Peculiar Bone Loss

The mesial and distal crests of the tooth #19 were even for a 50-year-old man 7 years ago.  Three years later, swelling developed around the distal root with bone loss (Fig.2 *).  Three months later, localized swelling occurred (Fig.3 *) with oozing.  The patient had thrombopenia (platelet 40 K).  The tooth was extracted with suture.  There is distolingual root tip resorption.  Two months and a half later (Fig.4), a 6x17 mm implant was placed (Fig.5).  The implant osteointegrated 5 months postop (Fig.6).  The distal crest re-appears 5 months (Fig.7), 2 years (Fig.8) and 2 years 8 months (Fig.10) post cementation.  At the last appointment, the patient complained of pain and swelling at #30 with mesial bone loss (Fig.10 *), as compared to Fig.9 taken 9 years ago.  The mesiolingual pocket is deep.  After scaling and Chlorhexidine irrigation, Arestin is locally administered.

It appears that the lower molars have a type of occlusal trauma.  There is anterior open bite (Fig.10 double arrows).

Return to Lower Molar Immediate Implant

Xin Wei, DDS, PhD, MS 1st edition 08/27/2016, last revision 08/27/2016