Oral surgery is a dental surgical discipline that includes the following procedures:
Most of these interventions are performed under local anesthesia, except in children and patients who cannot control their fear. The field of oral surgery overlaps with maxillofacial and periodontal surgery.
In terms of teamwork, the most common collaboration is between an oral surgeon and a prosthodontist through pre-prosthetic surgery, as well as between an oral surgeon and an orthodontist through orthodontic surgery.
Tooth Extraction and Oral Surgery
Routine tooth extraction and surgical removal of fractured or impacted teeth are usually performed on an outpatient basis under local anesthesia for most patients. Lengthy procedures are carried out under sedation or general anesthesia.
The decision on the type of anesthesia is made in agreement between the doctor and the patient. In doing so, numerous factors that can affect the course of the operation are taken into account: the type and complexity of the intervention, the patient’s age and psychophysical condition, etc.
Oral surgical interventions are painless and, in the largest percentage, without accompanying complications.
SURGICAL LIBERATION OF IMPACTED TEETH FOR ORTHODONTIC PURPOSES
Impacted teeth are unerupted teeth, trapped in the bone tissue of the upper or lower jaw. In most cases, wisdom teeth (third molars), then canines, incisors and premolars remain impacted.
Wisdom teeth grow much later than other teeth and in a certain number of people they cannot erupt, causing pain and swelling of the jaw.
Teeth can also grow at a certain angle, when there is a problem of lack of space for a proper position in the jaw. In cooperation with orthodontics, the crown of impacted teeth is surgically removed as part of oral surgery.
REPLANTATION AND TRANSPLANTATION OF TEETH
These interventions, although different, have something in common: preservation of the periodontal ligament of the tooth being replanted or transplanted.
TEETH REPLANTATION
Tooth replantation is an urgent surgical intervention that is performed with the aim of returning a completely knocked out tooth to its place (alveolus).
Immobilization is then performed, usually with a composite splint, less often with a wire or splint. This method provides adequate conditions for faster healing of periodontal ligaments.
After the intervention, the patient is explained to apply gentle pressure with the tongue on the fixed tooth several times during the day in order to avoid root ankylosis.
TOOTH TRANSPLANTATION
Tooth transplantation is most often performed in case of premature loss of first molars. On that occasion, by surgical extraction of unerupted wisdom teeth, they are used, along with processing of the alveolus during surgical intervention, for transplanting to toothless places.
Tooth transplantation is the surgical process of transplanting teeth. It is possible to transplant a tooth within the same jaw or from one jaw to another.
This procedure is carried out in two stages: 14-21 days apart. The first stage involves extracting the diseased tooth, processing the alveolus in terms of removing the septum and expanding its volume.
The second stage is performed after 14-21 days. When young granulation tissue, rich in blood vessels, has formed in the alveolus, the extracted impacted wisdom tooth is pressed into it, with the previous creation of the bed by simply cutting of the midportion.
APICECTOMY (RESECTION) OF TOOTH ROOTS
Apicectomy is amsurgical intervention on the root of the tooth, which includes the removal of the apex (tip of the tooth root) and the surrounding periapical, pathologically changed tissue. This procedure involves endodontic treatment of the root of the tooth with a definitive filling. In case of inadequately filled tooth and periapical change, apicectomy is performed with retrograde filling of the root canal.
Apical surgery is performed when it is necessary to remove the periapical lesion (process) and save the tooth.
Trauma to the teeth and jaws, as well as inadequate oral hygiene and the development of caries, can lead to the penetration of microorganisms into the interior of the teeth and the occurrence of a dentogenic infection. The infection, which occurs in both adults and children, first affects the pulp, and then spreads to the entire root canal.
This problem is successfully solved in many patients with endodontic conservative therapy. In cases where the endodontic conservative method is not effective enough, apicectomy is recommended as the most expedient solution.
SURGICAL REMOVAL OF JAW CYSTS
Cysts of the jaws are ovoid structures of a benign character, developed in the bones of the upper or lower jaw. They are filled with semi-liquid or liquid epithelial content, and their size varies from several millimeters to several centimeters in diameter.
Given that they tend to grow, jaw cysts can exert pressure on the surrounding tissue and cause resorption of the jaw bone. Being progressive, this process can cause tooth root resorption and tooth migration, but also exert pressure on blood vessels and nerves.
Depending on the type, size and localization of the cyst, a treatment plan is determined within the framework of oral or maxillofacial surgery. It is most often a question of a combination of surgical and medical therapy, which includes excision of the cyst, pathohistological analysis of the contents and prescription of medication.
ORAL SURGERY – MAXILLARY SINUS OPERATION
The maxillary sinuses belong to the group of paranasal sinuses filled with air and are part of the respiratory system. The frontal and ethmoid sinuses as well as the sphenoid sinus are also found in the bones of the face.
Diseases of the sinuses can be classified into four categories:
The domain of oral surgery is the treatment of cysts, chronic inflammation of the mucous membrane of the sinuses, as well as the treatment of oroantral communications.
Surgical treatment of other diseases of the ethmoid and frontal sinus falls under the scope of maxillofacial surgery or otorhinolaryngology.
PRE-PROSTHETIC SURGERY
Pre-prosthetic surgery is applied in creating the conditions for producing an aesthetic prosthetic replacement that fulfills its function.
This discipline includes:
ORAL SURGERY AND TREATMENT OF CHRONIC FACE AND JAW PAIN
Pain in the face and jaws (orofacial pain) is caused by a disturbance in the function of the trigeminal nerve, which is why this disease is also called trigeminal neuralgia.
Trigeminal neuralgia can be idiopathic, symptomatic and post-traumatic.
In addition to trigeminal neuralgia, atypical facial pain, postherpetic neuralgia, cluster neuralgia, etc. can occur.
