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Bone graft, wisdom tooth removal and a hole still open after 5 months

M

MissZ

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Jun 23, 2020
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5 months ago I had an ameloblastoma (odontogenic keratocyst) removed from my lower gum (early 40's). It was at the back of the jaw right underneath my last molar (a healthy tooth). During removal the same molar and unerupted wisdom tooth were extracted. Bone graft was necessary because supposedly bone was lost due to the size of the cyst. Recovery very slow and difficult. Until a month ago still had noticeable lump on the side of the gum with some discharge ( from opening mentioned below) and slight tenderness. At present time all appears to be calm, lump has decreased in size. I can still feel my lymph node on that side if that makes any difference. However what seems to be the spot where my wisdom tooth was extracted is still open when my surgeon goes in with the curved syringe, it goes deep. Otherwise appears closed when looking at it with a mirror but one can clearly see where the opening would be. MY QUESTION is, is this normal in my case after 5 months? Surgeon has been telling me that I need another surgery to close the hole. I don't want to go through this again. And I surely don't want to be paying for another surgery especially if it is not necessary. I am looking for opinion by professionals on whether or not this condition is normal in this situation and if perhaps could take more than 5 months for the hole to close up. Should I be concerned and is it possible for a hole like this one to close on its own eventually? Thank you!
 
Gordon

Gordon

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MY QUESTION is, is this normal in my case after 5 months?

Sorry, it's impossible to answer this via the internet. Need to see some x-rays in a series to see what's happening with the bone and no idea of your past medical history (in case there's something there that would affect healing).
Your best bet is to find another surgeon for a second opinion if you no longer trust the first one.
 
C

comfortdentist

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First an ameloblastoma is NOT an odontogenic keratocyst. These are distinctly different and with different problems. Both can reoccur although the ameloblastoma has a higher rate of recurrence and is more aggressive in general.
As to your details no one can tell you without a good examination. If you seek a second opinion the surgeon will need a cbct(ct) scan of the area. Actually your current surgeon may want one to determine the extent of your problem.
There are several possible situations here and they must be investigated.
Typically medical insurance gets involved in these surgeries. An excellent place for a second opinion is a teaching hospital that has an OMS program. The one here in Miami is excellent with some world class surgeons.
 
M

MissZ

Junior member
Joined
Jun 23, 2020
Messages
2
Location
usa
Thank you both for your responses! I wouldn't know the difference between the ameloblastoma and the keratocyst I simply copied it the way it was written in my biopsy report. I just assumed it was the same thing I never knew anything about this stuff. The surgery was considered medical and was through my health insurance. Was told the secondary would also be considered medical. Unfortunately in my area the clinic I am visiting seems to be the only one that does those types of surgeries. I did initially go to another oral surgeon who also referred me to my current surgeon due to the complexity of the case. Knowing that I didn't have the issue I am dealing with now before I had the surgery and the fact that the nerve on the side was cut during surgery and now I am still numb makes it very frustrating. I would like to go else where just don't know where. I have to search for a teaching hospital near me I guess.
 
C

comfortdentist

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You could inquire as to nerve grafting which is is highly specialized skill. I have no idea as to if you would possibly a candidate or not. Generally limited to major centers as the demand is so low.
 
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