A Dental Implant Case

Today I had the opportunity to explain to a new patient about the proper treatment protocol for a tooth that she is losing.  Here is a great lesson about what to do when you are about to lose a tooth.

The patient was told by her previous dentist:  “Your tooth has a infection.  Let’s put you on antibiotic.  Then…you come back for us to extract the tooth and to do some bone graft.  Then…TWO WEEKS LATER … we can prep the adjacent teeth for a bridge to replace that same missing tooth.”

I have never heard of any bone grafting material that can fully stabilize an extraction site in TWO WEEKS.  A typical bone grafting site requires any where from 4 to 6 months of healing time.

In addition, the tooth behind this failing tooth is also compromised.  Using it to anchor a bridge also will not provide the patient a predictable long term result.

In a case like this where an active infection is present due to a failed root canal treatment with compromised root structure we must be even more careful with our treatment plan.  A Gum Specialist (periodontist) or an Oral Surgeon would be best to handle the surgical aspect of this tooth.   The proper treatment sequence would follow something like this:

1.  Antibiotic Regiment to suppress the infection

2.  Extraction of the failed tooth with proper bone grafting done at the same time

3.  Wait for proper healing.  Typically 4-6 months

4.  Placement of the dental implant to replace the missing root

5.  Wait for proper healing.  Typically another 4-6 months.

6.  Placement of a new crown on top of the dental implant.

As a patient, you need to be educated enough about a complex procedure before agreeing to the recommended treatment.  Dental Implant treatments require proper coordination between a surgeon and a restorative dentist in order to achieve a successful outcome.  This patient had made a very wise decision to seek multiple consultations with different dentists before choosing her own treatment choice.

Let’s take a look at the tooth:

√  The furthest left arrow points to the compromised root which was proposed to be the anchor for a new bridge.

√ The middle arrow points to the fractured root of the tooth in question.

√ The right arrow points to the infection and bone loss around the infection.



Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

About alexnguyen

My career passion is to help enhance, restore, and preserve people's smiles View all posts by alexnguyen

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