Dental surgery

Dental surgery is a field of medicine dealing with surgical treatment of the oral cavity and maxillofacial region.

Patients most often associate it with tooth extraction, but thanks to current developments in medicine and the use of modern technologies and materials, we are able to keep the number of extractions to a minimum.

Our first priority is to protect our patients’ natural teeth.

Surgical procedures require exceptional precision and early accurate diagnosis. An integral tool in planning and preparing a treatment plan at an early stage is tomographic examination.

At the ARTIMEDICA clinic, we use CBCT 3D cone beam computed tomography for this purpose. At present, this is the most accurate method of non-invasive diagnosis. It allows us to create a realistic three-dimensional image of the internal tissues of the examined area.

The procedures are performed under local anaesthesia. To improve their effectiveness and patient comfort, we use a specialised computerised anaesthetic delivery system called SleeperOne and/or inhalation sedation with nitrous oxide.

Implantation is a surgical procedure involving the placement of an implant in the bone. It is the second part of implant-prosthetic treatment, after diagnosis, and precedes prosthetic restoration on implants.

Fig. Implantation procedure

In the first phase of the implantation procedure, an incision is made in the gum and the bone is exposed. In the next phase, the surgeon makes a hole in the jawbone and places the implant in it. The procedure is usually performed under local anaesthesia and lasts from 30 to 120 minutes, depending on the number of implants and additional procedures.

Chirurgia plastyczna dziąseł to:

• likwidacja uśmiechu dziąsłowego – tzw. gummy smile,
• wydłużenie klinicznej korony zęba,
• pokrycie recesji dziąsłowych,
• podcięcie wędzidełka wargi górnej i języka – frenulektomia,
• gingiwoplastyka,
• plastyka dziąsła i wyrostka kostnego,
• zabiegi regeneracyjne z użyciem biomateriałów kościotwórczych,
• poszerzenie strefy dziąsła rogowaciejącego,
• plastyka lub pogłębienie przedsionka jamy ustnej,
• inne.

Indications for tooth extraction include:

• complete destruction of the tooth by caries and the inability to treat it,
• serious mechanical injury (vertical fracture) and the impossibility of conservative or prosthetic treatment,
• prosthetic or orthodontic indications.

Extractions of impacted teeth  concern teeth that have already reached their full development but are not completely erupted. They may be completely or partially invisible in the oral cavity. Most often these are wisdom teeth (eights), upper canines, supernumerary and additional teeth. It is not always necessary to remove them.

Impacted teeth are eligible for extraction, i.e. removal, when:

• inflammation occurs in the tissues surrounding the tooth,
• they cause ongoing inflammation in adjacent teeth,
• they hinder the proper growth of teeth (supernumerary and additional teeth),
• cause pain due to pressure on neighbouring teeth, for example,
• there are prosthetic or orthodontic indications.

In the case of multi-rooted teeth, there is a chance to preserve the part of the tooth that has not been affected by inflammation.

• Hemisection – a procedure involving the removal of the root affected by inflammation along with part of the tooth crown; the remaining half of the tooth is secured with a prosthetic restoration. Hemisection can only be performed if the endodontic treatment has been successful and the tissues surrounding the remaining part of the tooth are healthy.
• Radectomy – a procedure involving the removal of only the root affected by the inflammatory process.

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Root tip resection involves removing the tip of the tooth root along with any inflammatory lesions. The root is secured and the bone defect (if necessary) is filled with bone substitute biomaterial. Thanks to advances in endodontic treatment, this procedure is performed relatively rarely, in cases of:

• anatomical reasons preventing proper root canal treatment,
• when repeat treatment (reendo) does not bring the desired results,
• presence of periapical lesions, when repeat endodontic treatment is not possible (prosthetic work has been performed on the tooth and a crown-root inlay has been placed in the canal),
• when a root cyst with a diameter greater than 8-10 mm has formed.