Following the Removal of an Abscessed Incisor, Bone Graft Material Was Placed in the Location. What Do You Recommend?

Approximately a 1 Inch Lateral Incision was made along with a corresponding vertical incision. At the follow up appointment concerns were raised about the fact that the gums were not healing and that due to the amount of initial infection that the implant may not take. A second follow up has been scheduled to access my situation. What can I be doing to ensure maximum care for this incisor gum area so that implant success occurs in the next 9 days before my next appointment?

Doctor Answers 3

Anterior socket grafting for future implant

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This is not an easy situation. The anterior cases demand a lot of treatment planning, clinical skills of the dentist. Usually in anterior cases before the implant placement the soft tissue graft is added to assure that the gum level will be adequate. In order to improve healing you can use Peridex for rinses, and also place it in the grafted area on gauze or q-tip. If you still will have questions about procedure, healing process and possible complication I would advise you to consult with periodontist or oral surgeon.

Bone graft/incision healing

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This is a good question as there are often many variables. Healing will vary based on many factors including your own overall health. The best way to do this is to keep the area very clean usually with warm salt water rinses.  Often they will have given you a " Peridex" type rinse which contains Chlorhexidine. You can gently massage the area with a Q-tip soaked in this several times a day.

You would want to avoid smoking and eating any hard or crunchy foods that might damage the sutures inadvertantly.


Jeff Gray  La Mesa CA

Jeff C. Gray, DDS
San Diego Dentist

Implant For A Missing Lateral Incisor

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It is difficult to tell you what is happening without a photo.  A 1 inch incision along with a vertical incision seems excessive unless the extraction was a difficult one. The experience of the surgeon is paramount.  Also the placement of the vertical incision is important in healing of the gum tissue.  Finally the suturing technique is important in this region becasue it is very esthetic.  Without seeing a photo it is difficult to say. As long as the infected tissue was removed and properly treated and the extraction site was grafted appropriately with an appropriate material there should be no difference in future implant success.  IF the area is not healing well there must be a reason, possible residual infection, other health issues causing delayed healing, inflammatory issues, etc.  Keep the region clean and care for the area as your surgeon tells you to and follow up with him

Brian Dorfman, MD, DMD
Phoenix Oral & Maxillofacial Surgeon

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