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Oral Surgery

When do you need oral surgery? Why?

What is oral surgery?

Oral surgery (odontostomatology) is a set of procedures that serve to eliminate disease, restore lost function and anatomical conditions, and prevent the occurrence of cancerous lesions.

Oral surgery

Restoring functional and aesthetic well-being to the entire odonto-stomatognathic system, i.e., teeth, bone, and soft tissue (gums, cheeks, tongue).

Surgeries

Tooth extraction.
Analysis and eventual removal of tissue.
Labial phrenulectomy.
Lingual frenulectomy.
Insertion of orthodontic mini screws to anchor braces.
Apicectomy (surgical endodontics).
Bone regeneration.
Maxillary cysts.
Alveolodental trauma.

Benefits:

Functional, biological and aesthetic.

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What types of interventions are performed?

Tooth extraction

The most well-known and widespread oral surgery procedure is tooth extraction. There are several causes that lead to extraction:

  • caries or fracture;

  • periodontitis (pyorrhea);

  • overlapping or inclusion of teeth;

  • infection;

  • granuloma;

  • wisdom teeth

Analysis and possible tissue sampling

The dental check-up includes an oral screening to intercept any abnormalities of the soft tissue or bone part. If suspicious lesions are present, all appropriate investigations (oral-ID) are implemented in order to rule out their presence. If necessary, a tissue sample (biopsy) is taken for sending to the hospital laboratory for histological analysis.

Labial frenectomy

Sometimes the labial frenulum, the thin band of tissue that connects the lips to the alveolar mucosa (tooth junction), is not in the correct position causing functional or cosmetic damage. Frenulectomy is performed to change the shape of the frenulum, preventing the formation of diastema (space between teeth) and possible bone injury between teeth.

Lingual frenectomy

The lingual frenulum is the band of tissue that connects the tongue to the jaw and regulates its movement.

A short frenulum limits the functionality of the tongue with possible disturbances to phonetics, swallowing, dental arch bone development and cervical posture. Lingual frenectomy is used to modify its length, restoring full tongue function.

Insertion of mini orthodontic screws to anchor braces

Small orthodontic screws made of titanium are inserted to better anchor the braces.

This allows for faster and more precise improvements in a variety of situations: closure of open bite, mandibular shifts, palate expansion, straightening of teeth, extrusion of included teeth, and dental derotation.

Other types of interventions

Apicectomy (surgical endodontics)

Removal of the apical part of the tooth root in case of infections that cannot be cured by devitalization. Infections may have been caused by many factors such as: previous substandard treatment, canal calcifications, resorption of the apices, trauma.

The gingiva is incised to discover where the infection is present. The bone is drilled to search for the infected area. It is cleaned, the root cut and further cleaning of the root itself. This is concluded with an airtight filling so that the area is no longer subject to bacterial attack.

From this point, the bone is self-healing, and after 6 months a follow-up X-ray confirms our healing status.

Bone regeneration

Introduction or stimulation of bone regrowth where missing, to restore the correct size for functional (biomechanical and dental hygiene) and esthetic reasons.

A biocompatible bone mixture is fixed at the site with custom (customized) titanium membranes or cages. In 6 to 8 months, osteoblast cells, which produce bone, find the substance on which to anchor and transform it into the person's own bone.

Horizontal bone regeneration: in the presence of the necessary height, but lacks bone thickness.

Vertical bone regeneration: lacking both height and thickness.

Sinus augmentation: recovery of thickness and height, going directly into the sinus.

Once the procedure is completed, the implant can be placed.

Maxillary cysts

These are lesions that can form in the mandible and maxilla.

They grow and expand by going on to "eat" the bone, creating infections and fractures.

They are removed completely, giving the bone a chance to regenerate.

Dental alveolus trauma

Accidental trauma is often encountered during sports or play activities, which can cause severe dental fractures, dental concussions (tooth enters bone), dislocations (tooth displacement), and complete avulsion (expulsion of the entire tooth from its socket).

It is necessary to retrieve the tooth or fragments and keep them bathed in biological fluids (e.g., bottled mineral water or milk) and intervene as soon as possible, within 4 hours of the trauma sustained.

The goal of the surgery is to save the tooth, reposition it properly, and block it (splinting) to allow the fibers of the bone to re-weld the tooth.

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Painless oral surgery

Anesthesia is used to perform oral surgery:

  • local anesthesia;

  • conscious sedation with Nitrogen Protoxide and Oxygen;

  • intravenous conscious sedation.

Local anesthesia

Infiltration with an anesthetic drug into the area to be operated on.

Our procedure involves anesthetizing the affected gum with cotton soaked in a specific substance to avoid pain caused by the needle.

For people with heart disease, we use anesthetics without adrenaline.

Conscious sedation

It is a technique that helps keep anxiety or fear of the dentist under control. It allows one to approach dental treatment in a pleasant and relaxing way, while remaining alert and conscious.

There are two different approaches and/or techniques

  • conscious sedation with Nitrous Oxide and Oxygen;

  • intravenous conscious sedation.

Using conscious sedation allows us to have the person's vital parameters under control at all times, giving us security and peace of mind. It allows us to avoid decompensation in people with medical conditions.

It is recommended for those with a history of heart disease, high blood pressure, those taking specific medications.

It is useful for treating children, because it allows them to experience the dentist as a positive, playful, painless experience, allowing them to gain his trust immediately.

It allows for a smoother post-operative course, with reduced side effects (less swelling, pain, etc.).

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Le fasi del percorso

Dental diagnosis

The surgeon performs a complete evaluation of the condition of the mouth: teeth, gums, tongue, mucous membranes, lymph nodes, palate.

Using radiographs and 3D CT scans, a clear view of the roots of the teeth, jaw bones, nerves, and any changes can be obtained. Only after a clear view of the situation is the individualized treatment plan drawn up.

Preoperative checkup

1

The duration of the surgery

The procedure takes different lengths of time depending on the type and operations to be performed. Normally an extraction takes about 30 minutes, while more complex procedures, such as maxillary regenerative surgery, can take between 2 and 3 hours.

Oral surgery

3

Preparation for surgery

The procedure is performed under local anesthesia, choosing together the most suitable option for a comfortable and relaxing session, minimizing any trauma, during and after the procedure.

Sedation with nitrous oxide

2

Postintervention

After surgery, prophylaxis and guidelines must be followed to reduce the risk of any bleeding, infection, or other. An emergency telephone number is always given, and the day after surgery the person in charge contacts the person to make sure the course is smooth.

Post surgery

4

Casi clinici

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