When a Dental Extraction Doesn’t Go as Expected

A Patient’s Journey:

Some dental stories are straightforward.Others are not.

This is the story of a patient who came to us not asking for a quick fix — but for understanding.

A History of Dental Trauma and Slow Healing

The patient had a long and complicated dental history, particularly involving the lower-left jaw. Over the years, she had undergone multiple procedures — including difficult extractions and apical surgery — all of which were described as traumatic, prolonged, and slow to heal.

Despite the gum tissue eventually closing over, the area never felt “right.” There was no sharp pain, no obvious infection — just a persistent sense of fragility and discomfort.

In January 2026, she underwent treatment for a lower-left molar under IV sedation at another clinic. Shortly after, she began experiencing atypical facial pain, alongside a growing concern that something deeper in the bone had never truly healed.

A Broader Health Context

What made her case especially complex was that this was not just a dental problem.

She had a background of:

• Poor wound healing since childhood cardiac surgery

• Marked sensitivity to medications and dental materials

• Periods of profound fatigue and weakness

• Significant weight loss during previous dental trauma

• High anxiety around invasive procedures

  
  

She was well-read, cautious, and understandably fearful of further intervention. Her goal was not aggressive treatment — it was clarity.

The Consultation: Listening First

When she presented for review, her primary concern was the lower-left premolar region, where teeth had previously been removed.

Clinically, the gum tissue looked intact — but the ridge felt thin and collapsed. Radiographic review, including prior CBCT imaging, revealed something important:a radiolucent defect in the jawbone, consistent with a non-healed cavitation.

There were no signs of acute infection. The nerve canal was safely distant. But the internal bone structure appeared compromised — hollowed, inactive, and poorly regenerated compared with surrounding bone.

This aligned with what the patient had been feeling all along.

Shared Decision-Making and Consent

Given her history, the discussion was deliberately unhurried.

We talked through:

• What cavitations are — and what they are not

• Why some extraction sites fail to heal internally

• The difference between surface healing and bone vitality

• Conservative options versus surgical intervention

• The role of platelet-rich fibrin (PRF) in supporting bone recovery

Only once she felt fully informed and comfortable did we proceed.Consent was obtained not just formally — but emotionally.

The Procedure: Addressing the Root of the Problem

Under local anaesthesia, a small mucoperiosteal flap was raised in the lower-left 4–5 region.

Almost immediately, the issue became clear.

Beneath what appeared to be healed gum tissue lay obvious necrotic bone — a true cavitation. The area lacked normal bleeding and vitality, confirming that the bone had never properly recovered from prior trauma.

The cavitation was carefully debrided using implant osteotomy drills, removing the compromised bone while preserving healthy surrounding structures. The site was then deliberately allowed to bleed, encouraging revascularisation.

Adjunctive ozone therapy was applied, followed by placement of PRF deep within the defect to support healing.

The area was closed gently and securely.

Photographic documentation was taken throughout — not for drama, but for transparency and clinical clarity.

Aftercare and Reflection

Postoperative care was simple and supportive.No aggressive medication.No unnecessary intervention.

What mattered most was giving the body the conditions it needed to heal — something it had not been able to do previously.

A review was planned for two weeks later to assess both:

• Local healing

• Changes in the patient’s facial pain and overall symptoms

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Why This Case Matters

This patient’s story highlights an important truth:

Not all dental problems declare themselves loudly.Some sit quietly beneath healed gum tissue, waiting to be recognised.

Cavitations are not a diagnosis to be made lightly — nor dismissed casually. They require:

• Careful imaging

• Clinical correlation

• Respect for the patient’s lived experience

• A measured, ethical approach to treatment

For this patient, the journey was as much about being heard as it was about surgery.

Final Thoughts

Dentistry is not only about teeth.It is about healing — and sometimes, about repairing what never truly healed in the first place.

If you have been told that “everything looks fine” but your body tells you otherwise, a thoughtful review may be the first step toward clarity.