Oral surgery

Oral surgery involves several procedures. What exactly is done?

Removal of a tooth or root

To remove a tooth or tooth root, first an anesthetic injection is given, which takes away pain sensitivity. In the case of simpler teeth, anesthesia is followed by tooth extraction and cleaning of the abscess if there are inflamed tissues. In most cases, there is no need to place stitches after the removal of a normal tooth.

If the tooth has several roots, it sometimes has to be drilled into several pieces and then removed in separate parts. This procedure is similar to a regular dental drill for a cavity.

Removal of partially or completely unerupted (wisdom) teeth

The procedure is performed under sterile conditions: the patient is covered with a sterile sheet, sterile instruments are used, and the doctor wears sterile gloves. Sterile coating is usually done after anesthetizing the tooth..

In order to get the tooth, a cut must be made on the gum and the tooth must be freed from the soft tissues. Sometimes the uncut teeth in the mouth are also covered with bone, in which case the bone must be drilled from the front. This sensation reminds the patient of a normal dental drill. Since the bone numbs more easily than the tooth, it is not painful. If the tooth roots branch in different directions, the tooth must be drilled into pieces and removed in separate parts.

Once the tooth has been removed, the dental abscess (the place where the tooth was inside the bone) must be carefully cleaned of inflamed tissue and rinsed to prevent loose tooth or bone debris from remaining in the alveolus, or dental abscess. Stitches are placed on the wound, which, depending on the thread used, must either be removed or they will dissolve by themselves.

Removal of the cyst and tooth root tip

A jaw cyst is a fluid-filled cavity in the upper or lower jaw bone that is lined with soft, non-bony cells. Such cavities make the jaws weaker and can also enlarge and become inflamed.

It is necessary to remove the tooth root tip if there is chronic inflammation around it (bone melting has occurred around the tooth tip and the cavity has been filled with inflamed granulation tissue), which is not amenable to treatment through the root canal. Such inflammations can lead to further bone melting and eventually damage the secondary teeth. In the case of chronic processes, exacerbations can also occur, which can result in, for example, a jaw abscess (see below).

The removal of the cyst of the jaws or the inflammation around the tip of the root of the tooth is also performed under sterile conditions and when the corresponding area is anesthetized with an injection.

The area of the cyst or inflammation is freed from soft tissues. If the cyst or inflammation has not destroyed the bone in front of itself, a drill is passed through the bone, which resembles the feeling of a normal dental drill. The contents of the cyst or inflammation are then thoroughly cleaned until clean bone can be felt in all directions. If it is a focus of inflammation around the root tip, a small part of the root tip of the tooth is also removed, and the root canal is filled a few millimeters from the tip with a special material. The prerequisite for removing the inflammation around the root tip is previous correct root canal treatment.

Sometimes there may also be a need (for example, if a dental implant is planned) to place new bone in the cavity of the cleaned cyst, this can be the patient's own bone from another area or artificial bone.

At the end of the procedure, stitches are placed on the soft tissues, which, depending on the thread used, must either be removed or dissolve by themselves.

Tooth release for orthodontic treatment

The procedure is similar to removing an unerupted tooth. After anesthesia, the patient is draped sterilely, an incision is made on the gum to free the tooth area from soft tissue, and enough bone is removed in front of the tooth to give the tooth enough space to enter the mouth. During the operation, a special part is attached to the tooth, with which the tooth starts to move into the right row next to the others. If necessary, stitches are also placed on the gum.

Cleft lip and tongue surgeries

The labial fold is a twisted formation that connects the lips and gums, the lingual fold connects the tongue and the floor of the mouth. Sometimes the teeth are too short, which can be accompanied by functional disturbances, for example in speech and eating.

This procedure can be done in two ways: with a scalpel or with a laser. In both cases, prior anesthesia is necessary, but with the laser it is usually not necessary to place stitches. The procedure is simple and quick, a short lip or tongue flap is released.

Removal of benign tumors from the oral cavity

The procedure is performed with a local anesthetic injection. The tumor is removed and stitches are placed on the wound. If necessary, the preparation is also sent to the laboratory for a histological examination, where the exact cells in the tumor are examined under a microscope.

Opening the abscess

An abscess is a pus formed due to inflammation, the most effective treatment of which is to cut it open. First, the area of swelling and abscess is anesthetized with an injection, and then an incision is made with a scalpel to allow the inflammatory fluid to escape. If there is a doubt that all the inflammatory fluid did not leave the wound or there is a risk that it will be added, a wound drain (a strip of latex or iodoform-impregnated gauze) is placed, which keeps the wound open and does not allow the inflammation to immediately become clogged again. The drain should be removed or replaced after 1-2 days.

Surgical removal of tartar

Surgical calculus removal is rarely used because dental curettage is very effective with modern instruments. Sometimes, however, it is necessary to free the tooth roots from the soft tissues under anesthesia and clean them of tartar. If necessary, osteoplasty is also performed, during which new bone is added to replace the bone defect caused by tartar. Sutures are then placed on the soft tissues.

Surgical preparation for prosthetics

The edentulous jaw may have both soft tissue and bony formations, which must be removed before prosthetics. The removal of soft tissue or formations on the gum is similar to the removal of tumors in the oral cavity. An anesthetic injection is also performed to remove the bony, so-called nodules (exostoses), then a cut is made on the gum above the exostose, and the nodule is flattened with a drill. At the end of the procedure, stitches are placed on the gum, which, depending on the material, must either be removed or they will dissolve by themselves. Surgical procedures often seem more daunting than they really are. Oral operations are accompanied by some inconveniences, but effective modern local anesthetics ensure that the procedures are painless and easy to tolerate.