Oral surgery

Oral surgery comprises procedures performed on the periodontal tissues (gums and bone) with the aim of removing or preserving a tooth. Everyone is familiar with tooth extractions, particularly the extraction of wisdom teeth, while apicoectomies or the removal of root tips, augmentations or the replacement of jawbone mass, flap surgery, etc., are somewhat less well known. The procedures are painless but involve varying degrees of bleeding. A considerable proportion of the procedures performed at our practice are oral surgical procedures. We perform the removal of wisdom teeth, tooth roots, etc.

A large proportion of surgical procedures consists of apicoectomies. Such a process affects the periodontal ligament and the bone tissue immediately surrounding the root tip, as well as organs elsewhere in the body. Such a tooth becomes a focus of inflammation. A surgical procedure in which the part of the root furthest from the dental crown (the root tip) is removed together with the surrounding inflamed tissue is called an apicoectomy. An apicoectomy is certainly not the first treatment of choice for inflamed areas around root tips. We opt for it if root canal treatment (endodontic treatment) has not been successful. The success of root canal treatment depends on the position of the tooth in the mouth, its accessibility for treatment, the anatomical characteristics of the tooth and root canals, the practitioner’s expertise, the quality of the materials, etc. Not every treatment of this kind can be successful, and only in such cases do we opt for a surgical procedure. The most common causes of unsuccessful root canal treatment and the consequent need for surgery are:

The procedure is painless. A pain-free state is achieved by injecting a substance for local numbing of the tissue (an anaesthetic) into the surgical area. The oral mucosa or gum is then incised in the region of the affected tooth root. The mucosa is gently retracted to provide access to the affected area. The bone over the lesion is removed with a bur, and the tip of the diseased root is excised. During the operation, the adequacy of the root canal filling is assessed and supplemented if necessary (retrograde root canal filling). The wound is closed with surgical sutures, which are removed after one week. The result is evaluated using an X-ray. The treated area may be moderately swollen for three days. Postoperative pain is mild, lasts only a few days and can be relieved with standard painkillers (we advise against aspirin because it affects blood clotting!). Complications following surgery are rare. Inflammation of the wound prolongs the healing time but usually has no lasting consequences. During a procedure in the upper jaw, the nasal cavity or maxillary sinus may be opened. In most cases, the opening heals spontaneously. During a procedure on the posterior teeth of the lower jaw, nerve damage may occur, causing a temporary sensory disturbance or tingling in part of the lower lip.