Oral Surgery is a recognized international specialist training course in dentistry. It is the specialty of dentistry that includes the diagnosis, surgical and related treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the head, mouth, teeth, gums, jaws and neck.
1. Odontectomy/Removal of Impacted Tooth
Wisdom teeth, or third molars, are the final teeth to develop. Most of us have four wisdom teeth, one in each corner of the mouth. They usually emerge during our late teens or early twenties. Often wisdom teeth become trapped, or impacted, in the jawbone and cause crowding, displacement, decay, infection, or gum disease. Impacted wisdom teeth can grow in many different directions: horizontally, vertically, or at an angle.
In most cases, it is recommended that impacted wisdom teeth are extracted. Wisdom tooth surgery is performed, usually under local anesthesia, in your dentist’s office, an outpatient surgical facility, or a hospital. Make arrangements for a responsible adult to drive you home and plan to rest at home for the remainder of the day.
Incision is made and overlying bone is removed, exposing crown of impacted tooth Tooth is extracted whole or surgically sectioned. The site is sutured closed.
To ease any discomfort and promote healing:
• Use ice packs on the cheek for swelling, alternating on and off every thirty minutes.
• Apply biting pressure with clean gauze to stop bleeding.
• Eat soft foods and drink extra liquids.
• Avoid hard or crunchy foods in the tender area.
• Brush carefully the day after surgery.
• Take prescribed medications and follow all instructions as directed.
Call the Dentist immediately in case of excessive bleeding or swelling, persistent, severe pain or fever.
2. Periodontal surgery
Gingivectomy is periodontal surgery that removes and reforms diseased gum tissue or other gingival buildup related to serious underlying conditions. For more chronic gingival conditions, gingivectomy is utilized after other non-surgical methods have been tried, and before gum disease has advanced enough to jeopardize the ligaments and bone supporting the teeth. Performed in a dentist’s office, the surgery is primarily done one quadrant of the mouth at a time under local anesthetic. Clinical attachment levels of the gum to teeth and supporting structures determine the success of the surgery. Surgery required beyond gingivectomy involves the regeneration of attachment structures through tissue and bone grafts.
3. Tissue Grafting
It is a procedure to replace missing thick tissue (keratinized gingiva), which has worn away from the necks of the teeth for a variety of reasons. The purpose of tissue “gum” grafting is to minimize and/or arrest the progression of recession.
Unfortunately associated with every type of recession, there is bone loss, because the bone resides just beneath the gums. Therefore, if the gums have receded, then the bone too has receded. The purpose of gum grafting is to arrest the progression of recession and thereby halt the bone loss as well, by restoring a thick zone of protective tissue around the neck of the tooth / teeth which exhibits an absence of this thick keratinized gum tissue.
4. Bone Grafting
It is a procedure that remedies insufficient bone thickness due to aging and natural recession. It offers hip, chin and allograft operations to help section bone from one site in the person’s body to another site. Bone grafting is a surgical procedure that replaces missing bone with material from the patient’s own body, an artificial, synthetic, or natural substitute. Bone grafting is used to repair bone fractures that are extremely complex, pose a significant risk to the patient, or fail to heal properly.
5. Bone Recontouring (alveoloplasty)
Sometimes the removal of a tooth or several teeth can leave jagged bone with sharp points. The dentist may recommend a procedure called alveoloplasty in which these sharp areas are smoothed. This is especially important for patients who use dentures or partial dentures. Bone recontouring and replacement is a great way to enhance your smile. While your teeth may be beautiful, you may have imperfections, indentations, or bulbous areas under the gum tissue. Through a simple procedure, we can recontour irregularly shaped bone, add bone to indentations, or even recontour the line of the bone around each tooth to give you a full and even-looking smile.
6. Incision & Drainage of Abscess
Incision and drainage of Abscess is a dental procedure that is required when a cavity or tooth infection spreads causing a dental abscess. Dental abscesses occur when bacteria from a cavity grows and extends into the mouth face jaw or throat. A dental abscess is generally quite painful and the pain tends to increase as the infection worsens. Pus builds up at the site of the infection causing gum inflammation and tenderness and if the abscess does not rupture and drain on its own it may have to be surgically drained in order to cure the infection.
7. Excision of Lesions
When excising a lesion, the physician attempts to remove it completely by using a scalpel to cut the shape of an ellipse around the lesion. Leaving an elliptical wound, rather than a circular wound, makes it easier to insert stitches. If a lesion is suspected to be cancerous, the physician will not cut directly around the lesion, but will attempt to also remove a healthy margin of tissue surrounding it. This is to ensure that no cancerous cells remain, which would allow the tumor to reappear.
8. Oro-Antral Fistula closure
Oroantral fistula is an uncommon complication in oral surgery. Although smaller fistulas of less than 5 mm in diameter may close spontaneously, larger fistulas always require surgical closures. The literature review revealed various procedures for the closure of oroantral fistulas. These procedures may be subdivided into local flap, distant flap and grafting. Procedures involving local flaps are usually adequate to close minor to moderate size defects. Those procedures utilizing the buccal mucoperiosteal flap as the tissue closure include straight-advancement, rotated, sliding and transversal flap procedures; while those involving the palatal mucoperiosteum are straight advancement, rotational-advancement, hinged and island flap procedures. The combinations of various local flaps to strengthen the tissue closure are also being advocated. The advantages and the limitations of these procedures are discussed. Distant flaps and bone grafts are usually indicated in the closure of larger defects in view of their greater tissue bulks. Tongue flaps have superseded extra-oral flaps from extremities and forehead for aesthetic reasons and also in view of their similar tissue replacement. Various tongue flap procedures are described. At present, various alloplastic materials such as gold, tantalum and polymethylmethacrylate are infrequently reported in the closure of oroantral fistulas. However, in the light of successful reports over the use of biological materials, collagen and fibrin, in the closure of oroantral fistulas, there seems to be another simple alternative technique for treating oroantral fistulas.
9. Sinus Lift
A sinus lift (a sinus augmentation) is surgery that adds bone to your upper jaw in the area of your molars and premolars to make it taller. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or “lifted.” A sinus lift usually is done by an oral and maxillofacial surgeon or a periodontist. It can happen that there is no longer enough bone in the molar area of the maxilla in the direction of the floor of the sinus because of the bone atrophy after tooth loss. As bone augmentation in this region is possible only with difficulty, a method was developed in which the floor of the sinus is raised and bone is inserted into the cavity produced, without injuring the mucosa of the sinus, which leads to an effective increase in the bone in the molar maxillary region. This operation is called a sinus lift. This operation can be carried out under local anesthesia and is done through the mouth so that there are no scars on the face. The sinus lift operation can often be done at the same time as the insertion of dental implants. The bone material which is inserted corresponds to that described already for bone augmentation.
A sinus lift is done when there is not enough bone in the upper jaw, or the sinuses are too close to the jaw, for dental implants to be placed. There are several reasons for this:
• Many people who have lost teeth in their upper jaw — particularly the molars teeth — do not have enough bone for implants to be placed. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.
• Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If teeth have been missing for a long time, there often is not enough bone left to place implants.
• The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus vary among individuals. In addition, the sinus can get larger as you age.
• Bone may have been lost because of periodontal (gum) disease.