Purulent Discharge on the Mesial and Distal: What is Going On?

purulent discharge suggests that infection is there, n leaving it is gonna make it worse, you'll have to * open the flap currette the area, * check for cement overhang under the PFM, * graft the site if substantial crestal bone loss is there, * and may be remove the abutment n wait for the infection to heal before re-attaching the abutment.

The graft material that you used may not have been a regenerative material. You should a regeneration material to give living bone result. Most bone gragt materials today are only fillers and do not give a good blood supply. Take the stuff out and redo the procedure with a regenerative material, it will work.

Don, do you have specific materials you could recommend? Dr.Y wasn't specific about what "bone graft" material had been used in his augmentation, so I would also like to find out from him what was used and how long he waited before placing the implant.

Dr Y If the bone looked good when the implant was placed,then you had a problem with it after loading, I would suspect with out seeing the case that you might have an occlussion problem.Is the implant mobile at all? Put your finger on the buccal surface and instruct the patient to grind hard in all directions.If you feel movement evaluate it for total occlusal relief,Good Luck Bill Pace DDS

Steve C, The literature says to use a demineralized bone that has been properly process. Dr Roberts, Dr Simmons and Dr Edwards have shown to allow 4 months after the regeneration procedure be implant placement and then allow 3-4 months for the bone to mature. However, Nobel and other non-research people will say implant in a day or an hour???? The question is "What do you want to do in you mouth?"

Dear Dr Y I am a beginner when it comes to implants and bone grafting, however, I have two very experienced mentors who both strongly advise to always leave a grafted socket for 6 months before attempting placement of any implant. Further, with upper anterior labially grafted sites, a flapped look at the 6 month point sometimes indicates leaving the site for another 4 months if the graft does not have a well intergrated appearance. To do otherwise will risk splitting of the graft off the ridge when the implant is placed. Regards John

Was the bone pink when you flapped it for the implant? There are many variables her not being able to see an xray. What speed did you do the osteotomy? How close was the buccal wall? What did it look like on uncovery? 1 or 2 stage? Antibiotics? Sterile technique? Flapless? We need to know a few things. Bill