Question from Raj: Why are graft particles coming out from my bone graft? (details below)
I’m a 31 year old who just had my lower left impacted wisdom tooth extracted and as my dentist also suggested bone grafting to preserve bone structure, I went along with it. It’s now 10 days post surgery and I still find graft particles of the bone graft (not alot, maybe a couple of em a day) sometimes tend to appear in my mouth. I did speak to my oral surgeon who performed the surgery and he said it could be due to the membrane not covering the graft site fully. He says it’s OK and to just continue monitoring and let him know if there is a lot of them coming out.
My question would be is this normal following a bone graft ? What’s the point of me doing the bone graft if these bone particles continue to come out thereby defeating the purpose of trying to regenerate the bone loss due to the extraction ? Or is this really a minor matter ?
I’m going to have my stitches (he did the permanent stitches) removed tomorrow and would appreciate your opinion on this. To be honest I’m kind of regretting doing the bone graft now and would appreciate your insight.
Thank you.
Regards,
Raj
Answer:
Dear Raj:
Although people rarely get a bone graft for a third molar extraction, I do not criticize your surgeon for recommending it, as I have seen patients with a periodontal defect behind the second molar caused by bone loss after a third molar was extracted.
Now to answer your question. In the case of an extraction socket graft for ridge preservation, it is common to see graft particles come out of the grafted area during the first few days, and it would depend on how well the collagen membrane or collagen plug seals the graft. In cases where you tuck the membrane under the soft tissue borders it seals better than in cases where it just covers the hole. After a couple of weeks, granulation tissue and epithelium start to cover the hole and cover the area, protecting the graft and allowing the bone in the socket walls to start growing tiny blood vessels through the graft to start the process of turning the bone graft particles into your own bone.
As long as most of the bone graft particles have remained in the socket and are covered by gum tissue to seal the wound, you should be fine. When your surgeon removes the sutures, he will examine the area and he will be able to tell you if everything is healing well.
Good luck !
Dentist In West Palm Beach
Carlos Boudet, DDS
1840 Forest Hill Blvd, Suite 204
West Palm Beach, Florida 33406
Phone: Call 561-968-6022
Website: http://www.boudetdds.com
Blog; http://mywestpalmbeachdentist.blogspot.com
I believe i have swallowed the synthetic bone graft material. Had procedure 2 days ago and believe the sutures busted. Is this synthetic bone graft material toxic if swallowed?
Hi Jeremy,
Swallowing some of the particles of the graft material will not hurt you.
Call your surgeon and tell them that you think the sutures are busted. They should be aware of what is going on so that they can guide you and tell you what to do.
I had a rear lower molar extracted fifteen days ago followed by granular bone grafting. The dentist said stitches would come out on their own, which they did. for the past six days everything felt fine and there looked to be white hard shapes in the socket that I assumed were the hardened material from the grafts. I have had no pain, bleeding or any signs of redness or irritation. After breakfast this morning when I went to brush my teeth, I noticed the white pieces were gone. There isn’t any pain or redness. but there just seems to be a hole where the white pieces were. It is a holiday weekend and I am scheduled for my followup on Tuesday. Is this the normal healing process? Should I avoid eating any solid foods until Tuesday?
Dear Gary:
Without examining you as a patient, I cannot tell you if you are healing normally.
There is nothing you can do other than avoid eating on that area.
Just call the dentist’s office and explain your concern. They are the ones that need to tell you what to do and maybe look at the graft area.
Thanks for your question and good luck!
Dear Dr. Carlos Boudet, I am from Myanmar and I did Implant place with the bone graft (lateral window sinus lift) at the upper left first molar region 3 months ago. But, from last 3 weeks, patient told me that there is a localized swelling at the buccal side of grafted area with pain and sometimes graft white particles are coming out.
Could you please kindly give me your expert opinion how to deal with this complication?
Sincerely,
Zayar Lin
Dear Dr. Lin
There are many things to consider here and you do not provide much information.
What happened during the first month?
Has the patient been seen?
Is the surgical site opened or a fistula present?
Maybe you should have done the graft first and wait for implant placement.
You should evaluate the patient and cover with an antibiotic like Augmentin.
Refer the case to an experienced oral surgeon and observe how he treats the complication.
Remember that you need to learn not only how to do a procedure, but also how to treat any complications that may develop.
Go back and re-examine everything you did and try to determine what you did wrong.
You can learn more from your mistakes than from successful cases.
Good luck!