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Multiple Infections in Same Tooth & Implant
I had trauma to the face several years ago and had root canals and crowns on my front top three teeth. Two years ago, #10 tooth felt sore when pushing a spot right below my nose. I had an apicoectomy done, took amoxicillin, and it was fine until a year later. After the second infection showed up, I had the tooth pulled, went on clindamycin, and a few months later my dentist placed an implant (that was Dec. 2012). I went on clindamycin after this procedure.
This year in June 2013, I started having headaches and not feeling well. After a week of that, a boil/pustule full of pus formed over that same tooth. My dentist uncovered the implant and did a bone graft over the top of the implant where the infection had eaten the bone away. He soaked it in clindamycin and I took clindamycin orally afterwards.
Six weeks after that, I started feeling bad again. My dentist put me on another round of clindamycin coupled with metronidazole. A 3D CONE x-ray showed that there was infection behind the top of the implant. This time, I had an oral surgeon uncover the implant and clean it out. He shocked me by taking only 10 minutes to uncover the implant and clean the infection. I asked him if he was sure he got all of it because my dentist said it would be difficult to remove the infection from behind the implant without removing the implant. The oral surgeon kind of gave me a glazed-over look and said he got it all. I felt in my gut that he did not get it all. He said I needed another bone graft and a gum graft to cover the hole in the gums left by the boil.
A week after that, the infection came back again. Now, I am taking amoxicillin and have seen a periodontist who wants to do a gum graft and place gum from the inside of my mouth over the implant so there isn't a hole anymore.
After five infections, multiple rounds of antibiotics, and seeing four different doctors (2 dentists, 1 oral surgeon, 1 periodontist), is there any end in sight for me?
This year in June 2013, I started having headaches and not feeling well. After a week of that, a boil/pustule full of pus formed over that same tooth. My dentist uncovered the implant and did a bone graft over the top of the implant where the infection had eaten the bone away. He soaked it in clindamycin and I took clindamycin orally afterwards.
Six weeks after that, I started feeling bad again. My dentist put me on another round of clindamycin coupled with metronidazole. A 3D CONE x-ray showed that there was infection behind the top of the implant. This time, I had an oral surgeon uncover the implant and clean it out. He shocked me by taking only 10 minutes to uncover the implant and clean the infection. I asked him if he was sure he got all of it because my dentist said it would be difficult to remove the infection from behind the implant without removing the implant. The oral surgeon kind of gave me a glazed-over look and said he got it all. I felt in my gut that he did not get it all. He said I needed another bone graft and a gum graft to cover the hole in the gums left by the boil.
A week after that, the infection came back again. Now, I am taking amoxicillin and have seen a periodontist who wants to do a gum graft and place gum from the inside of my mouth over the implant so there isn't a hole anymore.
After five infections, multiple rounds of antibiotics, and seeing four different doctors (2 dentists, 1 oral surgeon, 1 periodontist), is there any end in sight for me?
Thank you for your advice. I appreciate it!
MEDICAL PROFESSIONAL
I don't place implants so I'm not the best source of information but it appears to me that if there is an infection and its not responding to the treatment and antibiotics, either a different antibiotic may need to be used or the implant needs to be removed and the area allowed to heal again.
I forgot to mention that the dentist told me in June and oral surgeon told me a couple of weeks ago that the implant is completely integrated into the bone on all sides. Well, except for the part on the top that the infection keeps eating away. The implant is firm and steady. I guess that's why they don't want to remove it yet. My instincts since earlier this year were to have it removed, but none of them are advising me to do that right now. Should I go ahead and have it taken out anyway? My worst nightmare is that this infection keeps returning, they keep trying to save the implant, and then after all this trying and failing, they finally advise me to have it taken out. It's torture to keep going through all of this!
Early in the year, I went to my dentist complaining of aches and pains and feeling like something wasn't right with the implant. This was before there were outward signs of infection. He said if there was an infection, then he would remove the implant and let the area heal before trying to place a new one. The oral surgeon (who was my second opinion) said the same thing.
Since the infection came back, they both said that removing the implant would be difficult and would be hard on me. My dentist has said several times since then that he wants to try to save this implant. The periodontist (who he is friends with) told me a couple of weeks ago that removing the implant would leave permanent damage to my bone structure and they were trying to avoid it. I don't know why they have changed their tune since earlier this year. Maybe because the infection has eaten away so much bone? And to throw this in the mix....my father-in-law is a dentist too. He advised me against the implant in the beginning because he didn't think the trauma to my face left me with enough bone to support it.
I just finished the round of amoxicillin yesterday. The periodontist said we will play it by ear and if the infection stays away, then we will keep my appointment with him in September to do the gum graft. I have a bad feeling that I will start feeling ill again pretty soon after the antibiotics leave my system. Here's another bit of info...my dentist has only been placing implants for a year or two. He has told me that he has been getting advice from his colleagues on my case. I get the feeling that my complications are not something he has seen before and that's why I have so many other docs involved in this. Thanks for any advice you can give me!
Since the infection came back, they both said that removing the implant would be difficult and would be hard on me. My dentist has said several times since then that he wants to try to save this implant. The periodontist (who he is friends with) told me a couple of weeks ago that removing the implant would leave permanent damage to my bone structure and they were trying to avoid it. I don't know why they have changed their tune since earlier this year. Maybe because the infection has eaten away so much bone? And to throw this in the mix....my father-in-law is a dentist too. He advised me against the implant in the beginning because he didn't think the trauma to my face left me with enough bone to support it.
I just finished the round of amoxicillin yesterday. The periodontist said we will play it by ear and if the infection stays away, then we will keep my appointment with him in September to do the gum graft. I have a bad feeling that I will start feeling ill again pretty soon after the antibiotics leave my system. Here's another bit of info...my dentist has only been placing implants for a year or two. He has told me that he has been getting advice from his colleagues on my case. I get the feeling that my complications are not something he has seen before and that's why I have so many other docs involved in this. Thanks for any advice you can give me!
MEDICAL PROFESSIONAL
There hasn't been any discussion in regards to removing the implant, allowing the area to heal and then potentially placing a brand new implant?
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