ORAL SURGERY

What is alveotomy?

In addition to the simple extraction of teeth, we also extract impacted and retained teeth using the alveotomy procedure. Any tooth in the jaw can be impacted or retained. An impacted tooth cannot erupt into its position in the jaw due to a mechanical obstacle blocking its path, while a retained tooth does not erupt for reasons that are not mechanical. The most commonly impacted teeth are the third molars, commonly called wisdom teeth. Where the bone above the crown of the impacted tooth is connected with the oral cavity, this makes cleaning the tooth arch more difficult, and may result in inflammation of the surrounding gums, called pericoronitis. If the impacted or retained tooth causes problems for the patient, their extraction is recommended using alveotomy. This is an oral surgery procedure performed under local anaesthetic, making it completely painless for patients. The patient is conscious the entire time and can communicate with the oral surgeon. Before performing alveotomy, the oral surgeon takes a complete medical history of the patient. Itis important to list any and all drugs the patient is taking, in order to prevent any influence on bleeding during and after the procedure, and on the healing of the extraction wound. Alveotomy begins with the injection of a local anaesthetic. Following this, the surgeon makesan incision with a scalpel. The jaw bone is drilled open in order for the oral surgeon to be able to access the surgical area, and the tooth remaining in the jaw is removed from the bone using special surgical instruments (chisel, lever), with minimal trauma to the surrounding tissue. After the procedure, the wound is sutured for easier healing, and the patient receives post-surgical instructions. One week later, the patient comes into the clinic for a check-up and removal of the stitches.

What is apicoectomy?

This is an oral surgery technique that implies the removal of the root tips of an endodontically treated tooth. This is performed by an oral surgery specialist. Apicoectomy is performed when the endodontic treatment of a tooth did not result in the end of the painful symptoms and inflammation of the tooth, or when even repeated endodontic treatment did not result in a retraction of a granuloma on the tip of the root. This is confirmed by x-ray. Itis then recommended that the oral surgeon remove the tips of the tooth root (apicoectomy), in order for the tooth to remain in the jaw. This procedure is performed under local anaesthesia, making it completely painless. Prior to the apicoectomy, the oral surgeon takes a complete medical history of the patient. It is important to list any and all drugs the patient is taking, in order to prevent any influence on bleeding during and after the procedure, and on the healing of the extraction wound. A detailed description of the apicoectomy procedure is as follows: the first stepis the administration of the local anaesthetic. During the entire procedure, the patient is conscious and can communicate with the oral surgeon. Once the area is anaesthetised, the oral surgeon makes a horizontal incision at the level of the root tip of the affected tooth, and opens the bone with a drill in order to access the affected area. The tip of the affected tooth is removed, and any inflamed tissue in the bone is scraped off. If needed, it is possible to endodontically fill the root of the tooth to ensure impermeability of the canal, and then the wound is sutured close. This procedure takes from 30 to 60 minutes, depending on the thickness of the bone in the part of the mouth where it is being performed. After the procedure, the scar is barely visible, and the bone defect is filled within several months.

Apicoectomy is performed when endodontic treatment is not sufficient to repair the inflammatory processes within the bone due to the spread of infection from the root canal, or when there are oral cysts connected to the tooth root. After the apicoectomy, the tooth root is a little shorter, though the tooth remains in the jaw and retains its function and aesthetic.