Surgical

Implants

Dental implant surgery is a procedure that replaces tooth roots with metal, screw-like posts and replaces damaged or missing teeth with artificial teeth that look and function much like real ones. Dental implant surgery can offer a welcome alternative to dentures or bridgework that doesn't fit well and missing teeth.

The major benefit of implants is solid support for your new teeth — a process that requires the bone to heal tightly around the implant. The healing process may take 4-6 months.

Extraction Site Preparation

When removing a tooth it is important to consider what will be done with the empty space after that tooth is removed. Wisdom teeth are in the back of the mouth, so that site will heal on its own with no complications. If it is necessary to remove another tooth, plans must be made. If a tooth is removed and nothing is done with the extraction site, the jaw bone will degenerate and change shape during healing and can cause your teeth to shift. This can create problems in your bite and affect your ability to speak and chew.

If you want to fill the space with a dental implant, a sturdy jaw bone is necessary to install the implant. If you opt for a dental bridge, the bridge must be molded and placed before the teeth shift.

Your dentist is always open to a conversation on what you would like to do with your extraction site before removing a tooth. They will be able to make a recommendation and layout a treatment plan. Make sure to schedule follow up appointments to properly care for your extraction site.

Bone Grafting

Bone grafting is where the jawbone is built up to accommodate a dental implant or other restorative device. Bone grafting is a common procedure that is used frequently for dental implants and other periodontal procedures. The bone used to graft is taken from a sample from the patient. Many times, the bone is taken from another area of the mouth when drilling takes place. The bone fragments are suctioned from the mouth and used for the graft. Cadaver bone fragments are also used. They are harvested by bone banks and are a very safe source for bone donation.

Extraction

Impacted teeth and wisdom teeth that can potentially cause problems, like infections, need to be removed. Extractions can range from a single tooth to removing all four wisdom teeth at once. Based on the preference of the doctor and/or the patient, a local anesthetic could be used to numb the areas where the teeth will be extracted. Others will prefer to go under a general anesthetic so that they will be sedated during the procedure.

The gum tissue around the wisdom tooth is cut open to reveal the tooth. The tooth is loosened by gripping it tightly and wiggling it back and forth until it can be lifted out of the gums. Sometimes a tooth may be impacted so tightly that it cannot be simply lifted out of the gums. In cases like this, the tooth will be broken up into pieces first before being removed. Depending on the incision and extraction site, sutures may be needed to close the area. Soluble sutures are the best option, which will dissolve on their own.

After the surgery, you will need to rest. You need to be driven home by a friend or family member because of the anesthesia. You can expect for the extraction site to bleed for a little while after the surgery. Gauze will be applied at the completion of the surgery, and you will need to change it when it becomes soaked. If bleeding continues for longer than 24 hours you should call your dentist. Rest when you return home, but do not lie flat. This could prolong the bleeding. Prop your head up on a pillow when lying down. Your dentist will prescribe you pain medication, so if you become sore take as directed. You can also use an ice pack for the pain. Your dentist might also provide you with a cleaning solution to clean the extraction site.

You will be limited to soft foods for a few days after your surgery. Some recommended foods are:

Gelatin
Pudding
Yogurt
Mashed Potatoes
Ice Cream
Thin Soups
...and other food you can eat without chewing.

When drinking, make sure you do not use a straw. The sucking motion can loosen your sutures and slow the clotting process. The same goes for smoking. If you have prolonged pain, bleeding, irritation, or don't feel that the extraction site is healing properly call your dentist for a follow-up.

Ridge Augmentation

When you lose teeth, and do not replace them, the jawbone deteriorates where the tooth socket once was. This makes it difficult, and in some instances impossible to get dental implants or dentures later on. You may have not had the financial means at the time of the extraction for restorative surgery, but you may have the money now. The good news is that we can perform a process called ridge augmentation to restore the bone structure that is needed for restorative procedures such as dental implants. The process involves lifting the gum from the ridge to expose the defected area of the bone. Then the dentist uses a bone like substance to fill the defected areas. The ridge augmentation greatly improves the appearance of the mouth and increases the chances for success with the implants. With ridge augmentation, your implants will last for years.

Sinus Augmentation

Loss of posterior teeth may result in excessive forces being placed on your remaining teeth. Fortunately, the use of dental implants and crowns allow you to replace these missing teeth. However, the position of the sinus in the upper posterior areas may be too low for proper placement of dental implants.

A simple procedure allows the sinus floor to be repositioned, creating enough space to properly place an implant. Various grafting materials are used to encourage your bone to grow more quickly into the area, helping to stabilize the dental implant. Replace with your own bone in this area the grafting material as it grows into the area.

Under certain conditions, an even simpler procedure can be utilized. When possible, the bone remaining under the sinus floor is gently “pushed up”, thus lifting the floor of the “dropped” sinus. Bone replacement materials are then placed beneath this lifted bone. Once again the bone materials are replaced as your body grow new bone into this area.

Sinus augmentation procedures are highly predictable, with studies reporting over 85% success. Following sufficient healing of a sinus augmentation (8-10 months), implants are placed in a predictable and successful manner. It is important to realize that if the sinus augmentation procedure does not result in enough bone for implant placement, the additional bone may be regenerated through a second sinus augmentation procedure at the time of implant placement.