Can I have scar tissue over removed implant removed?

[Trudijane]

After numerous procedures/grafts to fix an implant it eventually had to be removed when it lost integration with the bone.  I've had many skin/tissue grafts to fix a problem over the implant.

Now, I have this scar tissue (my periodontist thinks) or something that feels like little marble in my very upper cheek.  It's really driving me crazy.  It doesn't hurt but it's distracting 24/7.  Can this be repairs as it once was?

I hope so because I'm finding this very hard to tolerate.
Thanks.

[Trudijane]

This is a follow-up to my previous situation.  After a year of procedures, I lost the implant.  A year later (now) I decided to try again to replace the implant.

This time, I needed a bone graft as shown by the tomograms.  So far 2 bone grafts failed since the sutures opened due to 'flap tension' according to my periodontist.  

I am now left with opening 2 weeks after the 2nd bone graft.  You can see the bone that was put in and it does not look like it's going to heal on it's own.  I'm SO tired of all the procedures and failing.

Any feedback would be appreciated.

[Trudijane]

My periodontist asked me to wait at least a month for full healing to take place after the removal of the implant.  I agreed and we both hoped that whatever was bothering me in my upper cheek/gum area would gradually go away.

After 3 weeks, it's still there and although there is no pain, it's the kind o feeling that is so bothersome and intrusive that I know I have to try to hollow this area.  I'm most aware of it when I smile/talk and so it has caused me to be antisocial and drink too much wine.

I know this sounds strange, but this is just how much whatever extra tissue there is back there, is bothering me.  He promised me he would send me to this oral surgeon to do what was necessary after month, however, I'm so scared that whatever he decides to do will make things even worse.  But I have to do something.  

I keep putting my tongue in the area which by the end of the day also hurts, but pushing my cheek to give my upper gum area room to breath feels a little better because then I don't feel like it's intruding on the other side.

This problem started after the procedure where my periodontist pushed something called a buccal fat pad (which emerged beneath my gum when he opened up a flap) back beneath the gum so that he could resuture the gums back together.  It took a long time since the fat pad was round and slippery.  I have a picture of it.  So - I wonder where it went?

Anyway, it was after this procedure that I had problems with having extra tissue in I think it's called the vestibule.  Although my periodontist says it's scar tissue, I'm not so sure.  I have this feeling it has something to do with the buccal fat pad.  Perhaps it's displaced?

I have another 2 weeks before I see my periodontist.  

[Trudijane]

Thanks very much for your reply.

My periodontist is having me wait for a month for all healing to take place to see if this scar tissue or whatever it may be will go away over time.  If it still bothers me, he's going to send me to an oral surgeon for an evaluation.

I massage the area every day and rinse with warm water.  I think it may be getting easier to bear, but some days I'm not sure.  Time will tell - but thanks for your advice.

I reallly appreciate it.

[Sanjivani Wanjari, MD]

Hi,
The marble like thing in your cheek, which you think is scar tissue can be surgically removed by your Doctor. It can then be sent for pathological examination to find out if it is scar tissue or something else. However if this is really scar tissue, there is no guarantee that the scarring will not reappear. Some people form more scar tissue than others. This is a body reaction.
The answer is based on information provided. Exact advice is not possible without a proper examination and investigations. You are requested to consult your Doctor. Take care and keep us posted.