Post-Operative Pain for Implant Patient: What Do You Recommend?

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?

5 thoughts on “Post-Operative Pain for Implant Patient: What Do You Recommend?

  1. Carlos Boudet, DDS says:

    You haven’t posted any radiographs or pictures, so we have no idea of the way things look other than what you tell us.
    Was the implant placed as a one-stage or submerged and covered by the tissue?
    Is the socket of the mesial root exposed?
    Antibiotics is not a standard protocol in a routine extraction, and I don’t think you would put an implant in a socket with an infection. The prudent treatment is to extract and wait, then place the implant.
    If there is no swelling, fever or signs of infection after a regimen of antibiotics, the benefits of a second round of antibiotics is questionable.

  2. peter fairbairn says:

    I am afraid any prolonged pain is indicative of infection and possible loss of the implant. Be very wary of placement into infected ( or adjacent tooth infection ) sites.
    All my patients never required pain medication by the following day if they do I become concerned.

  3. marik ina says:

    maybe… just maybe the patient had fatigue of the muscular jaw. sometimes they said around ipsi lateral submandibluar. sometimes they mean from masseter origo insertio. maybe just maybe…. u should ask the patient and listen to the complain, what time , when eating, after wake up etc… and make the diagnose later on.


Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Questions, Dental Implant Complications.
Bookmark Post-Operative Pain for Implant Patient: What Do You Recommend?

Videos to Watch:

Dealing with the Implant Gap

This short video discusses how to best deal with the gap after immediate implant insertion[...]

1 Comment

Watch Now!
Lower Right Molar Extraction & Immediate Implant Placement Using i-PRF

In this video, the lower right second molar was extracted and grafted with i-PRF and[...]


Watch Now!
Maxillary Implantation with Treatment of Chronic Sinusitis

This video shows two cases where implants were placed following treatment of Sinusitis. [...]


Watch Now!
Suturing in Guided Bone Regeneration

This video provides clinical tips for suturing techniques in Guided Bone Regeneration. In Guided Bone[...]

1 Comment

Watch Now!
Socket grafting with Collagen Dressing and Bond Apatite

This video demonstrates socket grafting with just bond apatite and a collagen wound dressing.[...]

Watch Now!
Dental Implant for Lower Right Second Molar

This video shows implant placement on the lower right second molar.[...]

Watch Now!
Saving a Bridge with Periodontal Therapy

This video shows a case involving a 48-year-old male who was referred for periodontal treatment[...]

Watch Now!
Immediate Loading Full Arch

This video shows a case of Immediate loading of a full arch with simultaneous guided[...]

Watch Now!
Apically Repositioned Flap Technique Around Implants

The apically positioned flap is a commonly used surgical approach, that may help the long[...]

Watch Now!
Digitally Planned Bone Augmentation and Immediate Implantation

This video shows a case using the Ring technique to provide bone augmentation along with[...]

Watch Now!
AnyRidge Implants: Replacement of Upper Left Molars

This video shows the replacement of maxillary upper left molars with Megagen AnyRidge Implants.[...]

1 Comment

Watch Now!
Guided Implant Surgery & Immediate Temporisation

This video demonstrates the placement of a missing pre-molar using computer-guided surgery and immediate temporization.[...]

1 Comment

Watch Now!