Oral Surgery Procedures

Dental Implants

Dental implants are used to replace tooth roots. Implants provide a strong foundation for fixed or removable replacement teeth. Dental implants are small anchors made of biocompatible metal, called titanium, placed in the jawbone. The anchors begin to fuse with the bone over a few months. After the fusing process, known as osseointegration, abutment posts are inserted into the anchors to allow for the attachment of the replacement teeth. To fabricate the replacement teeth, an impression is taken and a model of the bite is created. The replacement teeth are based on this model. Replacement teeth can either be crowns, bridges or dentures.

Wisdom Tooth Removal (3rd Molars)

A wisdom tooth that is deemed problematic is normally extracted to avoid any oral complications. To have a wisdom tooth removed, a small incision is made to open up the gum tissue over the tooth and remove any bone that is covering the tooth. Once the tooth is in view, it is grasped with a dental instrument, known as a forcep, and gently rocked back and forth to loosen it from the jaw bone and surrounding ligaments. Sometimes the tooth may need to be cut into smaller pieces to make it easier for removal. Stitches may be necessary after the removal of a wisdom tooth.

Impacted Tooth & Tooth Exposure

An impacted tooth is a tooth that fails to fully pass through the gums.

Impacted wisdom and cuspid (or canine) teeth are fairly common. To correct impacted teeth, there are a few treatment options. For impacted wisdom teeth, the most common procedure is extraction. For impacted canine teeth, several treatment modalities are available. Orthodontics (braces) can be used to open space for proper eruption. Primary (baby) teeth can either be extracted or surgically exposed to allow for the placement of an orthodontic bracket to help align the teeth.

Bone Grafting

Bone grafting is the replacement or enhancement of bone around teeth. When a tooth is lost, the surrounding bone collapses. Bone grafting is performed to reverse bone loss or enhance existing bone. The grafting material can be taken from parts of the body or from synthetic material. Bone grafting allows for proper support of dental implants or prostheses.

Orthognathic Surgery

Orthognathic surgery is done to correct misalignments or other abnormalities in the upper and/or lower jaw.

Orthognathic surgery can involve procedures such as an osteotomy (bone cutting), bone grafts, or distraction osteogenesis (stretching of the bone) and orthodontic (braces) care. Orthognathic correction is conducted in stages, and the course of treatment can last from a few months to a year or more.

In order to perform the procedure successfully, the jawbones will be repositioned in accordance with one’s specific needs. Inconspicuous incisions are usually made inside, and if needed, outside the mouth to allow for surgical plates, screws, wires and rubber bands to be used to hold your jaws in their new positions.

Labial or Lingual Frenectomies

A frenectomy is a simple surgical procedure performed to release the connection of the “frenum,” a connective muscle between two tissues. There are two types of oral frenectomies that are frequently performed on both adults and children for a variety of reasons.

A Labial Frenectomy is performed on the tissue that connects the lip to the gums. This may be performed on children or adults to aid with orthodontic treatment or even help with the proper fitting for a denture or appliance.

A Lingual Frenectomy may also be referred to as the release of tongue-ties (ankyloglossia). This procedure is performed on the connective tissue under the tongue. The procedure is often performed on neonatal patients to assist with nursing or on toddlers or older patients who need the surgery to help correct speech issues caused by limited movement due the the frenum.

Sinus Lift

A sinus lift is a surgery that adds bone to your upper jaw in the premolar and molar areas of your mouth. To add bone, an incision is made where the premolar and molar teeth were previously located. Once the bone is exposed, a small circular shape is made in the bone to access the sinus. Once the sinus is accessed, the sinus membrane is gently pushed up and away from the upper jaw. Once this is done, bone graft material is placed into the sinus space to change the shape and provide support. Once the bone is in place, the incision is closed and the healing process begins.

Additional Procedures

Facial Trauma

Facial trauma involves injuries to the bone, teeth, skin, gums or other soft tissues.

Depending on the type of facial trauma sustained, there are many different treatment options available. The primary goals of treatment are to stop any bleeding from occurring, create a clear airway, repair any broken or fractured bone, and or suture any damaged soft tissue. Treatment is immediate, as long as there are no neck fractures or life-threatening injuries.

Oral Pathology

Biopsies

The smooth, pink skin lining the mouth is called mucosa. Abnormalities in the color or texture of this skin can sometimes indicate pathology. Any concerns with the skin in the mouth, a sore that is not healing properly or a lump on the inside of the cheeks, palate, gums or lips, may merit a biopsy so that the tissue sample can be tested for oral cancer. Please do not ignore these warning signs and be sure to mention any concerns you may have during your visit.

Cleft Lip & Cleft Palate

Cleft lip is an opening/split in the upper lip, and cleft palate is an opening/split in the roof of the mouth (palate). Cleft lip and cleft palate result when these developing facial structures in an unborn baby do not close completely.

A series of surgeries can restore normal function and achieve a more normal appearance with minimal scarring.

A cleft lip is usually repaired between the ages of 3 to 6 months. Some children require a lip adhesion or a device such as a molding plate to bring the parts closer together before the full lip repair. A child with a repaired cleft lip will have a scar on the lip under the nose.

A cleft palate is usually repaired between 9 and 12 months of age. To repair the palate, the soft palate muscles from each side are connected to each other and the normal barrier between the mouth and nose is created.

Additional surgeries are needed to improve the appearance of the lip and nose, close the opening between the mouth and nose, help breathing, and stabilize and realign the jaw. Once the permanent teeth grow in, braces are often needed to straighten the teeth.

Ridge Expansion

Ridge Expansion
Adequate bone volume of the jawbone is necessary for the secure placement, stability, function, aesthetics and longevity of implants. Because tooth loss can result in diminished bone volume in the jawbone, a bone expansion procedure may be necessary prior to implant placement. This procedure can increase the height and/or width of the jaw ridge through the use of mechanical manipulation combined with a bone graft. The Ridge Expansion takes several months to mature and be sufficiently strong for the placement of implants. Ridge Expansion not only improves the function of implants, but is also a key contributor to the enhanced aesthetics, filling in the face around the gums and jaw and thus minimizing the appearance of aging.

TMJ Disorders

The temporomandibular joint (TMJ) is similar to a sliding hinge that connects your jawbone to your skull. TMJ disorders can cause pain in the jaw joint and in the muscles that control jaw movement.

To treat TMJ disorders, first the cause has to be identified. In less severe cases TMJ disorders can be treated with self-managed care (eating soft foods, using ice packs, avoiding extreme jaw movement) or nonsurgical treatments (anti-inflammatory medications, Botox injections, or stabilization splints). In severe cases surgical treatments (jaw joint replacements) may be necessary.

TMJ conditions fall into three main categories:

Myofascial pain – discomfort or pain in the muscles that control jaw function.
Internal derangement of the joint – a possible indicator of a displaced disc, dislocated jaw, or injury to the condyle.
Arthritis – a degenerative inflammatory disorder.

Sleep Disorders

Sleep apnea is a disorder in which one experiences one or more pauses in breathing or shallow breaths while you sleep.

Sleep apnea is an ongoing condition that disrupts sleep. When breathing is paused or becomes shallow, one will often move out of deep sleep and into light sleep, making the quality of sleep poor.

Sleep apnea can be treated with lifestyle changes, mouthpieces, breathing devices, and/or surgery.

For mild sleep apnea, a custom fitted mouthpiece or some lifestyle changes (weight loss, smoking cessation, clearing nasal passages) may be helpful.

For moderate to severe sleep apnea, a breathing device called CPAP (continuous positive airway pressure) or surgery to widen the breathing passages by shrinking, stiffening, or removing excess tissue in the mouth and throat or resetting the lower jaw may be helpful. A CPAP machine uses a mask that fits over your mouth and/or nose and gently blows air into your throat. This air pressure helps keep your airway open while you sleep. Surgery to shrink the tissue involves a small shot into the breathing passages. Surgery to stiffen excess tissue requires a small incision in the tissue and the insertion of a piece of stiff plastic.

Facial Cosmetic Surgery

Extractions

Apicoectomy

Gum Reshaping

Gum reshaping or contouring is a procedure performed to reshape the gums if they rest too low or too high on your teeth. In order to reshape the gum tissue, a line is drawn to mark the new gum line. Once approved, anesthesia is applied to the area and the contouring begins. A dental instrument (typically a scalpel or laser) is used to reshape the gum tissue and trim away any extra tissue overhanging the tooth.

Specialized Techniques

PRGF & PRF

Platelet Rich Growth Factors and Platelet Rich Fibrin are new techniques used to assist with tissue regeneration using the patient’s own tissues and centrifugation to minimize healing time and maximize healing potential following procedures.

These growth factors are in the form of a mixed gel that can be applied directly into tooth sockets and other sites. Placing this material in tooth sockets after tooth extractions can improve soft tissue healing and positively influence bone regeneration.

These techniques offer a new approach to tissue regeneration. PRP derives from the centrifugation of a patient’s own blood and contains growth factors that influence wound healing. This is important in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration.

Laser Surgery

Dental laser surgery uses a beam of intense light to correct dental problems. The energy produced by the laser cuts or vaporizes the tissue it is concentrated on. Laser surgery often means less discomfort, an easier and quicker recovery time and fewer, shorter appointments.

Lasers have several uses for dental surgery. Some common types of dental laser surgery include but are not limited to: dental cavities, root canals, gum surgery, dental abscess, biopsy, and treatment of lesions.

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