Oral & Maxillofacial Surgery
No one wants to lose their teeth, but sometimes it is necessary to undergo an extraction to restore and maintain the health of your smile. Extractions are never your dentist’s first choice, but in certain situations, the preservation of your oral health may be dependent on it.
Bone grafting is often closely associated with dental restorations such as bridgework and dental implants.
Sinus Lift is a surgical method by which we can increase the amount of bone tissue of the upper jaw, above the molars and premolars.
Need A Dental Implant but Not Enough Bone?
- Bone grafting is often closely associated with dental restorations such as bridgework and dental implants.
- In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site.
- When the jawbone associated with missing teeth shrinks, or has sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended.
Volume Shrinkage
- Periodontal Disease
Periodontal disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable. - Tooth Extraction
Studies have shown that patients who have experienced a tooth extraction subsequently lose 40-60% of the bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”. - Injuries and Infections
Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee.)
Sinus bone grafts are also performed to replace bone in the posterior upper jaw.
Sinus Lift (Graft)
Sinus Lift is a surgical method by which we can increase the amount of bone tissue of the upper jaw, above the molars and premolars.
The maxillary sinuses are behind your cheeks and on top of the upper teeth and are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.
To address this problem our dentist enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor’s bone is inserted into the floor of the sinus. After healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the Sinus Augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.
When patients experience extreme sensitivity, pain from a broken tooth, or are suffering from advanced periodontal disease, your dentist could recommend that you have a tooth extracted. During a simple extraction, the dentist can safely remove the affected tooth without the need for major surgery.
There are numerous situations in which a simple extraction is needed. Extractions are typically performed because of an active problem such as pain, swelling, decay, infection, as a preventative measure to avoid serious problems in the future, or to prepare your for another cosmetic or restorative procedure.
Common reasons for tooth extractions include:
- Advanced periodontal disease that has loosened the roots of your tooth
- Extra teeth or baby teeth that impede adult teeth
- Preparing a patient for orthodontic treatment
- Removing a fractured or malformed tooth
- Severe tooth decay which cannot be remedied with root canal therapy
- Removal of Wisdom Teeth
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so your doctor may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, your dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within your jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. In order to extract a tooth, your dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your doctor any concerns or preferences for sedation.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.
Wisdom teeth are types of molars found in the very back of your mouth. They usually appear in the late teens or early twenties, but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. When a wisdom tooth is impacted, it may need to be removed. If it is not removed, you may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.
Wisdom teeth are typically removed in the late teens or early twenties because there is a greater chance that the teeth’s roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier as well as shorten the recovery time.
In order to remove a wisdom tooth, your dentist first needs to numb the area around the tooth with a local anesthetic. Since the impacted tooth may still be under the gums and embedded in your jaw bone, your dentist will need to remove a portion of the covering bone to extract the tooth. In order to minimize the amount of bone that is removed with the tooth, your dentist will often “section” your wisdom tooth so that each piece can be removed through a small opening in the bone. Once your wisdom teeth have been extracted, the healing process begins. Depending on the degree of difficulty related to the extraction, healing time varies. Your dentist will share with you what to expect and provide instructions for a comfortable, efficient healing process.