Dental surgery – what is it?
Dental surgery – indications and contraindications
Surgical treatment is strictly conditioned by the range of indications, which, however, have changed in recent years due to the significant progress of endodontic and periodontological treatment. Nowadays it is possible to maintain the dead but properly treated teeth in the oral cavity and to regenerate bone surrounding the teeth and preventing their loosening and falling out.
Indications for extraction:
– teeth unsuitable for conservative and prosthetic treatment, with a significant tissue loss,
– longitudinal cracked teeth (so-called vertical root fracture),
– teeth which roots are surrounded by extensive lesions in the bone (visible on the X-ray),
– very loose tooth with a significant loss of the surrounding bone,
– recurrent periodontal abscess,
– third molar teeth (wisdom teeth) – detained in the bone, improperly located, causing pain or simple irrelevant to bite,
– additional, supernumerary teeth (appear as a result of developmental disorders),
– orthodontic indications.
Indications for gum surgery:
– overgrown gums (eg as a result of treatment with cyclosporin, calcium inhibitors, etc.),
– exposed tooth necks (recessions),
– exposed roots in molars.
Contraindications can be divided into general and local ones. General ones concern patient’s diseases and are usually relative, a procedure can be performed after appropriate preparation of the patient by the physician treating the systemic disease. Diabetes, blood diseases, or taking of anticoagulants (the treatment and prophylaxis of thromboembolism and its effects, such as myocardial infarction) are the most common general contraindications as they can seriously affect healing process. The most important local contraindication to remove teeth is surrounding them tumour mass. There are also strict rules of surgical procedure if the patient undergoes chemotherapy or radiotherapy, but those treatments are not contraindication to the extraction with appropriate precautions.
Dental surgery – types of treatments
The basic treatments are so-called alveolar surgery, ie extractions of teeth unsuitable for treatment, surgical removal of the eighth teeth, so-called third molars (“teeth of wisdom”), retained teeth. The typical treatment includes subsequent bones and gums formation to ensure the best healing and – which is extremely important – maintaining the correct bone volume, which naturally tends to disappear after removing the teeth. The more bones remain, the better the implants stabilization or the movable prosthesis maintenance. In the case of bone deficiency, there are some methods of its reconstruction with augmentation materials, which we also do in our clinic. After extraction, the implantologist or prosthetist takes care of the patient to plan further treatment.
An important part of dental surgery are soft tissue treatments: treatment of gum hypertrophy, removal of mucous cysts or frenula correction (mainly upper lip). The dental surgeon deals also with the hypertrophic and pre-cancerous lesions removal. In our clinic we use lasers for surgical procedures on soft tissues, which significantly shortens the procedure time, minimizes bleeding and ensures quick, painless healing.
In the surgery office we treat also cases of abscesses in the face and neck, which often have origin from the tooth. In the treatment of abscesses, it is necessary to operate (abscess incision) with antibiotic therapy. It is usually advisable to remove the tooth.
For dental surgery, cooperation with other specialists is very important, because it allows to quickly obtain satisfactory results. Plastic surgery within the gums, increasing gum width, covering the recession (exposed teeth necks) or regeneration of bones and gums in the interdental spaces requires cooperation of a surgeon with a periodontologist. Joint surgical and orthodontic treatment is a chance to bring the teeth into the line of occlusion (after surgery) and to reduce crowding by planned extractions because of orthodontic indications. The cooperation with the implantologist and the prosthetist is based on the procedures which increase the volume of the alveolar bone in case of its disappearance, which facilitates further treatment with prosthetic restorations.
Dental surgery – the course of the procedure
After collecting a detailed interview, which is extremely important in dental surgery due to possible complications and the impact of general diseases and medications taken by the patient on the entire procedure, the doctor presents a treatment plan and waits for patient’s agreement. Each surgical procedure carries the risk of complications, usually easy to supply, but the patient must be aware of them and strictly follow the doctor’s instructions. Surgical treatment usually starts with local anesthesia, which eliminates any pain and allows the surgeon work comfortably. The time of each procedure is different and depends on general and local factors. After the procedure, the patient receives a list of recommendations from the doctor.
It is necessary to follow those recommendations to ensure proper healing and prevent uncomfortable symptoms (see below). Typically, to ensure better healing, absorbable or non-absorbable sutures are assumed, depending on the physician’s decision. In the case of non-absorbable sutures, the patient must report for the next visit (usually about a week after the surgery) to remove them. This visit also involves controlling the healing process.
Dental surgery – location
If you are interested in performing the removal of wisdom teeth or other surgery, please report to our dental office located at street Ks. P. Wawrzyniaka 36a (Krzyki) in Wrocław.
Dental surgery – frequently asked questions (FAQ)
|Specialized consultation||150 PLN|
|An allergic test||150 PLN|
|Monoradicular tooth extraction||Starting at 250 PLN|
|Multiradicular tooth extraction||Starting at 3000 PLN|
|Extraction of deeply broken root by alveoral drilling with drills and levers||Starting at 250 PLN|
|Extraction of deeply broken root by alveoral drilling with panel shaping||Starting at 300 PLN|
|Operational removal of third molar||500 – 900 PLN|
|Surgical removal of tooth bud from orthodontic indications – germectomy||500 – 900 PLN|
|Surgical removal of a retained tooth||400 – 600 PLN|
|Surgical unveiling of the tooth crown||300 – 500 PLN|
|Surgical wound supply (sewing)||200 PLN|
|Taking the sample without the costs of histopathological examination (+ histopathological examination)||300(+50) PLN|
|Removal of bumps||Starting at 300 PLN|
|Correction of the oral-sinus connection||Starting at 500 PLN|
|Incision of abscess||300 PLN|
|Bone smoothing – exostosis||Starting at 200 PLN|
|Cutting the frenulum||300 PLN|
|Plastic surgery of the frenulum||300 PLN|
|Resection of a single-rooted tooth||Starting at 500 PLN|
|+ backfill||100 PLN|
|Hemisection, bicuspidization, radectomy||600 PLN|
|Removal of salivary duct stone||500 PLN|
|Cystectomy||Starting at 400 PLN|
|Plastic surgery of the oral vestibule||Starting at 300 PLN|
|Splinting of teeth (1 point)||100 PLN|
|GBR treatments (without material costs):|
|– one interdental space||Starting at 400 PLN|
|– one interradicular space||Starting at 300 PLN|
|– independent cavity in the interradicular space||Starting at 300 PLN|
|Recession coverage (subepithelial transplant)||Starting at 1000 PLN|
|Transplant of hard tissue||Starting at 3000 PLN|
|Soft tissue transplantation (incl. recessions)||Starting at 1200 PLN|
|Closed curettage 1 tooth||100 PLN|
|Open curettage 1 tooth||200 PLN|