What happened with the tooth and can we keep the hopeless tooth?
Posted on 08.12.2012 06:28 AM By TRI DUNG NGUYEN In Periodontics
Dear my nice colleagues,
Today, my patient comes clinic because she's had gum swollen and painful for about 02 months. The position of the pain is the palatal gum of tooth 17 (right upper second molar).
When using the probe, I'm very surprised because the very deep pocket at mesial and palatal side around tooth 17 (the probe can reach the apex easily). The tooth has connected with 16 by 02 gold crowns. However now, I can feel it's loosing. I put gutta percha cone and take the Xray to confirm the pocket depth. I detect the distal side of this tooth is the impacted wisdom! Generally, in my opinion, there's only buccal wall is still OK, then, this tooth should be extracted as soon as possible. My question is what is the problem (reason) for bone loss in this case. 05 years ago, this tooth was healthy, no pocket when she first came my clinic and took panoramic film. She hasn't complained about this tooth until about 02 months ago. I'm affraid about occlusion trauma, but 16 and 17 are connected together and I don't see any problem of occlusion when checking with articulating paper. Every year she also comes for teeth cleaning. Maybe my hygienist doesn't check the pocket well and it's my clinic's mistake.
The next question is that it is really hopeless tooth and need to be removed, or is there any technique to save this tooth?
The last question is in case of extraction, should I use allo bone and membrane to graft in the socket (socket preservation) immediately to preserve the bone (but with the risk of infection), or I should take out the tooth, let the socket heal naturally, stop the infection and start socket preservation or implant placement 02 or 04 months later?
Thank you very much for your help.