Oral Surgery Treatments
Why Bone Graft?
Over a period of time, the jawbone can atrophy or resorb after a tooth extraction, periodontal disease, missing teeth, oral pathology, trauma, or infection. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants.
Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.
The bone is either obtained from a tissue bank using cadaver (allograft) or animal bone (xenograft), or you own bone is taken from the jaw, chin, skull, hip or tibia. Your own bone is considered the best bone because it is vital bone, and can be used to graft large areas, but requires a second surgery site for grafting. Allograft and xenograft are convenient because they do not require a second surgery site. These grafts however, lack the potential to induce bone growth like your own bone can.
Socket Preservation: When a tooth or multiple teeth are extracted, the socket will often resorb and shrink in dimension over time. A socket preservation is a procedure in which an allograft or xenograft is placed into the socket to maintain the bony dimension to receive an implant in 3-4 months.
Ridge Augmentation: Overtime, the jawbone with missing teeth will often resorb. If implants are considered, they will often require the bone to be built back up to house the implant. Ridge augmentation is a procedure in which a bone graft is placed over the resorbed bone, and under the gum tissue. This can take anywhere from 3-6 months of healing, followed then by implant placement.
Sinus Lift: In the back upper jaw, there is an air filled space called the maxillary sinus. The maxillary sinuses are air-filled spaces behind each cheek in the back of the upper jaw. When the back upper teeth are removed, there is only a small amount of remaining bone separating the sinus from the mouth. Overtime, the sinus can increase in size while the jawbone in this area resorbs. If implants are being considered, and there is not enough existing bone, a sinus lift procedure is required. A sinus lift can be performed by making a window into the sinus and then adding bone along the sinus floor to create enough height to sufficiently house the implants. While implants are typically placed after 6 months of healing, in certain cases they can be placed at the same time as the sinus bone graft.
By the age of eighteen, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth or molar teeth are used to grind food up into a consistency suitable for swallowing.
The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as "wisdom teeth."
Why Should I Remove My Wisdom Teeth?
Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen, as wisdom teeth are the most commonly impacted teeth in the mouth. They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully. The location and impaction of the wisdom teeth can often create periodontal problems associated with teeth in front of them.
These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and can cause an infection. The result: swelling, stiffness, pain and illness. The location and impaction of the wisdom teeth can also often create periodontal problems with the teeth in front of them. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. The removal of wisdom teeth can be performed in the office as an outpatient surgery under local anesthesia, nitrous oxide analgesia (laughing gas) or IV sedation to maximize patient comfort. Your oral surgeon has the training, license and expertise to provide various types of anesthesia for patients.
The mouth is a complex structure consisting of hard tissues, such as the teeth and bone, as well as soft tissues, including the mucosa (cheeks, lips, and gums) and the tongue. Although it is rare, there are times when these tissues exhibit abnormal growth and development that can produce lesions or pathology in the oral cavity or surrounding areas. In other situations, certain oral tissues may undergo a change in tissue structure, due to a disease like cancer, and develop irregular growths or lesions. This is why routine dental care, including screenings for oral cancer are so important.
If during the course of a dental checkup or oral cancer screening a suspicious lesion or growth is discovered, patients are often referred to an oral surgeon for further evaluation and care. Abnormal findings on either dental x-rays or during the course of a dental exam prompting this referral may include the presence of an ulceration or a sore that does not heal, or evidence of a bump growing in either the jawbone, the gums, or the neck. The oral surgeon will perform a comprehensive exam on this patient and do a tissue biopsy, as well as order additional studies as needed to confirm the diagnosis.
If an individual on their own notices any suspicious growths, ulcerations, or unusual bumps anywhere in their mouth or in the head and neck region, it is important that they have them promptly evaluated. They should not hesitate to contact the dentist or oral surgeon with any concerns.