Apicoectomy Failure – Burbank Dental Implants Success Video Testimonial

Apicoectomy root canal procedures can and do fail leaving a bone defect. This bone defect can become problematic when having a dental implant. Even though a root canal and an apicoectomy can “save” a tooth, sometimes they are still lost. 

My patient came to my dental implant office in Burbank after realizing that her front tooth could not be saved. It is really an amazing video of her personal experience.  The best part is the ending, so make sure to watch the whole video. The pictures and x-rays are also included.

  (Please read: This is a follow up post to the same patient images used on a previous post.)

This is her personal experience with her dental implant and bone graft.

The stages of her procedures were as follows:

1. Extraction and bone graft and utilization of a removable “flipper” temporary.

2. Implant placement with an immediate same day fixed temporary.

3. Four months later, the final custom shaded and textured crown was delivered.

Here is how she started:

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Sorry for a little blood in this picture!!!  This shows great healing after the extraction and bone grafting.  Note how the bone is wide.

IMG_4132Implant placed without an incision -Ramsey Amin, DDS

IMG_4136Same day as surgery –this is the temporary on the implant.

IMG_4141Final smile!

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Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry
Burbank, California
https://www.burbankdentalimplants.com

 

10 thoughts on “Apicoectomy Failure – Burbank Dental Implants Success Video Testimonial”

  1. Hi Dr. Amin, I know you get a wide array of questions, and I’m hoping you might be able to respond to mine. I of course find this site after having the work done, it appears that apiectomies on front teeth seem to be a lost cause, but here I am. Due to an accident 25 years ago I had trauma on 8,9,10. 3 months ago I have had a apicoectomy and graft on number 9 due to a root canal failure, and an extraction and graft on 10 due to what I was told was a vertical crack. As I mention I am a few days past 3 months into this process, and I still have mobility on number 9. Should this be expected? I am still unable to eat normally and have to avoid this area because the mobility while not painful is terribly unnerving. How can I best navigate this circumstance, the plan is to place an implant in 10, and I guess hope for 9 to tighten up. Is this a time to just wait and be patient, or is this a time to try and correct course. Your advice would be most welcome. Thank you.

    Reply
    • If 9 is loose there is no way it will take. It probably just needs a bite adjustment for “fremitus” which is often overlooked! If the bite is the issue, the adjustment will often save it!

      Fremitus is the vibration we feel in teeth when the patient “chop-chops” on their natural bite or in maximum intercuspal occlusion. In anterior teeth, this is usually caused by a pathological occlusion, often an envelop-of-function violation. Like hypermobility, it is another sign of a pathological bite.

      Reply
      • Hi Dr. Amin, this saga is now far from over. Hoping you can offer some insights. My story begins in the previous post in 9/2021 – teeth 9 and 10 both developed fistulas, I was referred to an oral surgeon which removed and grafted 10, and performed an apico on 9. An implant was placed in 10 and currently has a healing cap, However the apico on 9 failed 10 months later. The oral surgeon has now removed 9 and grafted it. Now my regular dentist is recommending extraction of 8 (which is now loose after the oral surgery on 9) and waffling between placing an implant in 8 and an implant bridge on 8 and 10, or implanting 8, 9 as well and doing 3 implants. I don’t understand the waffle and I’m hoping you can share your thoughts.

        Reply
  2. Hello Dr Amin,

    I had my front four teeth crowned at the age of 15 (20 years ago) after a sporting accident. A few years after that I had to have one of them apicoected – which was done at a hospital. The apicoected tooth always had from xrays a dark shadow around one part of it (which I have in an email attachment). Which as there was no bleeding or swelling presumed as did other dentists was just scar tissue. It was a large apicoectomy. However 15 years later at the age of 30 (2008) I had them all recrowned with ceramic – and so all the posts were taken out. Four years on I had an xray taken (2012) and the dark image which was thought to be scar tissue seemed to have gone around the tooth now. I went to visit a top periodontist and endontist, both of which although they could see the change in shading on the images couldn’t see any external signs of infection and said don’t mess with it. Just leave it.

    Im just wondering whether you could shed any light? and if I need to do anything? The apicoected tooth seems stable – apparently not as stable as the others but stable enough. I noticed there didnt seem to be the evidence of a post like there was before in it? The old poreclain crowns all had metal posts which were taken out and replaced with fibre ones. Although I dont see the bright white evidence of any post in that tooth like the others under the more recent xrays now. Im wondering – has this caused the extra shadowing?

    Id appreciate your help :@)

    Thanks

    Reply
    • You definite a 3-D scan to really evaluate this. Most of these teeth leak and become a chronic source of infection over the years. You will likely need retreatment apico with a bone graft or an extraction altogether. The key is the 3-D scan for proper evaluation.

      The timeline sounds fairly normal. This tooth is not likely to last your entire lifetime unfortunately. Sorry for the bad news.

      Good luck

      Reply
      • Thanks so much for that. Is it possible to do bone graft without extracting the tooth? I’m trying to prolong the natural root for as long as possible?

        Reply
        • Yes it is possible to Graft around existing teeth.
          This will depend on what type of “defect” you have around the tooth.

          Most defects are not graftable which requires extraction but some are!!

          If the tooth is loose, it is hopeless.

          Good luck.

          Reply
  3. Not a comment but a question. My daughter had two apicoectomies, the last one four years ago which was done as an emergency operation in hospital. She once again had an abscess in 2013 and was advised to have a dental implant. The abscess was apparently removed, bone grafting done (and remember by now there was almost none of her own bone left to graft), and the first step of implantation was done, ALL SIMULTANEOUSLY on the same day and time and without any anaesthetic. After less than a month during an emergency procedure by another dentist, the implant was removed AND THE ABSCESS, which was apparently not completely removed during the bone grafting and implant stage. Thereafter every three and a half months she had bone grafting which did not work at all and eventually after one year she and her new dentist decided on a bridge which just works wonderful. No problems at all!!!! Having regard to the fact that she had two apicoectomies before during surgery under aneasthetic, should there not have been a waiting period of three to four months when the third abscess was removed to make sure that there was no further infection before bone grafting was done and dental implant started with? I am just curious to know. As I said, she is very happy with her bridge which I think should have been the first option in stead of an implant. By the way, she has a heart condition and is a smoker, obviously some factors which was not taken into consideration at all. Thank you.

    Reply
    • Hello Rencey,

      My guess is all of the infected tissue was not removed at the time of the first surgery. Removal of all of the dead tissue around of bad tooth is a learned skill. The key to doing this properly is to make a very large incision and exposing a lot of bone. Too many times a small incision is made to try to be conservative but it does not allow a well-meaning dentist to remove all of the infection/inflammation.

      Incision with wide margins in remote locations help with blood supply and complete removal of dead and/or dying tissues. With this type of incision and exposure it is very possible to do all procedures on the same day if the infection is not to serious. It is also most helpful for a single dentist to be in charge of all things. It sounds like you had to see several different dentists each of which may not have been on the same page.

      I am glad the bridge is working out for her. Sometimes a dental implant is not the best option for some patients. Make sure she flosses under it on a daily basis. This will lengthen the duration she will have this bridge. If she is under 45 years of age she will be replacing this bridge a few times. Of course diet is a huge part of longevity of a bridge. All soda must be eliminated!

      Thank you for sharing your story.

      Very Respectfully,

      Ramsey Amin, DDS
      Diplomate of the American Board of Oral Implantology/Implant Dentistry
      Fellow of the American Academy of Implant Dentistry
      Burbank, California

      Reply

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