Pain after Grafting in the Mandibular Second Molar: Any Experience with this?
Dr. L asks:
I have had the following clinical scenario happen three times during the past two years. In each instance the patient had a mandibular second molar extracted, the socket grafted with mineralized cancellous allograft, a membrane placed and four to five months time allowed to pass before placing the implant. At the time of implant placment the patient complained of pain upon drilling the osteotomy. Anesthesia was provided via buccal and lingual infiltration. I do not administer an inferior alveolar nerve block in the mandibular arch. During insertion of the implant, two of the patients complained of discomfort. Once placed, the pain subsided. In one of the three cases the patient had discomfort during the uncovering process when I inserted the healing collar. In this latter case the implant appears to be both clinically and radiographically integrated. In no other site in the mouth have I had this occur. Anyone have a similar experience in the mandibular second molar area or have insight as to what maybe causing these clinical symptoms?