DENTAL OPERATIONS

Dental surgery involves surgical procedures in the oral cavity. These are therefore operations concerning the teeth, jaws and soft tissues of the oral cavity.

Surgical periodontal therapy

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The aim of surgical periodontal treatment is to improve the long-term prognosis of the teeth. In addition, it attempts to reduce the depth of gingival pockets and thereby create the conditions for better oral hygiene.
Anti-infective treatment is always first choice but, if this proves unsuccessful, persistent probing depths are an indication for a subsequent surgical approach.
The primary aim of surgical periodontal therapy is to improve the prognosis of the teeth by reducing the pocket depths and facilitating oral hygiene at home.

Surgery to the labial frenulum

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The labial frenula are thin folds of connective tissue covered with oral mucosa which protrude into the oral cavity. If the labial frenulum is too well-developed, it can drive apart the central incisors and lead to a gap between the teeth (diastema). In an edentulous jaw, the labial frenulum can adversely affect the denture fit. Surgical reduction of an excessively large labial frenulum is known as excision of the frenulum or frenulectomy.

This is a minor operation performed under local anesthesia but it should not be done in children until the permanent anterior teeth have erupted.

Mucosal grafting

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In periodontitis, for instance, there is a risk that the mucous membranes will recede and scarring of the mucosa will occur. After the periodontitis has successfully been controlled, an attempt is made to remove the resulting lesion. For this purpose, the dentist takes mucosa from the palatal region and sews it in place in the enlarged, newly created wound area. The resulting wound in the palate is covered with a plate, then heals without any irritation.

Surgical extraction of wisdom teeth

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Surgical removal of wisdom teeth is a procedure performed by oral surgeons. The operation usually takes place under local anesthesia.
General anesthesia may be considered, however, if the extraction is expected to be particularly difficult or if a painless procedure cannot be guaranteed by nerve block or local anesthesia.
Frequently the tooth is anchored very firmly in the jaw, access between the other molars and the angle of the jaw is too small or the tooth lies horizontally in the jaw. In such cases, surgical extraction of the tooth is required.

Apicectomy

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Resection of a root apex (apicectomy) is frequently the last chance of preserving a tooth. If possible, the operation should always be preceded by revision of root canal treatment.
After a gingival flap has been raised, the bone over the region of the root apex is removed and the pathological site is exposed to an appropriate extent. The inflamed or cystic tissue in the apical area is removed and the root apex is shortened and smoothed as much as necessary. The gingival flap is then sutured in place.