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Oral Surgery/dispersed infection


You kindly answered some questions for me back in the winter ( Let me give you a brief update.

I had both a technetium scan and a gallium scan since we last corresponded. The Ga scan showed nothing at all and the Tc was deemed inconclusive for osteomyelitis. The Tc scan lit up somewhat, but it was considered ambiguous and within the parameters of a healing extraction site that had also undergone a sequestrectomy. So that was good news.

I realized that whatever I had wasn't spreading like wildfire, so I put it on the backburner.

I had my teeth cleaned in August, and they took an xray of the extraction site. It showed that the root channels from the tooth extraction seemed to have filled in completely. More good news.

The bad news is that I still have that lingering, non-diffuse drainage from the gums on the buccal side of the extraction site. It's been more than a year and a half since the tooth was pulled.

In your last message, you wrote, "Drainage for a infected area does not always come via a fistula.  There can be a more diffuse drainage at a lower volume.  Unfortunately, this type of drainage is indicative of significant dispersed infection vs a contained area."

Why is a dispersed infection unfortunate? What is the prognosis and treatment for it? Do you still advocate hyperbaric oxygen in light of the new information (the radioactive scans and the xray in Aug)? Do you believe that my problem has its source in the mandible, or do you think it's all in the gums?

Bob - Hyperbaric would be incorrect since your problem does not seem to develop from a chronic bone problem.  It sounds more so, especially with the negative scan results, that he situation is periodontal in origin.  It might be a good idea to have yourself examined by a periodontist to rule out a periodontal situation producing your symptoms.

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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicing for over 20 years. Assistant Clincal Professor at State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA- University of Connecticut DMD-University of Pennsylvania School of Dental Medicine Oral and Maxillofacial Surgical Residency - Roosevelt Hospital, NYC

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