Oral Surgery

Oral and Maxillofacial Surgery specializes in the diagnosis and treatment of diseases and injuries of the face, mouth, dentition, jaws and neck; preparation for and placement of dental implants ; removal of wisdom and diseased teeth; and, pathological and cosmetic problems.

Wisdom teeth are third molars. Normally people have three permanent molars that develop in each quadrant of the mouth. The third molars usually will try to grow in at around age 18 to 20 years.

Wisdom teeth are actually no different than any other tooth except that they are the last teeth to erupt. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them. Unfortunately, this does not always happen.

When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. A dentist must examine a patient's mouth and corresponding x-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems. Here are several common problems that occurs when the impacted wisdom teeth are not removed.

  • Bacteria and plaque build-up
  • Decay of adjacent
  • Formation of cysts (a fluid- filled sac) or tumors from follicle
  • Tumor development
  • Infection
  • Jaw and gum disease

Wisdom teeth are third molars. Normally people have three permanent molars that develop in each quadrant of the mouth. The third molars usually will try to grow in at around age 18 to 20 years. Wisdom teeth are actually no different than any other tooth except that they are the last teeth to erupt. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship, and have healthy gum tissue around them. Unfortunately, this does not always happen.

Erupted wisdom teeth may need to be removed. The dentist may recommend wisdom tooth removal if wisdom tooth

  • Interferes with the bite
  • Non-functional
  • Badly decayed
  • Involved with or at risk for periodontal disease
  • Interferes with restoration of an adjacent tooth

Every case is different and only your dentist can determine if there is a reason for you to have a tooth removed.

SYMPTOMS OF WISDOM TOOTH ERUPTION:
The following symptoms may indicate that the wisdom teeth have erupted and surfaced. However, each individual may experience symptoms differently. Symptoms may include:

  • Pain
  • Infection in the mouth
  • Facial swelling
  • Swelling of the gumline in the back of the mouth

Many oral health specialists will recommend removal of the wisdom teeth, (when the roots are approximately formed, or three-fourths developed, usually in the adolescent years), as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar. Third molar impaction is the most prevalent medical developmental disorder.

APISECTOMY:
An apisectomy is a surgical procedure that places a filling in the end of the root and removes any infected tissue from around the tip. Its aim is to contain any bacteria that may be remaining totally within the canal system.
This procedure would only be attempted after a traditional root canal has failed and because of the difficulty in accessing the tips of the roots it is generally only done on the anterior (front) teeth and by a specialist endodontist. Apisectomies performed on single rooted teeth have a success rate around 90%, the success rate this for teeth with multiple roots is much lower.
It may be performed in the following circumstances:

  • Root perforation- where during tooth preparation instruments have pierced the side of the root.
  • Persistent inflammation and infection remains due to a cyst.
  • The tip of the root has been fractured due to trauma and has become infected.
  • Where a post crown is in place and the tooth is problematic- removing posts is very difficult and can often lead to fracture of the root and the tooth being lost. An apisectomy leaves it undisturbed.
  • Fractured instruments in the canal that cannot be filled around adequately and appropriately.
  • Difficulty in performing the conventional root treatment due to a closed or very curved canal.

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