ORAL SURGERY

What is oral surgery?

Oral surgery is a specialised branch of dentistry that includes various surgical procedures to improve anatomical and biological anomalies of the oral regions.

What are the most common surgical procedures?

The most common surgical procedures are: tooth extraction, surgical removal of wisdom teeth and root fragments, apicoectomy, dental implant surgery, sinus lift surgery, tooth hemisection…

ALVEOTOMY

What is alveotomy?

Alveotomy (= cutting the alveolar bone around the tooth) is a surgical procedure which involves the removal of retained and impacted teeth.

What are impacted or retained teeth?

Impacted or retained teeth are teeth that are completely formed inside the bone, but are unable to erupt into the dental arch or outside of it. Their presence in the bone can be confirmed by X-ray imaging. The most commonly retained teeth are wisdom teeth (or third molars). Besides them, any other tooth can become impacted or retained, but this usually occurs in upper canines, and lower premolars. We can talk about one or more partially or completely retained teeth in the bone.

What causes tooth impaction and retention?

The most common reason for teeth being embedded completely (impacted) or partially (retained) in the jawbone is the direction of their eruption and/or the lack of space in the dental arch due to other teeth occupying the space or some other mechanical obstacle (bone or soft tissue).

What are the most common symptoms of impacted or retained wisdom teeth?

During the eruption process, impacted and retained wisdom teeth can produce symptoms such as pressing against other teeth, pain, swelling of the surrounding gums, difficulty opening the mouth due to which alveotomy is indicated.

What is the alveotomy of wisdom teeth?

Alveotomy of wisdom teeth is a removal of a particular part of the bone in which a wisdom tooth is embedded, thus preventing its extraction. The procedure is most commonly performed under local anaesthesia. Following the bone removal, tooth extraction is performed.

When is alveotomy indicated?

Strict indications for alveotomy include: persistent and recurrent pericoronitis (= an ongoing or repetitive inflammation of the gum partially covering the wisdom tooth crown), abscess, pulp inflammation and extensive tooth decay which is impossible to treat adequately in a conservative way, periodontal disease, cystic and tumorous changes and the second molar resorption caused by an impacted wisdom tooth. In cases where teeth are completely impacted, and cause no difficulties, there is no need for having them removed.

How long does the procedure take?

Alveotomy is considered a minor surgical procedure and takes about 30-45 minutes on average.

APICOECTOMY

What is apicoectomy?

Apicoectomy is a surgical procedure which involves the removal of the tooth’s root tip (apex) together with the periapical inflammatory focus. It enables the preservation of the teeth which cannot be treated endodontically and would otherwise require tooth extraction.

What is periapical inflammation?

Periapical inflammation is the inflammation of the bone region around the root tip of a tooth (apex) which is most commonly caused by untreated chronic tooth inflammation (granuloma) or tooth’s fractured root tips.

What is achieved by apicoectomy?

By performing apicoectomy we are preserving the tooth which cannot be treated endodontically and would otherwise require tooth extraction. Removing the root tip and the periapical process, the jawbone region is restored to health and pain relieved.

Which teeth can undergo apicoectomy?

All teeth can undergo apicoectomy, but it is usually done on front, single-rooted teeth.

What is the procedure for apicoectomy?

The surgical procedure of apicoectomy is performed under local anaesthesia. It starts with lifting the gum tissue flap and removing the part of the bone above the root tip region. The root tip of a tooth is removed together with the inflammatory process in the jawbone, followed by placing a retrograde filling in the root canal end and sealing it with root-end filling materials. Depending on each individual case, the tooth can be endodontically treated before or during the procedure. Finally, the gum tissue flap is placed back and the wound is stitched.

When is apicoectomy indicated?

Apicoectomy is indicated when there is a persistent periapical inflammation which is impossible to treat endodontically. In the case of endodontic treatment failure, which is usually the consequence of the complex root canal anatomy which makes it difficult to completely remove all affected tissues, apicoectomy will be performed to avoid tooth extraction.

How long does the procedure take?

Apicoectomy is considered a minor surgical procedure and takes about 30-60 minutes, depending on the region and the tooth it is performed on. Procedures performed on front teeth are generally the shortest, while those on lower molars take the longest.

CYSTECTOMY

What is cystectomy?

Cystectomy is a surgical procedure of the removal of small jaw cysts. The procedure is very similar to apicoectomy.

What are dental cysts and why do they need to be removed?

Dental cysts are pathological cavities lined with tissue and filled with liquid which can develop in the soft tissues and jaws. Cysts found on the tooth’s root tips are caused by various factors, but they should all be detected and removed as soon as possible due to their tendency to grow. Cysts are usually slow growing and may be detected years after they have developed, but if the cystic tissue inflammation occurs, they start to grow rapidly. As they grow, cysts destroy the surrounding tissues. If the tooth with a developed cyst is treated or extracted, but the cyst remains in the jaw, it will continue to grow.

What symptoms indicate jaw cysts?

As they start to develop, cysts do not usually cause any symptoms. Symptoms are displayed once the cyst has become extremely large or infected. A jaw lump above the tooth is one of the symptoms that may indicate a growing cyst, while pain and swelling indicate an infected cyst. By growing, a cyst can cause lesions and changes in the shape of the jaw, displacement of the adjacent teeth which are thus put at risk, it can even affect the sinuses or a nose (if in the upper jaw) and cause jaw fractures.

What is the procedure for cystectomy?

The surgical procedure of cystectomy is similar to apicoectomy. The presence of the cyst can be confirmed by an X-ray showing a localized oval formation appearing in the jaw singly or at the tip of a tooth’s root. The procedure is most commonly performed under local anaesthesia and starts with lifting the gum tissue flap above the cyst region. The cyst needs to be completely removed from the jaw. If it is formed at the tip of the tooth’s root, the tooth is, depending on its condition, either extracted or filled with a root-end retrograde filling. After the removal of the cyst, an artificial bone might be inserted into the empty cavity in order for the bone to heal completely.

How long does the procedure take?

Cystectomy is considered a minor surgical procedure and takes about 30-60 minutes, depending on the region and the size of the cyst.

FRENECTOMY / FRENULECTOMY

What is frenectomy?

Frenectomy is a surgical procedure which involves the removal of abnormal frenula (mucosal folds).

What is frenulum (frenum) and when does it need to be removed?

Frenulum is a mucosal fold that joins the upper and lower lip to the gums (lip frenulum) or the tongue to the floor of the mouth (lingual fraenulum). Sometimes it can be extremely voluminous and thick, with its fibres reaching deep between the central incisors. This can lead to negative effects: creating a space (diastema), gums pulling away from the teeth (recession), teeth separating after having orthodontic treatment (relapse). A short lingual frenulum can cause speech development problems, chewing and breastfeeding difficulty.

What is the procedure for frenectomy?

Frenectomy is a surgical procedure performed under local anaesthesia. It involves making a small incision to remove or replace the frenulum.

HEMISECTION

What is hemisection?

Hemisection is a surgical procedure which involves the removal of one root (which is most commonly affected by inflammatory process which cannot be treated) in multi-rooted teeth to preserve the remaining tooth structure.

TOOTH EXTRACTION

What is tooth extraction?

Tooth extraction is a procedure which involves the removal of the tooth or its remains from the tooth socket (alveolus).

What are the reasons for tooth extraction?

Modern dentistry aims primarily to prevent tooth loss. Still, sometimes tooth extraction is necessary and inevitable. The most common reasons for tooth extraction are: progressive periodontal disease (loose teeth), a cyst destroying the bone and a substantial inflammatory process affecting the bone region around the root tip which are both unable to treat by cystectomy or apicoectomy, orthodontic problems (lack of space), fractured tooth roots, impacted and retained teeth (embedded) and primary teeth which do not fall out spontaneously.

How long does the procedure take?

The duration of the tooth extraction procedure depends on how complicated the extraction is. In periodontal disease patients, tooth extraction can last a few minutes, whereas in the case of tooth ankylosis (teeth fused with a jawbone), teeth with a complex structure or teeth that are trapped in the bone, the procedure may take about 45 minutes.

What are the steps of oral surgery procedures?

• Each oral surgery procedure starts with the initial examination and medical history taking which allows the assessment of the status of Your oral health, Your general health and Your oral hygiene, as well as Your motivation and expectations. Possible destructive habits are also detected (smoking, alcohol). The clinical examination includes the extraoral and intraoral examination, with special attention paid to areas in which oral surgery procedures are going to be performed. Apart from the clinical examination, the analysis of X-ray and/or CBCT imaging of the alveolar bone is also necessary, followed by establishing the treatment plan.
• In the next visit the agreed surgical procedure is performed. In our office, all oral surgery procedures are performed by one of the leading oral surgery specialists. All procedures are performed under local anaesthesia and are completely painless.
• During the follow-up examination after 7-10 days (if not required otherwise) the stitches are removed.

What to do after the oral surgery procedure?

After the oral surgery procedure, you will be given instructions to make your postoperative recovery period as pleasant as possible. You will be given drug prescriptions and instructions as to which foods and drinks are desirable, and which are to be avoided. 10-12 hours after the procedure, the patient should rest and apply an ice pack to the outer surface of the face in the operated area. Although proper oral hygiene is necessary, You should avoid energetic mouth rinsing and rough brushing around the area where the procedure was performed in order for your wound to heal. It is important to follow these instructions because, otherwise, your stitches and blood clot formation might be compromised. Consuming hard foods and smoking should also be avoided. You may feel numbness in the operated area for a few days or weeks after the procedure. Feeling pain is also normal, but can be controlled by analgesics. All sensitivity in the area will usually disappear within 14 days. If necessary, you will be prescribed an antimicrobial mouth rinse (based on chlorhexidine) or antibiotics to reduce the inflammation.

Why choose to undergo oral surgery procedures in OUR practice?

1. All oral surgery procedures in our practice are performed exclusively by an excellent oral surgery specialist.

2. We try to make you feel comfortable and relaxed in our practice,without any fear.

3. We respect your wishes relating to the health and beauty of your future smile and try to fulfil them completely.

4. Our goal is to make your smile functional and aesthetically perfect.

5. All oral surgery procedures will be performed with high-quality materials

6. The work in your mouth will be painless and safe, we will do our best to make it as comfortable as possible and our service as good.

7. At any moment we are available to you for advice and consultation via mobile phone, e-mail and social media.

8. We try to keep our appointments.

9. You can pay in cash, but also in interest free instalments: American Express up to 12 instalments, Diners up to 6 instalments, Erste & Steiermärkische bank Maestro and MasterCard up to 12 instalments.

10. There is free parking in front of the practice.

If you think we can meet your criteria, feel free to contact us and make your appointment.

If you’re unable to find an answer to your question about oral surgery procedures, dental health or dental services, please feel free to contact us.

We are at your disposal!