Implant for abscessed failed root canal: can it wait?

Last Updated: Apr 25, 2016

Please see attached image (sorry for quality). Background: A week ago I felt a large hard lump along my jawbone. There’s noticeable swelling that I think hasn’t gotten any worse and it’s bothersome (it throbs sometimes) but not at all painful.

Dentist says he first noticed it two years ago. Hasn’t said if the defect has gotten bigger/deeper.

I’ve almost decided against the apicoectomy and endo re-treatment.

Extraction & immediate implant, will unfortunately need to wait for at least another month. Can it wait? Regarding bone loss…

It’s a long story, but for medical reasons I can’t take antibiotics.

If the abscess hasn’t subsided by the time the tooth is extracted, will it go away when the infected tooth is pulled out, even with implant in place??

I’m so confused…

Thank you for any advice you can provide.

![]](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2016/04/1.jpg)sorry about the quality!

10 Comments on Implant for abscessed failed root canal: can it wait?

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Dr. JLD

04/26/2016

I guess I would have to ask - why the hurry? Why not give the socket some healing time before doing the implant? I don't see the urgency here and have some misgivings about immediate placement into an area that has reportedly been infected for two years. Maybe I am too cautious, but this seems a moment to be cautious.

DrT

04/26/2016

With the area of infection on the x-ray in spite of the limitations of antibiotics, I would highly recommend one be used in this case.

Dennis Flanagan DDS MSc

04/26/2016

Remove the tooth as soon as possible. That plane film apical lesion is probably a lot larger. The longer you wait the more bone destruction will occur, lost bone you will have to grow back. Additionally the lesion should be scrupulously debrided to reduce the possibility of any remaining bacteria from colonizing an implant. Dennis Flanagan DDS MSc

James Hastings, DDS

04/27/2016

I agree on all counts. This tooth is not a reasonable candidate for endodontic re-treatment/apicoectomy. Long term survival prospects are poor. The antibiotic limitation notwithstanding, use of herbal supplements and a healthy immune system will enhance your ability to heal. Removal of the offending tooth, thorough curettage, bone grafting and a waiting period will probably give you the best opportunity for a good prognosis when the implant is placed. Immediate placement is not really your best option if you want this to work. Good luck! James H. Hastings, DDS

Howard Aaronson, DDS

05/02/2016

What is the big rush to extract The previous endodontic therapy is poor at best. Canals are poorly obturated and short Why sacrifice this tooth and place an implant. Retreatment is the first and best option

Jawdoc

04/30/2016

1. Remove the infected tooth 2. Thoroughly debride the socket & graft it. 3. Wait at least 3-6 mths 4. Take a series of PA radiographs monthly to check on healing process & the absence of pathological remnants (eg residual cysts etc) 5. Place implant 6. Delayed/late loading

CRS

05/01/2016

Extract tooth, great indication for debridement and Nd -Yag disenfect ion of site with immediate bone graft. The laser targets the pigmented bacteria. Would also need to know particulars on the antibiotic issue. Don't understand why dds would " watch this " develop allowing a head start on bacterial involvement in bone. The lump of the jawbone most likely is a chronic infection but it could be anything may need to drain and biopsy. Seek treatment elsewhere.

Valentin

05/04/2016

Extarct, curetage, lavage , wait 3 weeks , come back and implant 1-2mm subcrestal and submerged. Engage some solid bone , primary stability is not so important . Good luck

Peter Fairbairn

05/04/2016

Valentin, agree have done thousands like that , here is the protocol , "the body wants to heal lets work with it " http://www.hindawi.com/journals/ijd/2015/589135/,,,, Yes new research being done backs up what we see about primary not critical for goos integration .. Regards Peter

Nikos Pontikakos

10/12/2016

" Iâ€™ve almost decided against the apicoectomy and endo re-treatment. " I would advise you to reconsider re-treatment (apicoectomy ? only if the re-treatment is not enough to give your bone the chance to heal itself), the obturation on both roots is short. If the endo-specialist says it is untreatable, then consider a two- or three -stage implantation (extraction- implant-restore)

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