Oral and Maxillofacial Surgery
- Impacted Teeth
- Semi Impacted 20 Year Teeth
- Apical Resection
- Cyst Operations
- Preprosthetic Surgery
Causes of Extraction of Teeth
- Teeth that are too devastated to have fillings or dentures
- Acute or chronic inflamed teeth where root canal treatment cannot be performed
- Teeth with periodontal (gum) disease, in which the teeth have excessively lost their bone support
- Teeth that do not respond to apical resection (teeth with inflammation at the root tip by surgically cutting the root tip)
- Roots left in the mouth without any function
- Teeth that require extraction in orthodontic treatment (braces)
- Persistent primary teeth that do not fall out in the normal time when permanent teeth are present
- Supernumerary (extra) teeth
- Teeth associated with the sinus causing maxillary sinus infection
- Teeth that will cause focal infection (microorganisms causing infection in other organs and tissues from the infection focus, that is, through blood or lymph from the tooth)
What To Do After Tooth Extraction
- Bite the tampon for half an hour.
- After removing the tampon, you can take a suitable pain reliever, excluding aspirin and its derivatives.
- Do not consume very hot food or drink during the shooting day.
- Do not use cigarettes or alcohol during the shooting day.
- During the day of the shooting, do not rinse your mouth frequently and do not gargle.
- Do not brush the shooting area for 2 days.
- You do not need to use medication unless your doctor gives you a prescription.
- If you have pain for two days or more after the extraction, consult your doctor.
- Teeth that remain under the mucous membrane or bone, but not in the row of teeth, even though it is time to erupt, are called impacted teeth.
- Impacted teeth may tend to erupt in the following periods due to the pressure developed by the patient's use of prosthesis.
Why Do Teeth Remain Impacted?
- Local Causes
- Long-lasting inflammation thickens the mucous membrane on the tooth
- Pressure from neighboring teeth
- Very dense bone
- Abnormal positions
- Space in the jaw
- Presence of extra teeth or cystic formations around permanent teeth
- Infections in the jawbone
- Remaining milk teeth in the mouth longer than necessary
- Premature loss of milk teeth
- Local Causes
- Genetic causes
- Diseases that the mother had during pregnancy (such as scarlet fever, measles, chickenpox) and the drugs she used
- Cleft palate
- Wisdom teeth (third molar or wisdom tooth) are the teeth most frequently impacted because they are the last teeth to erupt in our mouth.
Radiographic evaluation is necessary to determine the shape of the impacted tooth, its proximity to the adjacent anatomical spaces, and whether there is a pathological condition around it. Periapical, occlusal and panoramic radiographs are used for radiographic evaluation.
What are the Conditions Requiring the Extraction of Impacted Teeth?
- Impacted teeth that damage neighboring teeth
- Impacted teeth that pose a risk of infection
- Teeth that interfere with orthodontic treatment
- Impacted teeth that cause or are in pathological formations such as cysts and tumors
- Impacted teeth forming a focal infection focus
- Impacted teeth causing pain of unknown origin (ear pain, jaw joint pain)
- Teeth that cause limitation of mouth opening
- Impacted teeth at the fracture line
What You Need to Do After the Surgery of Impacted Teeth
- Bite the tampon for half an hour.
- Apply cold externally to your operation area during the day of the operation.
- Do not consume hot food and drink during the day of the surgery.
- Do not smoke or use alcohol during the day of the operation.
- Do not take a hot shower and bath during the day of the operation.
- Do not rinse your mouth frequently during the day of the operation and do not gargle.
- Do not brush your surgery area for 1 week after the surgery or until your stitches are removed.
- Start using the drugs prescribed by your doctor after the surgery.
- In case of pain for two days or more following the operation, consult your doctor.
- Come to our clinic 1 week after the surgery to have your stitches removed.
Apical resection is the operation of surgically cutting the root tip of the teeth with inflammation at the root tip, removing the pathological formations in this region and at the same time cleaning and filling the root canal or canals from bacteria.
In Which Situations Is Apical Resection Surgery Performed?
- Incomplete root canal treatment due to excessive curvature, perforation (perforation) or calcification in the root canal
- In teeth where root canal cleaning and filling material application cannot be performed successfully in teeth whose root tip is not completely closed, that is, in teeth that cannot complete their development.
- In cases where root canal treatment cannot be performed when the root canal cannot be reached over the tooth (in the presence of crowns or bridge prostheses, that is, veneers)
- If the instrument is broken during root canal treatment, if the broken instrument must be removed, when it is necessary to remove the instrument
- In cases where cystic formations occur at the root end of the tooth
- Periapical radiography and clinical symptoms are the most realistic measures in the evaluation of healing after apical resection in cases where the 1/3 end of the tooth root is broken in the bone. Therefore, follow-up of patients is necessary.
A cyst is a walled pathological cavity that enlarges from the center to the periphery. The pressure created by the cysts while they are growing causes resorption in the roots of the neighboring teeth.
How Do Cysts Occur?
Cysts can develop from cell remnants that settle in the tissues during the embryological development process, or as a result of pathological changes in the root tip area as a result of irritation from the infected root canal, or as a result of this lesion remaining in the jawbone after the extraction of teeth with cystic lesions at the root tip.
Cyst Surgery The basic principle in cyst surgery is to remove the entire cyst together with its wall. Neighboring tooth roots that are not associated with the cyst lesion should be preserved and the teeth in the cyst should be kept in the mouth using the apical resection method. In some cyst types, a drain is placed inside the cyst in order to ensure that the teeth that are pushed by the pressure created by the cyst and that remain impacted will erupt (emerge). This drain is changed every week, reducing the pressure in the cyst, formation of new bone around the cyst and the eruption of the impacted teeth. Cyst treatment should not cause functional or aesthetic problems. Therefore, reconstruction of large cyst cavities with appropriate bone grafts (bone powder) and membranes (barrier) is required. Arrangement of jaw bones and soft tissues for prosthesis (Preprosthetic Surgical Procedures) These are surgical procedures performed to improve soft and hard tissues before prosthesis is made.
- Correction of indentations and protrusions on the jawbone (these cause continuous puncture wounds during the use of removable prostheses)
- Removal of torus (developmental bone growths, ie lobular bone protrusions) Frenectomy (removal of tongue and lip ties)
- Removal of formations (prosthesis margin tumor, irritation fibroma) that develop due to the irritation of the prosthesis edges to the mucosa.
- It involves the removal of mobile tissues (arrangement of mobile crests) on the jawbone with bone resorption as a result of unbalanced transmission of chewing pressures to the bone in patients who have been using the same prosthesis for many years with tooth loss at an early age.
The lip ligaments (frenum) attached to the top of the jawbone cause the margins of the prosthesis to be shorter than it should be in edentulous patients, which leads to a decrease in prosthesis retention. In dental patients, this lip tie (frenum) causes a gap (diastema) between two teeth. Tongue tie (frenum) may be short, restricting tongue movements and negatively affecting speech. For this reason, tongue and lip ties should be surgically removed when they cause functional and aesthetic problems.
It is the process of taking a piece from that area in order to examine the histopathological features of formations or lesions in the mouth and to make a diagnosis.
In which cases should a biopsy be taken?
- Lesions that persist for more than 3 weeks without any reason
- Inflammatory lesions persisting for 10-14 days or longer after removal of local irritation factors and after local treatment is applied
- Persistent hyperkeratotic (white colored) lesions in surface tissues
- Tumoral growths in tissue that can be seen or felt on palpation (palpation)
- Long-lasting and unknown inflammatory changes
- Lesions that prevent local functions (chewing, speaking, etc.)
- Bone lesions that cannot be diagnosed clinically and radiologically
- Lesions suspicious for malignancy