Post-Operative Swelling in Implant Patient Case: Potential Reasons?

I think that it is a normal postoperative swelling. this starts the next day of the surgery, peaks uo the third and fourth days and then gradually disapear. to reduce this, gentle handling of the tissues with copiuos irrigation and postoperative cold packs maybe of benifit. you have to tell the patient before surgery that he will encounter this. from the photo I can see that the space bwn implant and the tooth is wide, this may result in large black triangle. good luck Hamza

You did not mention your antibiotic protocol. I would follow her for a few days and if the swelling does not begin to diminish, I would consider changing antibiotics.

Normal post-op swelling. In the future consider giving PO/IV or IM steroids. 4 mg decadron IM/IV pre-op helps Medrol dose pak is another good option, given post-op The key really is handling of the tissue and good surgical protocol.

swelling is very common after surgery,in my experiences if the patient never had any GI problem,combination of dexametasone and NSAID will prevent the swelling effectively.Remember that swelling is normal but severe swelling will lead to tearing the suture ,tissue and accumulation of bacteria.

Doctor i think this is post-op swelling .it is quite normal for first few days after the surgery.change the antibiotic if the swelling persist and do not forget to prescribe steroids for 3days than taper.No worries

Sir, It seems that there is a cavity with deep caries at the distal of the crown of first premolar. Are you sure that its pulp is not involed and there is no need for RCT of the tooth?

If that is a second premolar implant, and the swelling does not follow the normal post-op course, it is possible that you have created some bleeding that exited the mandible through the mental foramen. These cases act different than sub-periosteal bleeding. Certainly change antibiotics if any swelling persists after three days.

Postoperative oedema is the expected and most common sequale of any surgical procedure. Ways to minimize this include: -Minimal trauma to the tissues regarding flap refelection and suturing. -Preoperative IM injection of corticosteroid (4mg dexamethason 1 hour PO) is an effective way to minimize the swelling. Corticosteroids act by preventing the release of archaedonic acid so interfering with intiation of the inflammatory cascade. -Post operative ice packs: 10 min/hour for at least six hours. please note that antibiotics are not the answer to everything. swelling caused by an inflammation (oedema) differs from that caused by infection. A prophylactic AB 1 hour before common surgical procedures is considered enough by many authors in the literature. Amoxicillin/clauvulanic acid 2gm or clindamycin 600 mg is the standard protocol. THERE IS REALLY NO BENIFIT OF PLCACING THE PATIENT ON AB POSTOPERATIVELY. Now looking at your case if the patient does not have any of the cardinal signs Of an infection (redness, hotness, fever....etc) then most likely this is just a normal postoperative oedema. Reassure your patient and follow up on the case. usually the oedema should go down on the 3-4 day PO.

Dr S, thanks for nice picture.as shown this is a post operative trauma induced oedema. 1]-- in such case use pre operative injectable of corticosteriod,Dexamethasone. 2]--one important ascertain thing u'd not taken care of is tension on tissue as the way u'd done suturing., sometime it causes FLARE, EDEMA n marginal seepage. 3]---ask patient for post operative external ice-pack. 4]--now antibiotic has not much role to play. 5]--take care to use the guidance n mbd rule protocol properly, improve suturin way 6]--wait n take a model analysis before load 7]--it's routine neeed not to worry

My opinion is: The inflamation or Edema is normal postoperatory , but sometime is due to forte manipulation of dental assisten retracter to far. another think is normal. don't worriers

Hello everybody My question is, if for example you have a patient that is on antibiotic therapy (Amoxicillin 500mg tid)for a tooth infection for one week already, and after that you need to give antibiotic prophylaxis for a surgical procedure. Do we need to change the antibiotic? since he is already on one week Amoxicillin.or is it ok to give the same kind of antibiotic for prophylaxis for the said surgical procedure? Thank you..

This should be ok. Remember we usually without a culture and sensitivity so you are taking an educated guess at best. Why not treat with augmentin and flagyl and give it the Sunday punch.

First, the basic tenants of infection treatment is first remove the source, second I&D third consider antibiotics. You should not place a patient on antibiotics and watch. You will watch it get worse. Lastly, I have attended courses where it is generally recommended that if a patient is on a course of abx and needs prophylaxis you should use an alternate regimin.

Dear master Dr.Jafari If you have read patient's history, you would see that there was no pain or sinus tract etc.; therefore involvement of the first premolar pulp is very unlikely. In my opinion, it seems to be a normal situation , this amount of swelling after implant insertion. Sincerely

i want to ask you, did you give the pt proper post operative instructions and did you give the pt NSAIDs? thank you