Bone Graft Exposed: How to Deal with this Condition?

the way is to wait almost 15-25 days to observe the healing and then eventually try, if the implant remains exposed, to screw for 180 -360 degrees the same implant in the depth. It depends, naturally, of what kind of implant did you used.this way is not practicable if you have any purulence or inflammation around the implant.

this kind of grafting material has really bad prognosis when exposed... I would say remove it and re graft with something like dynablast and use a resistant membrane like a pericardium one from zimmer and achieve tension free primary closure. dont use chlorexhidine, use diluted peroxide.

You may want to ask yourself: "If you do not know what to do, should you be doing the procedure?"

Should have been using chlorhexidine the day after the procedure. Let it granulate, even if the cover screw remains exposed. In my experience, it will heal pretty well. Another graft may be necessary depending on how much bone you lose, if any. I'm not familiar w/ epiguide, but I'm sure that after 5 days, the BioOss that is deeper down is going to be fine. Significant dehiscence implies lack of adequate release of periosteum, or improper selection of suturing technique. Use chlorhexidine 0.12% bid, after breakfast and before bed. Let it heal for 2-3 more weeks. Re-evaluate the situation at that time.

Without seeing the extent of damage, it is difficult to advise. That being said, I would consider nicking the wound margins with a high speed diamond bur. This will encourage healing. See the patient every 1-2 weeks and repeat this as needed until wound is closed. Craig

I would suggest if there is any sign of infection or sepsis. If there is none, just leave it for 3 months and take CT. Curettage all the granulation tissue and add bone graft if necessary. If there is infection or sepsis, excavate all the grafted stuff, and take a course of antibiotics fo a week. Then, re-schedule the bone graft until the soft tissue become totally collapsed.

First, Do not use chlorhexidine on any open wound. chlorhexidine kills bacteria, it also delays healing be having a negetive effect on fibroblast, JP; 1976. You may loose the graft. Let the body repair itself and correct the problem later (re-graft and/or re implant). Treat the area as if is were expose living bone after any oral surgery procedure. Antibiotics, YES. This grafting material has really bad prognosis when exposed.

I agree entirely with Joseph Kim, Use chlorhexidine rinse from day one, and let the site heal to completion. Nothing you can do surgically will help at this stage, just let the body do its thing. You may end up with a success despite exposure.

I had a bone graft done to my #19 molar this past Friday. I was doing great up until this morning when I finally developed pain and extreme fatigue. The pamphlet from the oral surgeon's office warned that day 3 was the peak of the pain / swelling period, so I guess I did expect it. Question, though. other than a "glue stitch" which fell off my tooth on Sunday, the doctor didn't cover the grafting material with any membrane or even stitch the wound up. I have a gaping hole where my tooth used to be, filled with a white substance. Is this normal? Should he have sewn my gum? Please help! Thank you!