Radiolucent periapical lesion in patient with osteoporosis: Recommendations for implant installation?
Last Updated: Oct 03, 2012
I have a 67 year old female patient with osteoporosis. Â I extracted #4 [maxillary right second premolar;15] due to a failed endodontic treatment and non-restorable root fracture 4 months prior. Â The tooth had an abscess and a very definite radiolucent periapical lesion visible on the pre-operative periapical radiograph. Â There was a significant buccal cortical plate defect following the extraction. I curretted the socket aggressively to remove infected material. Â I grafted with Bio-Oss and covered with a resorbable collagen membrane. Â I did not pack graft material in the very most periapical reaches of the extraction socket because I was concerned about penetrating the maxillary sinus. Â The medical history is significant for Metformin for well controlled diabetes and bisphosphonates for osteoporosis. Â She has been receiving IV Risedronate. Â I have postponed the implant installation for 6 weeks to see if the periapical ‘shadow’ disappears due to bone remodeling and continued healing. Â I am planning on installing a 10mm MIS SEVEN implant which will reach the area with the shadow.
1)Should I continue to wait and observe this shadow to see it will completely fill in with new bone?
2)Are there any special precautions I should take when I do the implant installation?
Any other recommendations would be appreciated.
Most current X-ray of the 15 site. Approx 4 months since exo + Bio-Oss
![]Most current X-ray of the 15 site. Approx 4 months since exo + Bio-Oss](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/10/Image012.jpg)
Infected 15 site before extraction and bone grafting
![]Infected 15 site before extraction and bone grafting](https://osseonews.nyc3.cdn.digitaloceanspaces.com/wp-content/uploads/2012/10/Image015.jpg)
22 Comments on Radiolucent periapical lesion in patient with osteoporosis: Recommendations for implant installation?
Leal
10/03/2012
Leal
10/03/2012
a
10/03/2012
CRS
10/04/2012
sb oms
10/04/2012
CRS
10/05/2012
Richard Hughes, DDS! FAAI
10/07/2012
CRS
10/07/2012
Richard Hughes DDS FAAID
10/08/2012
greg steiner
10/08/2012
pcPerio
10/09/2012
drD
10/09/2012
DrT
10/09/2012
gary omfs
10/10/2012
Farhan Qureshi
10/09/2012
Baker k. Vinci
10/09/2012
Baker k. Vinci
10/09/2012
Sam Jain DMD
10/10/2012
Baker k. Vinci
10/15/2012
CRS
10/20/2012
Richard Hughes, DDS, FAAI
10/22/2012
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10/03/2012