Exposed bone after pocket reduction

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toddd - 16 Jul 2006 23:06 GMT

Flap surgery went well and healing is doing okay. Except a small area of
exposed bone about 5mm wide on the inside of the jaw below the wisdom
socket.
The doctor says it will die off and the gum will cover it. I couldn't get
an answer about what caused it. Figuring a stitch broke. But after a month
it's still there and no evidence of healing. Does anybody know about how
long this will take? I also worry about this getting infected. Should it
be covered? Need antibiotics? Any other info appreciated.
tia

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Steven Bornfeld - 16 Jul 2006 23:28 GMT

> Flap surgery went well and healing is doing okay. Except a small area of
> exposed bone about 5mm wide on the inside of the jaw below the wisdom
[quoted text clipped - 5 lines]
> be covered? Need antibiotics? Any other info appreciated.
> tia

    I hope Dave will chime in. This is a bit unusual for pocket reduction
surgery.
    Because it's in the news, I have to ask if you're on any medications,
esp. for osteoporosis or to preserve bone strength in cancer therapy, as
these drugs have recently been shown to occasionally cause the kind of
situation you're reporting.
    If there is a small piece of non-vital bone (which can sometimes happen
with any kind of oral surgery, though I don't frequently hear of this
happening with periodontal pocket-reduction surgery), then this dead
piece of bone (called a sequestrum) can definitely retard healing. In
any case, after a month your dentist should give you guidance as to what
to expect.

Steve

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toddd - 17 Jul 2006 00:13 GMT

> > Flap surgery went well and healing is doing okay. Except a small area of
> > exposed bone about 5mm wide on the inside of the jaw below the wisdom
[quoted text clipped - 20 lines]
>
> Steve

No I have no pre-existing condition and am not on any medications. This
sequestrum (thanks for the proper terminology) isn't affecting the healing
where the pocket work was done. Those areas are doing fine.
This area is back below where my wisdom tooth used to be (taken out many
years ago). I've felt it since right after the surgery. Thought it was
maybe a stitch or some of that clay surgical dressing stuff all dried up.
But no it was indeed exposed bone. Thinking maybe that's where the stitches
ended and maybe it just broke loose.
The doctor's guidance is simply to come back to monitor the situation. He
says the bone will eventually get pinched off.
I'm just not comfortable with bone outside of my body if you know what I
mean. And not getting more info from the doctor (I'll push him a little
harder next appointment).

Thanks for getting back to me. And thanks for the education you guys
provide here.
Todd

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Jacob - 17 Jul 2006 22:02 GMT

Eventually, everything heals. It's hard to say what's what with this
without seeing it. Are you sure it is bone that's exposed?

> Flap surgery went well and healing is doing okay. Except a small area of
> exposed bone about 5mm wide on the inside of the jaw below the wisdom
[quoted text clipped - 6 lines]
> be covered? Need antibiotics? Any other info appreciated.
> tia

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toddd - 18 Jul 2006 02:11 GMT

> Eventually, everything heals. It's hard to say what's what with this
> without seeing it. Are you sure it is bone that's exposed?
[quoted text clipped - 9 lines]
> > be covered? Need antibiotics? Any other info appreciated.
> > tia

Yes indeed it is bone. Not a broken off sliver or anything. It's way back
below the wisdom socket. I figure it will heal. Just worry about
infection. So I rinse with warm salt water. Try not to keep tounging it.
Doctor says not to worry. I worry.
This is not normal. Maybe time to go see another doctor.

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Jacob - 18 Jul 2006 02:30 GMT

I don't think it would do anything to see another doctor; they wouldn't know
how the problem began and so it would be hard to determine the history of
it. However, as long as it's healing [called "secondary intention healing"
as opposed to "primary intention healing"] you should be fine. If it were
infected, it would likely be draining pus and you would notice/taste that
and would be aware of it. Sometimes, things do take longer to heal, but
nothing to be alarmed about. Humans are not machine made and everyone is
different; what might take one person a week to heal could easily take
another longer or, for that matter, shorter. Keep up the warm saline
rinses, and good luck.

>> Eventually, everything heals. It's hard to say what's what with this
>> without seeing it. Are you sure it is bone that's exposed?
[quoted text clipped - 20 lines]
> Doctor says not to worry. I worry.
> This is not normal. Maybe time to go see another doctor.

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toddd - 18 Jul 2006 17:08 GMT

Thanks to everybody for the replies. I'll be patient and give it time.

> I don't think it would do anything to see another doctor; they wouldn't know
> how the problem began and so it would be hard to determine the history of
[quoted text clipped - 31 lines]
> > Doctor says not to worry. I worry.
> > This is not normal. Maybe time to go see another doctor.

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Joel344 - 18 Jul 2006 13:14 GMT

It'll heal ...... give it time ... and quit playing with it.,

Joe

--
Joel34

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