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Dr. B. asks:
I had placed an internal hex 3.8mm x 12mm implant fixture in the distal root socket of a lower first molar immediately after extraction. The standard protocol of antibiotic cover and curettage of the socket were followed. No bone graft material was used. Sutures were removed after 7 days after implant placement. The patient presented for routine follow up 15 days after implant placement. Routine radiographs for taken for follow up and abnormalities were noted. The implant is not mobile, gingival healing is within normal limits without recession or dehiscence. But the patient complains of episodes of pain and heaviness in the area where the implant was placed and also in the ipsilateral submandibular lymph node. The submandibular lymph node is not enlarged and does not feel any different from the contralateral submandibular lymph node. Should I prescribe another round of antibiotics? Should I prescribe a different antibiotic the second time around? Should I just watch and wait? What do you recommend?