How to fill a hole...

RE: How to fill a hole...

Evelyn Barbour-Hill — Mon, 03 Sep 2018 22:21:30 GMT

You could use plaster of paris. I'm not suggesting you should, but as a historical note, it can be and has been used successfully to fill holes in bone.

Autograft should be cheap – free, in fact!

RE: How to fill a hole...

Iain Richards — Mon, 03 Sep 2018 19:34:43 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Iain Richards"]

As the pocket doesn't look that inflammed, is there any need to do anything? This is a genuine clinical question, not a snarky comment!

[/quote]

It looks very inflamed to me. And as it is constantly suffering food packing, it can only get worse.

[/quote]Trip to specsavers booked!

RE: How to fill a hole...

Anthony Todd — Mon, 03 Sep 2018 15:48:54 GMT

Try "dental bone void filler" search on google; seems a few products for just that???

RE: How to fill a hole...

Evelyn Barbour-Hill — Mon, 03 Sep 2018 15:16:57 GMT

[quote user="Martin Atkinson"]I can see there is the gold standard way of fixing this but would it not be effective enough to scrape out the mucosa in the deficit, create a mucosal flap to suture over and allow a clot/granulation tissue to fill the majority of the deficit? £100's instead of £1000's. [/quote]

If it worked. Bit of a waste of money if it didn't.

RE: How to fill a hole...

Martin Atkinson — Mon, 03 Sep 2018 15:12:08 GMT

[quote user="Rob Davis"]

[quote user="Iain Richards"]

As the pocket doesn't look that inflammed, is there any need to do anything? This is a genuine clinical question, not a snarky comment!

[/quote]

The mucosa in the pocket in significantly inflamed and stinks (that is the owners main complaint at the moment!). It could be left, but unless the owner is able to flush it daily (unlikely) then there will at the very least be ongoing significant halitosis, and I suspect may lead to further problems.

[/quote]I can see there is the gold standard way of fixing this but would it not be effective enough to scrape out the mucosa in the deficit, create a mucosal flap to suture over and allow a clot/granulation tissue to fill the majority of the deficit? £100's instead of £1000's.

RE: How to fill a hole...

Rob Davis — Mon, 03 Sep 2018 08:54:02 GMT

[quote user="Iain Richards"]

As the pocket doesn't look that inflammed, is there any need to do anything? This is a genuine clinical question, not a snarky comment!

[/quote]

RE: How to fill a hole...

Rob Davis — Mon, 03 Sep 2018 08:51:56 GMT

[quote user="Peter Southerden"]Great images![/quote]

Glad you like them!

[quote user="Peter Southerden"]The post op shows why the mucosa has healed as it has and the region that would benefit from a graft.[/quote]

For future reference, what might has you done differently at the initial surgery to avoid this problem? I did consider using a graft at the time (I did post the question on here but received no replies) but the deficit was so huge that it would have required a prohibitively large amount of graft material.

RE: How to fill a hole...

Evelyn Barbour-Hill — Sun, 02 Sep 2018 23:35:29 GMT

[quote user="Iain Richards"]

As the pocket doesn't look that inflammed, is there any need to do anything? This is a genuine clinical question, not a snarky comment!

[/quote]

It looks very inflamed to me. And as it is constantly suffering food packing, it can only get worse.

RE: How to fill a hole...

Peter Southerden — Sun, 02 Sep 2018 23:21:15 GMT

Hi Rob

Great images! The post op shows why the mucosa has healed as it has and the region that would benefit from a graft.

Thanks

Pete

RE: How to fill a hole...

Peter Southerden — Sun, 02 Sep 2018 23:16:57 GMT

Hi Rob

I'd use an allograft but an autograft would be as good/better.

Pete

RE: How to fill a hole...

Iain Richards — Sun, 02 Sep 2018 13:34:58 GMT

As the pocket doesn't look that inflammed, is there any need to do anything? This is a genuine clinical question, not a snarky comment!

RE: How to fill a hole...

Rob Davis — Sat, 01 Sep 2018 10:33:44 GMT

Hi Pete, that was quick!

I have just uploaded some images to the gallery, though the order seems to have been messed up and I can't see any titles, but I'm sure you can work them out.

CT was done yesterday, I can upload more images if you would like to see them.

[quote user="Peter Southerden"]Then probably bone graft[/quote]

Would you do an autologous graft or use allograft, bioglass etc?

ED'S NOTE - ROB'S IMAGES NOW UPLOADED TO THE GALLERY WITH CAPTIONS, AND IN ORDER (I THINK/HOPE)

RE: How to fill a hole...

Peter Southerden — Sat, 01 Sep 2018 10:23:17 GMT

Hi Rob

You need an x ray or preferably CT first. Then probably bone graft, excise the inflamed tissue and reconstruction. Do you have images of the original odontoma? It would be interesting to see them.

Yours

Pete