65 year old female smoker. Severely infected #30 was extracted, curetted grafted and membrane placed. 2 week post op healing was normal. Pt presented at 5 weeks with graft blown out and a5 mm deep tissue lined socket. Patient has bilateral buccal mandibular exostosis. My question is should I regraft at this point, and remove exostosis to get a primary closure or wait 6-9 months for healing and then hope for enough bone to place an implant? Thanks for your opinions.
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If she has bilateral exostosis then it can be assumed that she has a wide ridge and never needed the graft in the first place. Do nothing and feel free to place an implant in 6-8 weeks.