A middle aged woman presented with a swollen gingiva buccal to tooth #15 which had a previous RCT and crown. The crown had fallen off with the post sticking up and a dentist cleaned it up and recemented the crown. A few days later her gum swelled up and her dentist said she had food impacted and gave her antibiotics and Peridex to rinse with. It only slightly improved and she came to see me. It appeared to be a bigger problem and I referred her to an endodontist who took a CBCT and diagnosed a fractured root and recommended extraction. The CBCT also shows a large infection induced perforation into the sinus and the patient has sinus pressure and sometimes pain when bending over.
I am wondering if I should place a membrane and bone graft after extracting the tooth or if I should let it drain on its own? She would like to have an implant once it has healed.
Any good feedback will be appreciated.
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