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Oral Surgery/bone graft implant issue

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Question
Hi, I had a bone graft implant done on my right upper jaw on a pre molar about 25 days ago. Since the first week I noticed a bad smell and look at the place and saw a whitesh light yellow liquid around the stitches. I clean around the area and went back to the dentist to remove them. Afte the stitches were removed I still have the light yellow liquid coming out from the surgery opening. I noticed that at the time of the surgery the sinus membrane was punctured a small hole according to the dentist. He used a bone graft with colagen and said that it will heal with time. I still have the light yellow secretion coming out from the wound and can see that there is a communication between the nose and mouth because if I gently blow the nose the liquid comes out and the terrible smell also. The dentist said that I should wait until it heals, to keep clean the area, but I'm very concerned about this since I had aortic valve replace 5 months ago and a Infection could be bad if goes to the new valve. I took antibiotic 500 mg every 6 hour for 5 days, including two pills before the procedure, also took more after I noticed the yellowsh liquid coming out from the cut afraid of a infection. The area is not red, there is no pain, my nose is clear and breathing is normal without obstruction. When I look on thew mirror and blow the nose gently I can see the liquid coming out. Should I be concern about a infection or this is a normal healing process after a bone graft implant?  I appreciated you input on this. Thank you

Answer
Hi Carlos

Yes you do have an infection and what looks like purulent drainage coming out the graft site! You should see an Oral surgeon urgently for a second opinion  and most likely have it removed right away as well as cleaning up the area in view of your aortic prosthesis.
When there is an infection in a bone graft, the graft will undoubtly fail and there is no way it will recover with this much pus coming out and an oro-antral fistula.

Don't waste too much time waiting!

All the best,

Chawket MANNA¤,DDS,Ph.D

Oral Surgery

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Chawket MANNAI, DDS,Ph.D Diplomate ABOMS

Expertise

I am a US board certified Oral & Maxillofacial Surgeon trained at UCLA and Parkland Memorial Hospital (Dallas) with more than 25 years of experience and will provide answers to all questions pertaining to the Oral& Maxillofacial Surgery region including Orthognathic Surgery, Trauma,TMJ, Implantology, tumour surgery (excluding cancer and Oral Dermatology),reconstructive surgery...

Experience

Extensive in all fields for the past 25 years hospital and office based.

Organizations
American Association of Oral & Maxillofacial Surgeons American College of Oral & Maxillofacial Surgeons British Association of Oral & Maxillofacial Surgeons

Publications
2006: Mannai Chawket Early implant loading in severely resorbed maxilla using xenograft, autograft, and platelet-rich plasma in 97 patients. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2006;64(9):1420-6. Bayonne, France. c.mannai@surgical.net 1998: Bell W H; Mannai C [An interview with Dr. W.H. Bell and Dr. C. Mannai. Interview by Colette Orival-Demange.] L' Orthodontie franšaise 1998;69(1):225-9. 1988: Abemayor E; Zemplenyi J; Mannai C; Webb D J; Canalis R F The fixation of malar fractures with the transnasal Kirschner wire. The Journal of otolaryngology 1988;17(4):179-82. Division of Head and Neck Surgery, Harbor-UCLA Medical Center, Torrance 90509. 1988: Wald R M; Abemayor E; Zemplenyi J; Mannai C; Lesavoy M A The transoral treatment of mandibular fractures using noncompression miniplates: a prospective study. Annals of plastic surgery 1988;20(5):409-13. Division of Plastic Surgery, Harbor/UCLA Medical Center. 1988: Di S; Bell W H; Mannai C; Seale N S; Hurt W C; Taylor J; Waite D E Long-term evaluation of human teeth after Le Fort I osteotomy: a histologic and developmental study. Oral surgery, oral medicine, and oral pathology 1988;65(4):379-86. Division of Oral and Maxillofacial Surgery, University of Texas Health Science Center, Dallas. 1988: Bell W H; Mannai C; Luhr H G Art and science of the Le Fort I down fracture. The International journal of adult orthodontics and orthognathic surgery 1988;3(1):23-52. 1986: Mannai C; Schwartz H C Juvenile nasopharyngeal angiofibroma presenting as a facial swelling. A case report. Journal of maxillofacial surgery 1986;14(6):329-31. 1986: Mannai C; Leake D; Pizzoferrato A; Ciapetti G; Sangiorgi C Histologic evaluation of purified bovine tendon collagen sponge in tooth extraction sites in dogs. Oral surgery, oral medicine, and oral pathology 1986;61(4):315-23.

Education/Credentials
DDS,Ph.D Fellow and Diplomate American Board of Oral & Maxillofacial Surgery Residency training:Harbor-UCLA MedicalCenter 1982-1985 Fellow OMFS Parkland Memorial Hospital Dallas Texas with William H.BELL

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