Wendy
 
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