RB

In regard to a 14-year problem, with two surgical attempts that failed to resolve it ...

There would be no question in our mind that we would have an oral surgeon treat our case. That is the highest level of authority in dentistry for this type of problem. (We're unclear if both of the dentists you mention are.) (With your having used the term "pathology report," we anticipate that some of the unsuccessful attempts were performed by an oral surgeon. Even so we would still have the most faith in that type of practitioner.)

In regard to removing the PDL post-extraction, we weren't really familiar with this (and can't imagine that in the vast majority of extractions performed by general dentists this is accomplished, especially if you're referring to removing 1mm of bone).

We Googled around. Here's a link to an oral surgery text book (Contemporary Oral and Maxillofacial Surgery, 2013). The linked portion of the book states: "The remnants of the periodontal ligament ... are in the best condition to provide for rapid healing. Vigorous curettage (scraping) of the socket wall merely produces additional injury and may delay healing."

Here's an abstract from published research (2002). The last line states that the findings of their study suggest that some of the cells that contribute to bone formation after an extraction come from the periodontal ligament.

The abstract for this highly cited research paper (1994) states (last line) that cells originating in the PDL transform into bone-forming cells during extraction socket healing.

We found some sources stating what you mention above. But the ones we found by no means came close to having the same level of accepted authority as the ones we've linked to.

If your non-traditional dentist is a fresh DDS/MD oral surgeon grad, we stand corrected. But being older and more traditional, we're just not familiar with the alternative approach.

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