Ack Smiles Logo M
   
 SERVICES  GALLERY  BLOG 973 921 0505

ORAL & MAXILLOFACIAL SURGERY

Apicoectomy

Going into the jawbone are roots that keep every tooth in your mouth bonded to your gum and in its place. The teeth located in the back of your mouth have multiple roots as compared to the teeth at the front of your mouth that have only one root each. The name given to the part where roots start entering the tooth is called the apex. They are busy in providing blood to the teeth in your mouth and what we see on the surface and call teeth are called crowns by dentists.

You must have heard the term root canal; it is the procedure that is meant to clean the infected tissues in the roots or remove them completely if required. Apicoectomy comes after the root canal treatment hasn't yielded any worthwhile results. In apicoectomy the dentist will get rid of the apex and might fill that portion with some filling in order to stop the infection from spreading. If this is not done, the roots are dangerous not only for their own tooth but other teeth in the mouth as well.

Reasons for an apicoectomy

If the area surrounding the tooth gets inflamed, the pain can be unbearable for the sufferer. If the case is taken to the dentist on time he will do his best to utilize the apicoectomy procedures to stop this infection and pain and still keep the tooth in working condition. It is only when the root canal treatment has gone ineffective the dentists go for apicoectomy.

Given below are the many reasons why a dentist would go for apicoectomy:

  • If the root canal procedure is not able to do its job of cleaning the complex network of roots present beneath the teeth, it becomes necessary to go for apicoectomy in order to stop the further damage from taking place.
  • Another reason why a dentist will go for apicoectomy is when a root canal procedure hasn't gone well and something has caused the roots to block.
  • The shape of the root canal also plays an important role in the health of your teeth and gums. If the root canal is not in a good shape, apicoectomy will be suggested and recommended.

What does getting an apicoectomy involve?

It starts with the panoramic x-ray to see what's causing the problem even after a root canal procedure has taken place. If possible, the dentist will try to solve the problem with some medication. Anesthesia will be used if it has become compulsory to go for apicoectomy.

The first thing that needs to be done is exposing the roots and this is done by cutting some part of the gum so the roots can be seen underneath it. When the infected root has been spotted, the dentist will use his special instruments to get rid of that infected root. After that, a special filling agent is used so the root is sealed and stitches will follow to put the slit gum back into its original position.

You don't necessarily have to stay in a hospital before this type of surgery. The dentist will inform you of any precautionary measures and care that needs to be taken. Stitches are often removed after a few weeks but the complete healing process will require months.

If you have already had a root canal but you are still experiencing the same problems with your gums and teeth as you were before the treatment, let us know and we'll instantly find a solution for your problem.

Bone Grafting

Bone grafting has a close relation with procedures that are required for dental restoration. Dental implants and other types of dentures are good examples of procedures that are closely tied with bone grafting. When a denture is necessary for a patient the dentist has to make sure that the jawbone is strong enough to provide the support required for bridge or denture to stay in its place. If, however, the jawbone is not in a position to support the denture or implant, the bone grafting comes into play at this point.

Other reasons for jawbone to recede are given below:

  • Periodontal diseases are major causes for the jawbone to recede from its normal position. It is a progressive condition where the infection doesn't stop and keeps spreading in rest of the teeth as well.
  • Researches have revealed that 40% to 60% of the patients who had their teeth extracted have shown clear signs of recession in the jawbone. This type of bone loss has been given the name of bone defect by dentists.
  • There are many other reasons for jawbone to recede and injuries caused by blows on the mouth or other reasons can result in the recession of jawbone.

Reasons for bone grafts

The success rate of bone grafting makes it a highly recommended procedure for dental care. It can give people with missing teeth or other teeth abnormalities a good replacement of various other forms of treatments. By enhancing the features of jawbone, bone grafting can cure many dental diseases including the filling of voids or crevices.

The effects of bone grafting on the enhancement of jawbone can be viewed in two major categories and forms:

Jaw Stabilization - The process makes the jawbone and its foundations strong enough to support dental implants. If the structure of the jawbone is deformed, bone grafting takes care of that too.

Preservation - Many dental procedures result in receding jawbone and tooth extraction is extremely notorious for this incident. Bone grafting can halt and slow down this process as well.

Oral Examination

A complete and detailed examination of the oral cavity is conducted before bone grafting can be suggested to the patient. This is to make sure that in case of any periodontal disease's presence, these issues can be taken care of before bone grafting. A panoramic x-ray is best suited to assess the condition of a patient's jawbone and complete oral cavity. After the x-rays have been taken the dentist will manually check the area to figure out the amount of bone that needs grafting.

What Does Bone Grafting Involve?

Different types and kinds of bone grafting procedures can be taken up by the dentists it depends on the dentist you go to as to what procedure he will select for you.

Autogenous Bone Graft - In this procedure the required bone will be taken from posteriors of the same patient's oral cavity and this is the most predictable and successful way of bone grafting.

Allograft Bone Graft - In this process the synthetic bone plays its role instead of natural bone of the patient.

Xenograft - This type of grafting will make use of the cow bone for a successful treatment.
The bone grafting process is not an instant process and it usually takes longer - up to months in order to complete.

On most occasions and as mentioned earlier, the bone will usually be taken from your own oral cavity but if that's not the case, a bone bank will be approached. Once the grafted bone has been anchored into the affected area the cells will start to bond together through natural process and finally become normal as your normal bone used to be before it was affected.

The surgery takes place under the influence of local anesthesia and the area where the bone is grafted is cut first. Synthetic membranes can also be used at times. The purpose of synthetic membrane is to stop any attacks from bacteria while the new bone is growing. Even though it is a complete surgery, you will not need to stay for a night in the clinic or hospital. If any medications are necessary, your dentist will help you with them.

Call us to know more about bone grafting or if you think you might need one.

Dental Implants

Dental implants have proved over the years how they are the best for people who want their missing teeth to be back and also want a solution that is more reliable than dentures and removable partial dentures. Dental implants are stable, durable and their longevity is unmatched.

Artificially a root is created before implanting a tooth in your mouth and this root is most often made from titanium. The periodontist does this job because this procedure requires special expertise. Teeth that are closest to the natural ones in appearance are then implanted to give esthetic beauty as well as healthy teeth.

Lasting for years, these implants might require some checkups on the way and some cleaning so you can visit your dentist on your regular annual checkups and have them attended.

Reasons for dental implants:

  • Filling in the gaps created by missing teeth
  • Stabilizing the teeth and giving them a strong bite force
  • Creating an esthetically beautiful smile
  • Returning normal speech to the patient
  • Restoration of facial and oral tissues

What does getting dental implants involve?

Quite a few visits must be paid to the dentist for a complete dental implant procedure.

X-rays are important before getting the dental implants because x-rays provide a better view of the conditions inside the mouth as to whether they are suitable for implants or not. The implant goes inside the bone and this requires healing that could take around 6 months. Furthermore, a post is required for keeping the tooth bonded to the structure. At times the post comes with another additional part called the anchor so you don't have to visit the doctor multiple times to get anchor and post in place.

Molds that have already been taken now help the dentist to place the right sized and shaped artificial teeth to be placed on the root. Here, the time and visits to your dentist depend on the number of teeth you need to get fixed. Once the healing process has completed your teeth have bonded to the structure strongly and you can feel their strength by biting on your food.

Whatever care you need to pay to your dental implants will be told by your dentist during the procedure and when the treatment has completed.

And if you still have any questions regarding the process and treatment, you can always contact us on our phone lines.

Impacted Canines

There are in total 4 canines in a human's teeth called the maxillary (the upper ones) and the mandibular (the lower ones). You would also see the name cuspids being used for them and from the movies comes another famous name, fangs. Their roots are relatively thicker then the teeth surrounding them and they are held firmly to the gums. Since they have roots longer than any other teeth in the mouth, you would often notice that these are the last teeth to develop in human children.

When a canine tooth is not able to perform its function properly or the development phase is blocked for some reason, you name this condition the impacted canines. Even though this condition is pretty common in wisdom teeth but the canine teeth are no exceptions to this condition as well. Wisdom teeth due to their lack of functioning and purpose in mouth are often chosen to be removed by many patients. That's not the case with canines so when this condition takes place with canine teeth, the issue must be addressed.

Closing Gaps - They stand at the end of front teeth and their job is to close the gaps that might arise if they are not present on closing the mouth.

Canines are a bit pointy and thus come into play when you bite on your food. They are the first ones to come into contact and thus they decide how your mouth closes.

Alignment of your jaw is extremely important if you want to look beautiful while smiling and for other health related purposes as well. However, if your canines are not aligned properly, they will affect the rest of the teeth in the mouth as well.

What causes canine teeth to become impacted?

There could be many reasons for this particular condition:

Extra Teeth - Some people grow extra teeth in their mouth and thus the canines don't get space to erupt. In short, where the canine was supposed to erupt, there is already a tooth resting and it is not giving space to the canine to come out of the gum.

Overcrowding - Canines, as mentioned earlier, are the last ones to develop so if there is already a crowd of other teeth in the mouth, these teeth will not give space to canines to erupt.

Unusual Growths - Unusual growths can be seen on gums that make the gum so big that the canines are not able to erupt and come out of the gum.

To forestall the problems of canine teeth, it is recommended that thorough examinations of the teeth are carefully conducted twice a year. The dentist will write down the number of teeth in the patient's mouth and keep a track of that number in the following checkups. This counting of number of teeth is extremely important for children. In the childhood the dentist can still expect the canine to come out itself but if it doesn't, necessary measures must be taken because in older patients the eruption of canines will be highly unlikely.

Oral Examination

A panorama x-ray can be taken by the dentist to view the number of teeth in the mouth and their respective locations. The dentist will take these x-rays and try to find out the reason for impaction and once the problem has been figured out, a treatment will be suggested. The main purpose of any treatment will be to create the conditions that are suitable for canine teeth to come out. Your local dentist or the oral surgeon should be able to do this job.

What does the treatment of impacted canines involve?

When the reason for non-eruption of canine teeth is overcrowded frontal teeth region, extraction of teeth is what's highly recommended by the dentists. Using the local anesthesia the surgeon will remove some of the teeth that are stopping the eruption of canine and with the help of brackets the canine will be guided to grow normally and in the right position.

When the problem has been detected in its early stages i.e. when the patient is still a child, all it needs is an orthodontic brace. Whatever instructions are involved in the procedure, surgery and post-surgery will be given to you by the dentist. It's not one of the serious cases so even if the surgery is required, you will not be asked to stay for a night.

Mini Dental Implants

Mini Dental Implants (MDIs) have changed the face of implant placement. Unlike full implant placement where multiple dental visits are required, MDIs eliminate the need for surgery. The development of long term MDIs now allows the dentist to place anchors in the jaw during one non-invasive treatment. The most common use for MDIs is the stabilization of dentures and overdentures. MDIs firmly anchor the dental prosthesis, which means there is no longer any need to suffer with ill-fitting, loose dentures.

MDIs are designed to eliminate bone grafting and expedite treatment. Full implants require significant bone grafting and a recovery period. The latent period allowed the anchor of the implant to properly embed itself into the jawbone. The smaller size of MDIs means that no recovery period is necessary, and the denture can be fitted the same day.

What is the configuration of mini dental implants?

An MDI is a tiny dental implant (similar to a screw) that is designed to act in place of a natural tooth root. MDIs are generally constructed from titanium and are either sprayed with calcium phosphate, or contain it along the length of the screw portion. The design and structure of MDIs promotes quick healing and long lasting results. The head portion of the implant looks very much like a ball. This ball fits firmly into the retaining mechanism and together these structures hold the dentures at a designated level. The dentures sit comfortably on the gum tissue and are able to withstand significant amounts of pressure and natural force.

What are the advantages of MDI placement?

MDIs are a true innovation for people who are reluctant to have invasive dental surgery and for denture wearers. One significant advantage MDIs have over full implants is that they offer a viable treatment choice for patients who have experienced extensive bone loss. Depending on the quality and density of jawbone available at the implant site, four of these mini implants may be implanted at one time. Unlike full implants, MDIs don't require invasive surgery, which makes MDIs a gentler option. MDIs also minimize cost. Full-sized implants can be expensive to place, especially if many visits are required. The most common use for MDIs is to stabilize a lower denture, however they can be placed anywhere in the mouth.

Here are some of the other advantages associated with MDIs:

  • Better smelling breath
  • Clearer speech
  • Easier chewing and biting
  • Easier cleaning
  • Firmer denture fit
  • High success rate. Less discomfort
  • No cutting or sutures
  • No need for adhesives or messy bonding agents
  • No rotting food beneath the denture
  • No slipping, wobbling or discomfort
  • Permanent results
  • Quick treatment time
  • Reduced costs

How are mini dental implants placed?

The whole mini dental implant placement procedure takes approximately one hour. Generally, in the case of lower jaw implants, four MDIs will be placed about 5mm apart. Prior to inserting MDIs, the dentist will use many diagnostic and planning tools to find the optimal place to implant them.

Here is a brief overview of the MDI placement procedure:

  • A mild anesthetic is administered
  • A small hole is drilled in the jawbone to situate each MDI
  • Each implant is screwed into place and tightened with a winged wrench
  • Finally, a ratchet wrench is used to fully stabilize the MDIs
  • The denture is measured against the mini implants and marks are made to indicate where the MDIs will fit
  • The denture is sent to the laboratory to have holes drilled to accommodate the MDIs

Once the denture has been fully modified, it can be affixed to the MDIs. The rubber O-ring on each MDI snaps into the designated spot on the denture, and the denture then rests snugly on the gum tissue. MDIs hold the denture comfortably in a tight-fitting way for a lifetime.

In almost all cases, no stitching is required and no real discomfort is felt after the procedure. After the denture placement procedure is complete, light eating can be resumed. The denture can be removed and cleaned at will. MDIs enhance the natural beauty of the smile and restore full functionality to the teeth.

If you have any questions or concerns about mini dental implants, please ask your dentist.

Sleep Apnea Appliances

Sleep apnea is the name of a condition that takes place when a person is sleeping and since it is fatal in nature, the patients must have it remedied as soon as they get to know about it. American men and women are suffering from this condition where 10% men and 6 % women aging 40 and above are the most common victims. What happens in this condition isn't known to most of the patients because it takes place during their sleep: they stop breathing and these repetitive stop-points in the breathing can happen several times in the same night.

Various devices have been devised to get rid of this problem where most of them use the mechanism of somehow separating the two jaws because this gives space to air to flow in the breathing system. There are various benefits of these devices including a more comfortable sleep, no snoring and a more relaxed next day. It is best that you lose weight before using these appliances since weight gain is another reason for this problem.

The devices used to cure the sleep apnea have been categorized on two major classes: the ones that can be adjusted and those that are fixed. Some devices that you will usually find and their descriptions are given below for you to see:

Thornton Adjustable Positioner

Also known as TAP 3, this is a small device and works best for most of the patients. This device has two major parts and the entire structure looks more like mouth-guard. When a person wears this unit the forward push to the jaw makes it easier for air to flow into the breathing system. There is another positioned that fixes on the lower jaw but this one is adjustable as opposed to the one for the upper jaw. Even though it pushes your jaw into a particular position, your lips will not stay separate while sleeping.

OASYS Appliance

OASYS is another great device and works on the jawbone and the tongue. The tongue is pushed to the front of the mouth and the adjustment made into the jawbone makes the air flow freely. One part of this appliance is working on your nasal cavity to keep its area big enough for air to pass freely. This is one of the friendliest device found for patients and since it is adjustable the patients love it even more.

KlearwayTM Appliance

Klaerway is directed towards lowering or completely eliminating the snoring and also help in remedying sleep apnea. The working of this device is also identical to other devices i.e. it is meant to push the jaw forward for free flow of air. Made from acrylic the device may soften if warm water is poured on it but since it is useful during sleep, the scenario involving warm water might not arise ever.

Herbst Telescopic Appliance

This device has been highly recommended for patients with moderate conditions of sleep apnea and is another device made from acrylic. There are wires and clasps on the device so it can fit in the mouth and these components make this device very stable and fixed in the mouth so you won't have to fear that it would dislodge easily. Snoring is also cured with the help of this device.

If you would like to know more about these devices or how they work, we are waiting for your calls and to help you with whatever inquiries you have.

Wisdom Teeth Extractions

The last four teeth, which are actually molars, located in the back of the teeth arrangement are called the wisdom teeth. They can continue to erupt even until the age of 25. Their location is quite close to the throat and they are located on both, upper and lower jaw. They are given the name of “wisdom teeth” because their eruption period is when a person is maturing and entering his/her adulthood

There are various occasions when the wisdom teeth do not come out of the mouth because they can't find the space to do so. This results in a very painful situation where the tooth somehow erupts but its position is very awkward in the mouth. This situation must be addressed because if it is not then it can cause infection in other teeth and even tumors and cysts of mouth.

A dentist will look at the teeth and categorize its impaction on a scale and thus there are degrees of impaction.

Soft Tissue Impaction: In this type of impaction the tooth has managed to come out of the bones but its impaction point is just where it has to erupt from the softer part of the gum. This makes the gum even softer and while chewing food the area can become damaged and swollen. This is a painful situation and must be addressed as soon as possible.

Partial Bony Impaction: Here the situation is a bit more difficult because the some part of the tooth is out of the gum but some of it is still stuck in the bone. To avoid infection, one must go to the dentist as soon as possible.

Complete Bony Impaction: This is even more complex because the tooth hasn't managed at all to come out of the bone. Extraction is difficult and needs more care than previous two scenarios.

Reasons to remove wisdom teeth

On most occasions the wisdom teeth are removed because they are causing pain and swelling in the mouth of the patient and if the issue is not addressed on time the situation can worsen to tumor in the mouth. Sometimes, more extractions might be needed simultaneously when the there are multiple molars or wisdom teeth that are facing impaction in the mouth.

Damage to nearby teeth: Tooth decay is very much possible when the impacted wisdom teeth are not given proper care.

The biggest impact is on the teeth that are adjacent to the wisdom teeth. Bone loss is also possible in many cases.

Disease: It is not a very common case but it isn't an exception too - cysts can be formed if the impaction is constantly hurting the bones and gums.

Infection: When you eat and chew your food, some particles are left stuck in the impacted wisdom teeth area. This results in infections that could be dangerous for your entire oral cavity.

Tooth Crowding: Again, it is not a very common case but it can happen as well: the wisdom tooth when impacted puts pressure on other teeth. This constant pressure disturbs their position in the arrangement and they can become twisted as a result.

Wisdom teeth examination

Digital and panoramic x-rays are most important in examining the wisdom teeth and their conditions. A thorough examination is needed because any problems with the wisdom teeth are extremely painful. The examinations are not only meant to cure some problem but also to indicate if any problems might arise in near or far future. If the impaction has already taken place, the x-rays will reveal the effects of impaction on other teeth surrounding the wisdom teeth. It is highly recommended that you have examinations specifically of wisdom teeth in the teenage years. Whatever the degree of impaction is, the dentist will suggest the remedy and will go with either extraction or other methods.

What does the removal of wisdom teeth involve?

If you look around you will find out that this treatment is a very common one: many people have had their wisdom teeth removed in teen ages. Once again, local anesthesia is enough to start the treatment or in other cases intravenous sedation can also be used. It is an easier form of treatment so you don't have to make a stay for an entire night. If there are any instructions that must be given, your dentist is the best person to give them to you.