bone grafting and loose tooth

[hoho603]

I had a bad implant on tooth #10 which was put in on April 14, 2008. There is no bone cover the outer side of the implant. Also, the implant was placed in a position with close to #9.

the implant was taken out on Aug. 14, 2008 by another doctor. She used BMP-2 which cause big swelling over 2-3 weeks. and light swelling afterwards.

On Aug. 30. I noticed my #9 become loose and very sensitive to percussion. On that day, my gum on #9 and #10 was seriously inflamed. Since then, I took anti-biotics, ibuprofen,.

I noticed the inflamation was totally gone on 9/14 . But my tooth #9 still loose. the sensitivity of percussion reduced but still have some.

Is the extended swelling pushed my #9 down? will this looseness be forever? is there a way to restore it back to its original condition?

my #9 is very healthy. never have any problem before. Thanks.

[Jerome Tsang, DDS]

I would advise you to go back to your periodontist for some home care instructions but I would recommend the following from your description on the internet.

I would definitely maintain your oral hygiene and try to keep the area as clean as possible to prevent any irritation of the healing tissue from bacteria/food/plaque/tartar.  Now don't brush too hard as it will cause damage to the gum or tooth.  Being gentle but very thorough is most important, not how hard you brush.  Plaque/food is soft, it is easy to remove but its all over the place.

I would stop touching the tooth is possible.  Eating on it is okay as long as you don't overdo it with any hard foods on the front tooth.  Try to cut your food up and eat/chew on the back if possible.

If the tooth is displaced (out of its proper position), you can do orthodontics and move the tooth later on if necessary.  

Did I cover all your questions/concerns?

[Jerome Tsang, DDS]

You can still see an orthodontist... but you will not be able to move the implant once it is placed.  It is ankylosed, meaning that the bone grows right up to the implant surface and cannot move.  There is no ligaments or anything else like a normal tooth.

[hoho603]

Yes. It addressed all my concern. Thanks.

A new question, with implant in my mouth, can I still see orthodontics to adjust #9? I already had an implant on #19. and after bone grafting of #10, another implant will be placed on that position. thanks

[hoho603]

Thanks very much for your reply. It really soothes my anxiety.

So, during this healing period, should I avoid all the activities including chewing on my left side?

I actually shake my #9 a little bit to see how loose it might be, will it permanently make my #9 loose? (well during past 10 days, I 've been doing this, hope it won't cause any damage).

also, I suspect my #9 actuall fall off a llittle bit, is it possible? if it fall off a little bit, due to
1. gum inflamation which peak on Aug. 30, and almost gone now
2. extended swelling around the surgical area which lasted around 3 weeks . It really swell a lot, almost whole half face , and then surgical area and areas around surgical area. It might push my #9 a little bit down. (considering the location of bone grafting).

then, how to restore my #9 to its original position if it fall off a little bit due to above reason? or it will be this way permanently?

because if #9 fall off alittle bit, my bite from bottom tooth will make it weaker. ( I mean more loose).

[Jerome Tsang, DDS]

I think you've asked this question before.

If the implant has been removed, it will take almost 3-4 months for the bone to completely heal in the area including the area around #9.  If its improving, I would assume that with some more time, the area should be okay.  I would wait a few more months to see how it turns out but unfortunately, it takes a long time for bone to fully heal.  If you can imagine, some people wear casts when they break their arms for weeks to months and your mouth heals at the same speed.