Oral surgery

Oral surgery treatments are performed in local anesthesia in order to treat pathological processes on teeth, bone and soft tissues of the mouth. The most common treatments done in dental practice are the following:

Tooth extractions

If it is not possible to repair or reconstruct a tooth to be functional again, then extraction is necessary. Teeth with infection on surrounding tissue can indanger the health of a patient. The only solution is extraction of the infected tooth. The extraction can be simple or surgical.

Impacted teeth extraction

Impacted teeth are the ones which could not find their place in teeth alignment but for some reason have remained partially or fully stuck in bone tissue of either jaw. Most often the teeth that fail to emerge are molars or canines. Their position can be the cause of the alignment disorder, can threaten a neighbouring tooth and more than often can lead to formation of cysts in the bone tissue. If they have partially emerged their outer surface is prone to caries. Also, accumulated food between gum tissue and partially emerged wisdom tooth can lead to serious infections which can endangere patient’s life. Due to their size lower wisdom teeth occupy considerable space in the bone tissue of the lower jaw, making it less resistant to blows (in case of accidents, falls, fights…) which results in jaw fractures in the area where impacted wisdom tooth is positioned. Even when impacted teeth do not cause any problems it is advisable to have them extracted just for the above mentioned reasons. Impacted theeth are surgically removed and the best age to do that is between 14 and 25 when the postoperative care is the easiest.

Apicoectopmy (root-end resection)

When a tooth is not treated or devastated with caries, the infection from the root canal spreads onto the surrounding bone making a periapical granuloma. This is a chronical (which can turn into acute) inflammation around the root-end which can lead to serious implications on surrounding tissues. Periapical granuloma is treated by filling the tooth canal which terminates the source of infection, leading to bone tissue regeneration in the area of the root-end. If traditional treatment is not possible or the inflammation perseveres after traditional treatment, the solution is root-end resection or apicoectopmy. Before surgical treatment it is necessary to properly fill the root canal. The process of curettage is used to remove granuloma around the tip of the root along with an affected part of the root tip itself. The tooth is shortened and filled, with the healthy bone tissue, ready to heal and return to normal function.

Cystectomy

Cysts are oval pathological cavities filled with liquid and coated with tissue. They can be found on bone and soft tissues. Dental cysts can, without showing any symptoms, grow considerably with a patient being unaware of their existence. Their growth is slow and more than often they are detected on x-ray images done for the purpose of other dental treatment. They can be the cause of acute infection; they can disturb tooth growing or spread through surrounding tissues and weaken bone tissue. After it has formed, a cyst grows independently of the tooth which was its cause. Due to that reason, the treatment of bone cysts requires both treatment of all teeth which are in contact with cystic lesion and removal of a cyst – cystectomy. If a cyst has affected a larger portion of a tooth root, that tooth must be extracted which will be followed by cystectomy. After the surgical procedure it is necessary to send the cyst tissue for histopathological verification as there are tumours very similar to cysts and their presence cannot be neglected.

Bone leveling

The extraction of one or more teeth can leave the bone under the gum uneaven preventing the fitting of denture prosthetics. Bone leveling is a surgical procedure which is the most common in pre prosthetic surgery with the aim to remodel and remove sharp bone edges, exostosis and other outgrowth which deter further prosthetic treatment. With this procedure we create a comfortable and painless fitiing of denture prosthetics.

Frenulum resection

Frenulum is a fold of tissue which connects upper or lower lip with the gum. Lingual frenum is a fold which connects the tongue to the floor of the mouth. Strong labial frenum can create a gap between upper front teeth and can also cause the recession of the gums off the middle incisors or can obstruct fitting of denture prosthetics with eldely toothless patients. Lingual frenum with children can restrict tongue movements and consequently affect speech. These anomalities of the folds inside the mouth can be eliminated by performing frenectomy which means shifting frenum towards lips or tongue reducing its impact on soft tissues around teeth and tongue.

Periodontal flap surgery

Periodontal flap surgery is performed on the teeth with developed paradonotopathy where traditional treatment is not possible. Separating and lifting gingiva from underlying tissue provide better access to the root of the diseased tooth as well as to the bone tissue around it. Pathologicaly changed tissue will be removed and the pockets around the tooth will be cleaned leaving the tooth surface and surrounding bones clean. If it is possible we can fix artificial bone around the treated teeth, which will give them stronger support and save them for the future.