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Question:
Repeated Implant Failure? I had an implant done to replace an upper tooth three years ago.
Starting about eight months ago, my general dentist noticed a fistule on the gum above the implant. After trying 3 courses of antibiotics which did not clear up the infection, he referred me to a periodontist.
A couple of months ago the periodontist performed an operation on my gum, cutting into it above the implant, cleaning up the infection and doing a bone graft. I followed all the instructions for care of the area, and it seemed like everying was going well.
Unfortunately, the fistule is back and so is the infection. I have a call in to my general dentist and the periodontist, but I am worrried that they will be scratching their heads over this - and since the periodontist is new to my case, he even seems a bit defensive about what caused the problem to begin with, much less how to correct it.
I am at my wits end. I don't want to lose the implant and I hate the thought of dentures. I have already endured so much for this particular tooth, I really would appreciate any help you might be able to give. The only thought I had was that the infection might possibly be related to my sinuses in some way. I notice my sinuses on the side of the implant have really been bothering me. ...Visitor from MT
Answer:
I can understand your concern and frustration with this upper implant and crown that seems to be failing.
A sinus infection would not usually result in a fistula, but if the implant was placed in close proximity to your sinus it could be a problem. If the implant extended up into the sinus, a chronic infection could be the result.
It sounds as if there was some type of bone loss around your implant due to the fact that you mentioned the Periodontist attempted to treat the area with a cleaning out of the infected tissue, and the placement of bone graft material. From your E-mail it seems that this treatment was not able to solve the problem.
Although Titanium dental implants have a very high success rate (slightly higher success rate with mandibular/lower implants) they are not always 100% successful. However, once the failing implant is removed and healing has taken place, it is usually possible to have a successful implant completed in the general area of the original implant.
I realize hearing me talk about failing implants does not sound hopeful, but considering this is the second time this infection has returned, it is a possibility you should consider.
I recommend seeing an oral surgeon in your area, or in a larger city near you. A second opinion by an experienced implant oral surgeon would ease your mind about what options you have concerning this seemingly failing implant.
TotalConfidenceDentistry.com
Ron Briglia, DMD
Chester County Medical Building
600 East Marshall Street, Suite 201
West Chester PA 19380
(610) 692-4440
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