Oral Surgery

Bone Grafting

Bone grafting is commonly performed by an oral and maxillofacial surgeon to replace or augment bone in areas of tooth loss. Bone grafting to the jaws and facial structures may be necessary in a wide variety of scenarios. The most common bone grafts are facial skeleton and jaw procedures. Other common procedures include tooth extraction site graft, bone graft reconstruction and for a sinus lift. Shrinkage of bone often occurs when a tooth is lost due to trauma, severe caries, or periodontal disease. Additionally, bone loss may have already occurred due to infection or pathology around a tooth. There are many artificial biocompatible bone substitutes available.

To place the removed bone in the recipient site, little holes are drilled in the existing bone to cause bleeding. This is done because blood provides cells that help the bone heal. The block of bone that was removed will be anchored in place with titanium screws. A mixture of the patient's bone marrow and some other bone-graft material will then be placed around the edges of bone block. Finally, a membrane is placed over the area and the incision closed.

The bone graft will take about 6 to 12 months to heal before dental implants can be placed. At that time, the titanium screws used to anchor the bone block in place will be removed before the implant is placed.

Crown Lengthening

Crown lengthening is a surgical procedure that re-contours the gum tissue and often the underlying bone of a tooth. Crown lengthening is often for a tooth to be fitted with a crown. It provides necessary space between the supporting bone and crown, which prevents the new crown from damaging bone and gum tissue.

Tooth Extraction

When the extraction of a tooth is required:

  1. An incision in the gums is made
  2. The tooth is removed
  3. The area is stitched up and is allowed to heal

During this time, it is important to think about a tooth replacement option. An extracted tooth leaves an open area in the jaw which, in time, allows the neighboring teeth to drift into the area where the tooth was extracted. This in turn, causes a chain reaction to all the surrounding teeth. Also, if you are considering placing an implant in the future, you should consider asking your dentist to place a bone graft at the time of surgery to preserve the bone width and height.

Wisdom Tooth Development

Wisdom teeth generally begin to form in your pre-teen years. By late teen years, the crown of the wisdom teeth will begin to erupt through the gums if there is adequate room. By mid twenties, your wisdom teeth will either be able to fully erupt or will have become impacted. Early removal of wisdom teeth makes the procedure easier for the patient to tolerate and promotes faster healing after wards. By your early forties, the wisdom teeth roots have become fully anchored to the jawbone and if required to be extracted, will be much harder and will need more time to heal.

Wisdom Tooth Problems

The problems involving your wisdom teeth may be caused by the size of your jaw and/or by how crowded your teeth are. Common warning symptoms that there is an un-natural problem in the development of your wisdom teeth could be pain and swelling.

Symptoms can be caused by:

  1. Infection to the gums
  2. A crowded tooth displacing neighboring teeth
  3. A decayed wisdom tooth
  4. Poorly positioned wisdom tooth
  5. A cyst that destroys bone

Wisdom Tooth Positions

Wisdom teeth under ideal circumstances should grow in straight like any other tooth. However, it is common for wisdom teeth to become impacted inside the jaw or just under the gums. If this occurs, your wisdom teeth should be removed.

Common Impactions:

  1. Horizontal Impaction
  2. Angular Impaction
  3. Vertical Impaction
  4. Soft Tissue Impaction

Wisdom Tooth Removal

Wisdom teeth can lead to problems if there isn't enough space for them to surface or they come through in the wrong position.

Wisdom teeth also known as third molars are the last teeth to erupt into the mouth. Wisdom teeth typically appear around a person's mid-twenties but can erupt much later. It the wisdom teeth doesn't have enough space symptoms can occur. The wisdom teeth may only partially erupt or might not come through at all. Dentists designate wisdom teeth 'impacted' if they are wholly or partly blocked from eruption into the mouth. The tooth may lie at an angle and remain tipped against an adjacent tooth. Impacted wisdom teeth can cause problems like pain and swelling; The mouth could ache when stretched open wide or it may be difficult to open your mouth. Tenderness when chewing and biting may occur. Earaches may develop from the spread of pain in the mouth. Symptoms may be intermittent but can begin anytime without warning. If you are experiencing symptoms, it is best to get treatment 'usually removal' as soon as you can to avoid potentially expensive and painful complications.

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