Procedures such as apicectomy (surgical removal of inflammatory lesions or cysts located at the top of a tooth root), hemisection (removal of a single, diseased root of a molar or premolar tooth) - allow to save the tooth which would otherwise have to be extracted. The "classic" surgical procedures performed in clinics include, among others: extraction, surgical removal of detained teeth (especially the "wisdom teeth"), plasticity of connections between the oral cavity and the maxillary sinus, treatment of complicated abscesses.
In recent years, implantology constitutes a vast part of dental surgery - i.e. the replenishment of a missing tooth or teeth with an artificial material which, when implanted into the alveolar process, is the analogue of its own root on which the tooth is reconstructed. Until recently, implants were placed in the jawbone only in places which provided for sufficient dimensions and density of jawbone, which limited the indications for use thereof. Nowadays there are more and more plans to place implants where they are most desired from a prosthetic point of view. This has been made possible, among other things, by the development of the following techniques:
Guided bone regeneration - augmentationDuring the healing of the bone wound, the clot is partially replaced by connective tissue which then disappears. If the wound was covered with a material insulating (membrane) the connective tissue and epithelium from the clot, bone tissue would be formed. Guided bone regeneration is based on this assumption. In some cases there is a lack of sufficient and good quality bone tissue and in this case it is necessary to use natural or synthetic bone replacement materials.
Bone tissue regeneration is used not only during implantation but also in cases as follows:
- with extensive extractions;
- after the surgical removal of the retained teeth;
- after enucleation bone cysts;
- after apicectomy;
- in osteoplastic procedures, e.g. for alveolar elevation;
- sinus lift.
Contemporary surgery covers also procedures on soft tissues: corrections of the gum shape, overgrown frenulum and numerous procedures preparing and improving the effects of prosthetic and orthodontic treatment. All procedures are performed under local anaesthesia and, in the case of longer procedures, often under general anaesthesia. Nowadays, surgery is an interdisciplinary speciality and in most cases it cooperates with other dental specialties. Thanks to close cooperation between specialists, it gives much better results of final treatment and consequently brings satisfaction.
Surgical procedures associated with treatment in other areas of dentistry as follows:
- Removal of oral irritants, fibroma, epulis, papilloma and other inflammatory lesions on the mucous membrane, alveolar plasticity improving anatomical conditions for prosthetic restoration.
- The above-mentioned hemisection procedure saves the rest of the tooth which is often the only pillar of the permanent prosthetic restoration.
- Uncovering the retained teeth (usually wisdom teeth in the jaw) for further orthodontic treatment with fixed braces.
- Transplantation - a procedure which involves moving a tooth from one place of the dental arch to another. Eights can be transplanted to replace the lost "sixes". This type of treatment is also used in the case of malpositioned canine cutting.
- When the supporting tooth tissue has disappeared and the tooth ligament system and the surrounding bone are destroyed, procedures leading to the regeneration of bone tissue and periodontal tissues are performed.
- Thanks to the rapid development of endodontic treatment methods, the number of required root resections of teeth affected by inflammation has significantly decreased, but in some cases it is still the only treatment method.
In periodontal diseases the following treatments are invaluable:
- Closed Root Planning (also known as curretage) - consists of deep cleaning of dental roots using surgical methods (separating the gums and cleaning which gives therapeutic effects)
- Open Root Planning - consists in surgical unveiling of gums and thorough cleaning of teeth roots. The procedure is completed by stitching the gums, so they heal easily. This type of curretage eliminates perfectly gum inflammation and leads to the inhibition of periodontal disease.