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Oral and Maxillofacial Surgery

  • Impacted teeth
  • Semi-buried wisdom teeth
  • Apical Resection
  • Cyst Operations
  • Preprotetic Surgery
  • Phrenectomy
  • Biopsy

Reasons for tooth extractions

  • Teeth which are beyond filling or prosthesis
  • Acute or chronically inflamed teeth that are not suitable for root canal treatment
  • Teeth with periodontal disease (gum disease) where the teeth lose their bone support to an extreme extent
  • Teeth that do not respond to apical resection (teeth with an inflammation of the root tip, cutting the root end by surgery)
  • Roots trapped in the mouth without any function
  • Teeth that require extraction in orthodontic treatment (wire therapy)
  • Persistent primary teeth that have not been discarded in the normal time while permanent teeth are present
  • Supernumerary teeth
  • Teeth associated with sinuses causing maxillary sinus infection
  • Teeth that cause focal infection (causing microorganisms to infect other organs and tissues via blood or lymph nodes by infected teeth).

What To Do After Tooth Extraction

  • Bite the cotton wad for half an hour.
  • Following the removal of the tampon, you may receive a suitable analgesic medication, except aspirin and its derivatives.
  • Do not consume very hot food or drinks during the day of extraction.
  • Do not smoke or drink alcohol during the day of extraction.
  • Do not rinse and gargle frequently during the day of extraction.
  • Do not brush the extraction area for 2 days.
  • You do not need to use medication unless your doctor gives you a prescription.
  • Consult your doctor in case of pain for two or more days following the extraction.

Impacted Teeth

  • Teeth that do not take their place in the tooth array when their time comes but remain underneath the mucosa or bone are called impacted teeth.
  • Impacted teeth may erupt at a later date due to pressure generated by a prosthesis used by the patient.

Why Teeth Remain Impacted?

Local Reasons

  • Long-lasting inflammation thickens the mucosa on the tooth
  • Pressure of adjacent teeth
  • Very dense bone
  • Abnormal positions
  • Lack of space in the jaw
  • Excessive teeth or cystic formations around permanent teeth
  • Infections of the jaw bone
  • Primary teeth remain in the mouth longer than necessary
  • Premature loss of primary teeth

Local Reasons

  • Genetic reasons
  • Diseases of the mother during pregnancy (scarlet fever, measles, chicken pox, etc.) and drugs used
  • Anemia
  • Tuberculosis
  • Cleft palate
  • Wisdom teeth (third molars or wisdom teeth) are the most commonly impacted teeth in our mouths because they erupt the last.

Radiographic Evaluation
Radiographic evaluation is necessary to determine the shape of the impacted tooth, its proximity to adjacent anatomic cavities and whether there is a pathological condition around it. Periapical, occlusal and panoramic radiographs are used for radiographic evaluation.

What are the conditions that require the extraction of impacted teeth?

  • Impacted teeth damaging adjacent teeth
  • Impacted teeth posing an infection risk
  • Teeth preventing orthodontic treatment
  • Impacted teeth that cause or are involved in pathological formations such as cysts and tumors
  • Impacted teeth that form a focal infection focus
  • Impacted teeth causing idiopathical pain (ear ache, jaw joint pain)
  • Teeth that restrict the mouth from opening
  • Impacted teeth in a fault line

What You Need to Do After an Impacted Tooth Surgery

  • Bite the cotton wad for half an hour.
  • Apply an external cold application to the area of surgery throughout the day of the operation.
  • Do not consume hot food and drink during the day of surgery.
  • Do not smoke or drink alcohol during the day of surgery.
  • Do not take a hot shower or bath during the day of surgery.
  • Do not rinse and gargle frequently during the day of surgery.
  • Do not brush the surgery area for 1 week after surgery or until your sutures are removed.
  • Start using the medications prescribed by your dentist following surgery.
  • In case of pain for two days or more after surgery, consult your dentist.
  • Come to our clinic 1 week after the surgery day to have your sutures removed.

Apical Resection
Apical resection is the procedure of cutting the root end of the teeth with inflammation at the root end, removing the pathological formations in this area and at the same time eliminating the root canal or canals from bacteria and filling them.

When is Apical Resection Surgery applied?

  • Root canal treatment cannot be fully carried out because of excessive curvature of the root of the tooth, perforation or due to the presence of calcification within the root canal
  • Root canal cleaning and filling can not be successfully applied to the teeth because the root canal is not completely closed, in other words the teeth have not developed in full
  • In cases where root canal treatment cannot be carried out because the root canal cannot be accessed through the tooth (in the presence of crowns or bridge prostheses)
  • To remove an instrument if an instrument has broken during root canal treatment and the broken instrument must be removed
  • In cases where cystic formations occur at the root end of the tooth
  • In case 1/3 of the tip of the root is broken within the bone

The most realistic measures in the assessment of recovery after apical resection are periapical radiography and clinical symptoms. Therefore, follow-up of patients is necessary.

Cysts
A cyst is a pathological cavity surrounded by a wall that grows from the center to the periphery. The pressure created by cysts during growth causes resorption in the roots of adjacent teeth, loss of adjacent teeth may occur when cysts grow excessively.

How do Cysts Occur?
Cysts may develop from cell debris settled in tissues during embryological development, as well as pathological changes in the root tip area caused by irritation from the infected root canal, or as a result of the retention of a lesion within the jawbone after extraction of teeth with cystic lesions at the root tip.

Cyst Surgery
The basic principle of cyst surgery is to remove the entire cyst with its periphery. Adjacent tooth roots not associated with the cyst lesion should be preserved and apical resection of the teeth in the cyst should be maintained within the mouth. In some types of cysts, a drain is placed within a cyst in order to ensure that impacted teeth erupt with the pressure generated by the cyst. This resistance is changed every week to reduce the pressure inside the cyst and to ensure that new bone forms around the cyst and impacted teeth erupt. Treatment of cysts should not cause functional or aesthetic problems.

Therefore, reconstruction of large cyst cavities with appropriate bone grafts (bone dust) and membranes (barrier) is required.

(Preprotetic Surgical Procedures) are carried out to improve soft and hard tissues of the jaw bones before the prosthesis is prepared.

This enables the following;
• Correcting the indentations and protrusions on the jawbone (these can cause permanent impact wounds during the use of removable prostheses)
• Removal of the torus (developmental bone growth, ie lobular bone protrusions)
• Phrenectomy (removal of tongue and lip ligaments)
• Removal of formations (prosthetic edge tumors, irritation fibroma) caused by irritation of the mucosa by the edges of the prosthesis tip margins
• It involves the removal of moving tissues (regulation of mobile crest) on the jaw bone with bone resorption incurred as a result of the uneven transmission of mastication pressure on the bone of patients who have used the same prosthesis for many years together with early tooth loss.

Frenectomy
Lip ligaments (frenum) adhering to the top of the jawbone cause the prosthesis boundaries to be shorter than necessary and thus reduce prosthesis retention in patients without teeth. In patients with teeth, this lip ligament (frenum) leads to the formation of a gap between two teeth (diastema). The tongue ligament (frenum) may be short, restricting tongue movement and adversely affect speech. Therefore, tongue and lip ligaments should be removed surgically when they cause functional and aesthetic problems.

Biopsy
It is the process of taking samples from the relevant area in order to examine and diagnose histopathological features of formations or lesions incurring in the mouth.

Which cases justify a biopsy?
• Lesions lasting longer than 3 weeks without any cause
• Inflammatory lesions persisting for 10-14 days or longer after removing local irritation factors and after local treatment
• Stubborn hyperkeratotic (white) lesions in surface tissues
• Tumor growths in the tissue that are visible or felt by palpation
• Long-lasting inflammatory changes of unknown cause
• Lesions that interfere with local functions (chewing, speaking, etc.)
• Clinically and radiologically fully undiagnosed bone lesions
• Malignancy suspicious lesions