Dental Surgery

The wisdom tooth, that is the third molar, often does not have adequate space so that it can fully erupt and take its place in the dentition. The semi-impacted third molar causes problems because it causes inflammation to the tissues that surround it (pericoronitis), caries to the adjacent tooth and continuous injury to the cheek area. Impacted third molars can cause the displacement of the adjacent teeth in the dentition, and thus often orthodontists require their extraction during or after the orthodontic treatment.

The third molar is extracted with a minor surgical operation under local anesthesia, following a particular methodology which ensures its quick removal and the protection of the adjacent tissues.

There are cases in which it is observed that one or more teeth (usually the upper cuspid) remain in the jaw in such a position, that they cannot erupt in the mouth. Many times, the patient discovers the problem after observing that the respective deciduous tooth (baby tooth) has remained in the mouth for a much longer time than usual. It can be found radiographically that the respective permanent tooth is impacted and usually with the wrong direction of eruption. In this case, the combination of surgery and orthodontics is necessary and offers very good results.

After the precise determination of the position of the impacted tooth with cone beam computed tomography (CBCT SCAN), the operation is planned with the participation of our orthodontists, so that they can place an orthodontic brace on the impacted tooth, and in order to have a clear picture about the path that the impacted tooth must follow until it takes a correct position in the dentition. The impacted tooth is surgically exposed and the orthodontic brace is placed on its crown. Subsequently, with the use of special springs, traction forces are exerted and the impacted tooth erupts little by little and is guided to the desired position.

When a tooth is necrosed and the dead cells of the dental pulp (nerve) remain inside the interior cavity of the root or are diffused outside it, an inflammation is generated with specific limits in the bone, which surrounds the root of the tooth, which is called periapical cyst. If after the endodontic treatment (root canal treatment) the infected root is not adequately sterilized and the inflammation continues to exist, the solution is apicoectomy. Many times, such inflammations may remain asymptomatic in the mouth for many years (chronic inflammations) and expand, silently destroying adjacent anatomical elements, until at some point of time when they pass into an acute phase with very “loud” symptoms, such as sudden swelling and pain. For this reason, at our medical offices, our standing practice is to require from almost all our new patients a panoramic X-ray, for the early diagnosis of such conditions.

Apicoectomy is a small surgical operation, which has as goal to remove the cyst and clean the area it covers, as well as to cut off the edge of the root of the tooth which is considered infected by dead cells. Thorough cleaning is very important, so that the human body can undertake the healing of the area, that is the filling of the bone deficit with bone cells.

Many times there are fractured residual roots from previous extractions or even cysts which remain after the extraction of the teeth and which may cause inflammations and discomfort or prevent the placement of an implant in the particular area. In this case, the removal of these residues can be performed only surgically.

The prosthetic restoration of a patient requires the existence of specific anatomical conditions, in order to be successful. However, many times these anatomical requirements do not exist, either due to anatomical particularities of the patient, such as exostoses and gingival hyperplasia, or due to the extensive absorption of the bone of the jaws after the loss of teeth. Pre-prosthetic surgery has as goal to reshape the various structures of the mouth, so that the appropriate conditions for the prosthetic restoration are created. The operations of pre-prosthetic surgery may regard the restructuring both of the soft tissues of the mouth (gums and mucosa), and of the bone of the jaws.

Supernumerary are the teeth that exist in the dentition in excess of the normal ones. Supernumerary teeth may be completely asymptomatic, however they may also cause problems, such as pain, due to the pressure they exert on the adjacent anatomical tissues or disturb the eruption of adjacent teeth.

After the appropriate clinical and, necessarily, radiographic examination with cone beam computed tomography (CBCT SCAN), the position of the supernumerary tooth is determined, as well as the best possible way of surgical access, that is from where one can reach more easily the tooth and remove it, without harming the adjacent anatomical tissues and teeth.