Surgery

The average adult has thirty-two teeth by age eighteen: sixteen teeth on the top and sixteen teeth on the bottom. However, 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 known as "wisdom teeth" or third molars and considered to me rudimental teeth which our ancestry had.

Wisdom teeth are the last teeth to develop within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth often do not have to be removed. The removal of wisdom teeth is necessary when they are prevented from properly erupting within the mouth (also known as impacted). 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.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. This results in swelling, stiffness, pain and illness. 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.

Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. The ideal time to remove impacted wisdom teeth is at age 14-15 for girls and age 15-16 for boys.

With an oral examination and x-rays of the mouth, your ddentist will evaluate the position of the wisdom teeth and predict if there may be present or future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort.

Apicoectomy

In some cases conservative endodontic treatment alone cannot maintain the tooth. Endodontic surgery includes any surgical procedure used to remove inflammation and/or infection from your roots and surrounding areas or to repair a given problem. Endodontic surgery can help maintain your tooth in situations such as:

  • narrow channels, calcium deposits, or extremely torturous canal systems which are unable to be treated to the end;
  • failure to heal after nonsurgical initially successful treatment even when the original treatment is done to ideal which potentially may be due to a cyst that must be mechanically removed or bacteria that have embedded themselves at the end of the root causing persistent infection;
  • damaged root surfaces or surrounding bone which is called resorption.

The most common surgical procedure is called root end resection or apicoectomy. During this procedure the very tio of the root is cut off and a filling at the end of the root is filled to help seal the root structure.

This procedure includes following steps:

  1. Local anesthesia.
  2. The gum tissue is reflected away from the tooth to allow observing of the area.
  3. Bone is removed to give access to the tissue at the end of the root.
  4. Removing the inflammed and/or infected tissue.
  5. Cuting off the root end and place a filling to help seal the end of the root.
  6. A filling is placed to remove embedded bacteria at the end of the root or branching of canal system which was untreatable with current techniques.
  7. A bone graft is placed to replace missing bone tissue.
  8. The soft tissue is sutured and the bone.

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