Advanced Oral Surgical Procedures
Impacted Wisdom Teeth
Impacted wisdom teeth, or third molars, can produce complications such as infections, damage to the adjacent tooth, and cyst formation. It is generally recommended that wisdom teeth be removed ideally in the late teens to mid twenties. Younger patients are commonly asymptomatic, but studies have shown that eventually 85% of wisdom teeth eventually become problematic and require removal. Younger patients have the advantage of better and faster healing potential, and also, surgery is easier and less complicated when the roots of the wisdom teeth are not fully formed.
It is generally recommended that all four wisdom teeth be removed at the same time with the comfort of intravenous sedation. Dr. Dickey thoroughly explains the clinical findings, indications for surgery, and anticipated postoperative course during the initial consultation and is happy to answer any questions.
With the advent of dental implants, replacement of a single missing tooth or multiple missing teeth can be accomplished without a removable prosthesis or prepping adjacent teeth for a bridge. Dental implants are cylindrical titanium posts that screw into the jaw bones and has an excellent success rate. After a period of healing, the titanium implant fuses (osseointegrates) to the surround bone. The integrated implant now acts as a new root system, on to which a crown or cap is placed for the most natural form and function. Implants can also be utilized to support and anchor a complete denture that would otherwise not be stable or comfortable to wear. In certain situations, a tooth can be removed and an immediate implant can be placed.
Generally, the restorative dentist is the “captain of the ship” and will decide the location and number of implants that need to be placed. Dr. Dickey will evaluate the sites to ensure adequate bone and spacing is available to accommodate an implant. Dr. Dickey will work closely with the restorative dentist to insure a comprehensive treatment plan to meet the restorative needs of both the patient and referring dentist.
On occasion, bone grafting or “sinus lifting” is required prior to placement of dental implants. After the early loss of a tooth, the surround bone begins to resorb over time. In a traumatic loss of a tooth, the supporting bone is sometimes completely lost along with the tooth or teeth.
When the dentist and oral surgeon plan on restoring the edentulous space(s) with an implant, the quality and quantity of bone must be first assessed. If there is insufficient bone to support an implant, a bone grafting procedure (site development) must be performed either prior to or during the placement of an implant.
Autogenous bone can be harvested from the patients own body (hip, tibia, or mandible) and grafted into the deficient areas with relative ease and patient comfort. Otherwise, synthetic or cadaveric bone can be used as a grafting material. Platelet-Rich-Plasma is used to enhance the bone graft.
Pathology and Infections
Although not exceedingly common, cysts and tumors can develop in the jaw bone. They can be completely asymptomatic and discovered on a routine x-ray. On occasion, the cyst or tumor can reach large sizes, causing pain, discomfort and disfigurement. Benign or malignant lesions can also occur on the soft tissues in the oral cavity. All lesions in the mouth or jaws need to be evaluated and possibly biopsied.
Oral and Maxillofacial Surgeons are uniquely trained to diagnose and treat lesions occurring in the oral cavity and jaw bones (maxilla and mandible). Also, large abscesses may form from infected or necrotic teeth. Left untreated, odontogenic infections can become life-threatening and always require prompt treatment. Dr. Dickey has extensive experience in diagnosing and treating benign cysts and tumors of the jaws. Dr. Dickey will clinically and radiographically evaluate the lesion or infection and discuss the patient’s treatment needs during the initial consultation.