Expert: Rafael Mosery,D.D.S. - 8/28/2007

Question
I had Nr. 3 of my teeth extracted because it was infected and could not be saved. The Dentist who extracted it, put a Zimmer implant right away in the cavity and told me he had to do a sinus punch. After three weeks the cavity still was not healed and there was an airflow towards the sinus. After checking the dentist stitched it up again. No luck. After two more weeks, he told me that he was going to do surgery again to check if the area under the implant was infected. It was and he took it out. That is two weeks ago. I did start bleeding profusely the night after the sugery and ended up in the emergency ward. The bleeding stopped. At a check up after the surgery to take the implant out, I was told that it was too early to tell how everything was. I will go this week ( two weeks after the surgery) for a check up. I am worried, because the area still has a deep hole. What should be next. Is it normal that a dentist puts an implant in right after extraction? Is is not better to wait until the infected area has healed completely? Could you please advise me what to do next? Thank you

Answer
It is not uncommon to place the implant immediately at the time of extraction providing certain criteria are met.There has to be ample bone to support the implant fullyto achieve what we call primary stability.In this case it sounds like although the intentions were noble the outcome went south.At this time the treatment of choice would be achieve a more ideal site to accept the implant perhaps a bone graft or sinus elevation procedure would be in order to achieve this.Then wait 8 months for full healing and place the implant.Wait six months for full integration then restore.