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ORAL SURGERY
Written by Administrator   
Wednesday, 07 July 2004 09:54

The removal of teeth / the extraction of teeth
In many cases, problems caused by neglected and decayed teeth can only be solved by the extraction of teeth. Infection from a necrosed tooth may spread on the root apex and the periapical bone causing an inflammation as a result of which the tissue surrounding the bone gets swollen, the tooth gets detached and may react painfully to touch. Inflammation around the teeth in the upper jaw can spread on the facial cavity causing sinusitis. If the inflammation is chronic and an abscess can be seen around the root apex in the X-ray, the only solution is the removal of the tooth.

Sometimes even the removal of a healthy tooth becomes necessary: 
. third molar 
. wedged in canine 
. irregular position of a tooth 
. very loose tooth 
. because of an orthodontic treatment

The removal of a tooth is always preceded by an examination and an X-ray. The dentist decides if the patient needs only a simple tooth removal or an operative intervention on the basis of the X-ray.

 

Simple removal of teeth, tooth extraction
The procedure is carried out under local anesthetic (2% Lidocain). After the dentist made sure the operational area is numb, he gently separates the gum from the tooth with a turret in order to prevent damages to the mucous membrane. Then, he removes the tooth by forceps. If the tooth is inflamed the removal of the inflamed tissue from the wound cavity is also necessary. 

Surgical removal of teeth, operative tooth extraction
An operative intervention must be carried out if the decay has damaged the dental neck or the crown, since in this case the forcesps would crack the tooth. Furthermore, such a procedure is inevitable for example if the tooth is multirooted or the apex is everted; in the case of a wedged in wisdom tooth; if the roots of the upper molars are too close to the facial cavity to avoid the risk of the fracture of the cavity structure. The procedure is carried out under local anesthetic (2% Lidocain). After separating the gum from the tooth by creating a flap, the bone around the root is removed by a chisel, then the tooth is extracted. The inflamed tissue is also removed from the wound cavity. The next step is to adjust the rough surface of the bone in the tooth socket by ribblers. Finally, the edges of the wound are joined and the operational area is closed by a suture.

Wisdom Teeth Removal
Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.
Wisdom teeth present potential problems when they are misaligned - they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through or erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed "impacted." Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

Root apex resection/ root resection
The inflammation of the area around the root apex generally results from pulpitis. The bacteria spreading from the pulp infects the alveolodental membrane and the bone surrounding it. It causes the inflammation of the root apex and the formation of an infection focus. In this case, the area around the root apex becomes sensitive to pressure. 
The procedure is carried out under local anesthetic (Lidocain injection). The first step is to make an incision around the tooth to gently remove the gum from the tooth, then a hole is drilled in the bone. The size of the hole depends on how extended the area affected by the infection is. Following this, 1/3 of the root apex together with the inflamed tissue is removed with the help of a drill. The root filling is then cemented. Finally, the sharp edges are adjusted and the gum is placed back before suturing the wound.

Last Updated ( Monday, 09 February 2009 04:25 )