MEDICAL SECOND OPINION

Oral Surgery and Implant

What Procedures Are Conducted in Oral and Maxillofacial Surgery?

•    Operations for abscesses and cysts
•    Removal of wisdom teeth
•    Dental implant procedures
•    Surgery on the jaws
•    Extractions of teeth

When Are Cyst Operations (Apical Resection) Necessary?

•    When the tooth's root is excessively curved or obstructed, making root canal treatment unfeasible,
•    If a canal instrument breaks during the procedure and needs extraction,
•    When a root canal treatment cannot be executed due to a permanent restoration (like porcelain) that cannot be removed,
•    In the presence of a cyst or chronic abscess at the tooth's root end,
•    When a patient continues to experience pain even after undergoing root canal therapy,
•    In cases where a portion of the root end has fractured inside the bone.

Why should a poorly positioned wisdom tooth be extracted even though it causes no discomfort?

Misaligned wisdom teeth can become a breeding ground for infections, manifesting as pain and swelling at unpredictable times.
•    Due to their hard-to-reach location, wisdom teeth are challenging to maintain clean through regular brushing and flossing. This difficulty allows bacteria and food remnants to accumulate, resulting in tooth decay that, if left untreated, can quickly lead to infections.
•    The buildup of bacteria and food particles in this region also contributes to halitosis (bad breath).
•    Wisdom teeth that are improperly aligned and remain underneath the gums can cause adjacent teeth to crowd and shift, resulting in dental misalignment.
•    Moreover, bacteria accumulating under the gum line around an impacted tooth can initiate infections.
Is it possible to remove a wisdom tooth during an active infection?
Typically, it is not advisable. Removing a tooth that is currently infected could lead to the spread of the infection in the surrounding area, delaying the healing process of the wound. The infection can be managed with proper oral hygiene practices, the use of antibiotics, and sometimes by extracting the opposing wisdom tooth.

What Are the Guidelines for Postoperative Care?

•    The surgical site should be left undisturbed to avoid pain, infection, and bleeding.
•    Avoid using the side of the mouth where surgery was performed for chewing during the first 24 hours.
•    Refrain from smoking for the first 24 hours as the chemicals in cigarettes can increase bleeding and hinder healing.
•    Avoid spitting in the first 24 hours to prevent increased bleeding and dislodgment of blood clots.
•    Keep gauze pads in place over the surgical area for at least 30 minutes to facilitate clot formation.
•    To minimize facial swelling and slow down blood circulation, apply a cold compress (ice) to the area intermittently: 2-3 minutes on, followed by a 2-3 minute break. Continue this cycle for 48 hours.
•    Resume gentle rinsing and brushing after 24 hours.
•    If swelling occurs after the initial 48 hours, applying heat to the area can help increase circulation and reduce swelling.
•    Follow the dentist's instructions and take all prescribed medications as directed.

When Is Wisdom Tooth Extraction Necessary?

The third molars, or wisdom teeth, are the last to emerge in the mouth, typically appearing between the ages of 17 and 25. Due to their late eruption during the '20s, they are popularly known as "wisdom teeth." It's possible for some individuals never to develop wisdom teeth at all. If wisdom teeth emerge correctly aligned and do not disturb nearby teeth or tissues, there is no harm in leaving them as is. Nonetheless, there are instances where these teeth do not erupt and remain impacted within the jaw. Given the potential for damage from teeth that are misaligned or embedded in the jawbone, extraction might be considered necessary. Furthermore, the emergence of wisdom teeth can be obstructed in individuals with narrow dental arches due to insufficient space, leading to complications with gums, bones, and adjacent teeth.

What Are Dental Implants and When Should They Be Considered?

 Dental implants offer a solution for replacing missing teeth. They consist of titanium screws that are surgically inserted into the jawbone in areas where teeth are absent, serving as a substitute for the natural tooth root. After these implants integrate with the bone, a porcelain crown is attached to mimic the appearance and function of a natural tooth. This option is considered the most lifelike solution for prosthetic teeth, both aesthetically and in terms of chewing efficiency. Due to their numerous benefits, dental implants have become increasingly favored in recent years. They are versatile, suitable for replacing everything from a single missing tooth to several missing teeth, and can be utilized to support fixed bridges or dentures without affecting adjacent teeth, providing a stable and permanent solution for those previously reliant on removable prosthetics.

What Benefits Do Dental Implants Offer?

Dental implant therapy is highly favored due to its user-friendly nature, comfort, reliability, and aesthetic appeal, making it a well-accepted option for patients. The porcelain crowns used with implants deliver a natural and aesthetically pleasing appearance, effectively replacing missing teeth. A significant benefit is the preservation of adjacent healthy teeth, which remain unaltered during the procedure. Compared to other dental prosthetics, implants boast a considerably longer lifespan. There are documented instances where implants have remained intact and functional for as long as 41 years. Additionally, dental implants can significantly boost a patient's self-esteem by mitigating the negative psychological impacts associated with tooth loss.

Does Implant Treatment Offer Longevity?

The development of dental implants can be traced back to the early 19th century. Currently, there are implants in clinical use that are nearly 35-40 years old and still in near-perfect condition. If the implants selected are appropriate for the patient's condition, properly installed, and the patient maintains good oral hygiene, these implants can last for many years without any complications.

Are Implants Suitable for Everyone?

Implants can be considered for any patient who is in overall good health. There is no upper age limit for implant treatment as long as the patient maintains good general health. However, implant treatment may not be recommended for individuals whose bone development is not yet complete. Implants require a certain thickness and width, meaning the jawbone must have adequate height and width to accommodate the implant. The bone's quality is also crucial; bones that are either too hard or too soft may impact the success of the implant. Additionally, the condition of the gums and the proximity to other anatomical structures play a significant role in the feasibility and success of implant treatments.

In which cases can implants be used?

Regardless of whether it's for a single missing tooth or several, an implant can be placed as long as there is enough bone to support it. The key factors to consider are the bone's width and height, as well as its proximity to adjacent teeth and anatomical features. Radiographic imaging or computed tomography scans are essential tools for accurately assessing the state of the bone for this purpose.

Is an implant procedure painful?

In all dental treatments, including implant procedures, patients should not experience any discomfort if the appropriate anesthesia is administered beforehand. For individuals who have a fear of local anesthesia or possess a severe gag reflex, implant procedures can also be carried out under general anesthesia. After the surgery, patients might experience minor discomfort similar to that of a tooth extraction. This slight pain, typically occurring on the evening of the treatment, can usually be managed with over-the-counter pain medication.

How long does the total treatment take?

Implant therapy is conducted in two phases. The first phase involves the placement of the implant, with the duration for each implant taking roughly ten minutes, though this can vary based on the patient's specific tooth and bone anatomy. The second phase, concerning the fitting of the prosthetic, occurs about 2-3 months following the implant placement. This interval essentially marks the total length of the treatment process. During this period, temporary prostheses are used, which should not compromise either aesthetics or functionality.

How long after the implants have been mounted can the prosthesis be fitted?

The period required for the implants to integrate with the bone, known as osseointegration, spans about 2-3 months. It is crucial during this phase to minimize the pressure exerted on the implants. A temporary prosthesis can be employed during recovery as long as it does not apply undue pressure on the implants. The permanent prosthesis can be fitted once the implants have fully integrated with the jawbone.

Is it necessary to place an individual implant for each missing tooth?

Not necessarily. For situations involving the absence of more than two teeth, a plan may be devised to support a bridge prosthesis across the edentulous area, with strategically placed implants that allow for spaces between them.

What happens if the implant doesn’t fuse with the bone?

If an implant fails to integrate with the bone, the likelihood is quite low when the implant is properly placed, with failure rates around 1-2%. Such failures typically manifest within the initial three months after the implant has been placed. In these instances, the implant can be removed through a process as straightforward as tooth extraction. Assuming there is no significant damage to the bone, it may be possible to replace it with a slightly larger implant. Should there be considerable bone loss, a new implant might be placed after allowing time for bone regeneration or, alternatively, traditional prosthetic options could be explored.

Where and how are implant treatments performed?

Implant procedures involve a collaborative approach among various dental specialists. This team typically includes a maxillofacial surgeon responsible for inserting the implants into the jawbone, a prosthodontist who crafts and fits the prosthesis over the implants, and a periodontist who assesses and maintains the health of the gums after the procedure. Conducting such treatments within a comprehensive medical center is crucial for ensuring patient health. A detailed assessment of the patient’s overall health, examination of the implant site, and specific diagnostic tests are essential components of this process. Additionally, imaging techniques such as panoramic x-rays or dental cone beam computed tomography (CBCT) are often utilized to evaluate the bone's condition.

What are the advantages of implant treatment?

Patients who lack teeth in their lower jaw and use a removable prosthesis often report discomfort and difficulty chewing due to the prosthesis's continuous movement. Over time, this issue exacerbates as the bone tissue that supports the prosthesis wears down. Implant therapy addresses these complaints by halting the bone's degradation. For individuals missing segments of teeth in either the lower or upper jaw, a removable prosthesis with clasps or a fixed bridge prosthesis may temporarily replace the missing teeth. However, the challenges associated with removable dentures and the necessity to alter healthy teeth for bridge placement present significant drawbacks. Implant-based solutions using fixed prostheses eliminate these negative aspects. When only a single tooth is missing, traditional methods typically involve altering at least two adjacent teeth to accommodate a bridge. An individual implant obviates the need to modify surrounding teeth, offering a solution that is both aesthetically pleasing and functional.

Will the implant be unsuccessful?

The likelihood of implant failure is relatively low, around 1-2%. It's crucial to evaluate a patient's overall health status prior to proceeding with implant therapy. For individuals with certain conditions, like diabetes, it's advisable to avoid implant procedures. Additionally, the success rate of implants decreases for smokers or those who neglect proper oral hygiene. The site for the implant must be meticulously examined. Factors such as the available bone quantity, its quality, and proximity to anatomical structures must all be taken into account. With diligent preparation for the implant procedure and proper care by the patient, implants can remain securely in place for an extended period without any complications.

Do implants cause cancer?

The belief that implants might cause cancer is a widespread misunderstanding. Yet, there is no scientific evidence available up to now indicating that implants are linked to an increased risk of cancer.

Created at 15.06.2024 04:03
Updated at 15.06.2024 04:03

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