“I had a recent extraction procedure but there are fragments still in the x-ray?”
I recently removed a lower left wisdom tooth, a molar root, and on the lower right side another molar. The lower left wisdom tooth had a fragment still remaining and was removed with a second procedure. The molar has fragments that I can literally feel with my tongue and there are visible lines in the x-ray but the surgeon told me it was just bone that could be shaven down. I'm not sure I agree with that assessment and would like a new set of eyes to take a look at my situation.
Male | 37 years old
Complaint duration: 2 months
6 Answers
It could be a bone sequestrum or possibly tooth fragment. It’s common and requires a simple follow up to remove it. It appears you have a large cavity in the tooth in front of it which may need root canal treatment.
An X-ray of the extraction site would alleviate your concerns. During the healing process the extraction socket may present with something called a "bony spicule," which is like a bone splinter. These normally are pushed to the surface and disappear. Sometimes the extraction socket feels like there is something sharp, but that is just the way the gum is healing. Your surgeon probably didn't explain things fully, or during such an anxiety filled appointment, the information wasn't fully understood. I would not stress over this. The photo enclosed appears like the extraction site is healing within normal limits.
Lower molars are notorious for pieces of tooth or bone breaking off during extraction. Sometimes as you describe, it is necessary to go back in to retrieve an unwanted piece of tooth. In rare cases, a portion of the root may remain after the extraction and the surgeon may elect to leave it in place, since trying to retrieve it may be risky to other teeth and/or nerves and blood vessels.
Bone can break during extraction. Sometimes that small break is clean through and the piece can easily be seen and removed.
Other times, however, the bone fractures but doesn't detach. Over time it will eventually dislodge and try to come out through the gum, just like a splinter. Often that is on the tongue side of the extraction site. Patients have been know to remove the "splinter" themselves, but your dentist can do that as well.
Also, removing a tooth can result in a sharp contour to the bone that will eventually smooth out on its own. It can be very irritating to the tongue. If is too much of a problem, your dentist can remedy it, but that may involve some minor, additional surgery.
Dr. Conrad
Bone can break during extraction. Sometimes that small break is clean through and the piece can easily be seen and removed.
Other times, however, the bone fractures but doesn't detach. Over time it will eventually dislodge and try to come out through the gum, just like a splinter. Often that is on the tongue side of the extraction site. Patients have been know to remove the "splinter" themselves, but your dentist can do that as well.
Also, removing a tooth can result in a sharp contour to the bone that will eventually smooth out on its own. It can be very irritating to the tongue. If is too much of a problem, your dentist can remedy it, but that may involve some minor, additional surgery.
Dr. Conrad
It is fairly common to have sequestra, little pieces of bone that work their way out of the bone after an extraction.
The oral surgeon is correct. It is not unusual to have a sharp edge of bone protrude through the gum. It is easy to shave down so the gum can grow over it and close the extraction site.
Drew Shulman DMD, MAGD
Drew Shulman DMD, MAGD
Get a second opinion from another oral surgeon. It is hard to read the X-rays, but it seems that bone fragments are trying to be removed from your body and they probably will in time. Warm salt water rinses will help your body push out these bone fragments.
