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Can infection from dental abscess prevent socket graft and delay bone graft until after extracted tooth heals?

I have an abscessed tooth #30. The Periodontist will extract the abscessed tooth and put collagen plugs in the socket to aid healing and is using a flap. I thought it was best to bone graft the socket at the time of extraction. I've read grafting the socket is best but the Periodontist is not recommending this. I do want to proceed with an implant and realize this process can take months.

Doctor Answers 4

Grafting and infection

February 19th, 2014
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Grafting materials have better success rate if they are placed in the site that has no inflammation or active infection going on. For better results  abscessed tooth should be extracted, infection resolved and then bone grafting and implant placement (simultaneous or staged) performed.
Implants are an excellent treatment option that we can offer to our patients, however you as a patient have to be patient, because it takes some time.  Good luck!
Zina Kaleinikova, DDS, MS


Cleveland Dentist
5.0 out of 5 stars 2 reviews

Grafting at the time infected tooth is extracted.

February 19th, 2014
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Like others who have answered, I support grafting at the time the tooth is extracted.  It is prudent to take antibiotics prior to the extraction. Once the tooth is out of the socket, the surgeon can thoroughly clean and disinfect the area prior to placement of the graft. Even when there is no infection present, we are always asking our bone grafts to heal in the presence of bacteria. It is simply the nature of working in the mouth.
Steven Patty, DDS

Steven Patty, DDS
Charlotte Oral & Maxillofacial Surgeon

The effect of a dental abscess on the placement of a bone graft

February 19th, 2014
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Thank you for your question. It is excellent that you are planning on restoring your infected tooth with an implant. If a dental abscess is present, it is always more predictable to extract the tooth and let the site heal before attempting to place a bone graft. For some infected teeth, the patient can be placed on antibiotics for a few days to decrease the infection. After a few days, the tooth can be extracted, the site curettaged, and a bone graft may be placed. If there is a large infection, however, this may not be a possibility as it could risk infection/failure of the bone graft. Based on your description, I would recommend trusting the judgement of your periodontist. Good luck and best wishes. 
Charles Sutera, DMD

Charles Sutera, DMD
Boston Dentist

Infected tooth and bone graft

February 19th, 2014
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what your periodontist is suggesting is not wrong.
There are different ways of achieving the final result (replacing your tooth with an implant)

Personally, I start the patient on Antibiotics 3 days before the extraction.  extract the tooth and clean the tooth socket and bone graft and continue my patients on antibiotics for another 7 days  This is how I was trained.

There are recent reports that other doctors are extracting and placing implants at the same time even if the tooth has infection.

Others, extract, wait for 6 weeks of tissue healing and resolution of infection, go back and bone graft or place the implant.

All these are well documented in the literature.

And your treatment will depend on ,  your surgeon's training, his/ her comfort level as each approach has it's pros and cons.


Elly Tehrani, DMD, MSD

Elly Tehrani, DMD, MSD
Toronto Periodontist
5.0 out of 5 stars 30 reviews

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