Surgical procedures such as wisdom tooth removal cyst enucleation and biopsies, bone manipulation and fractures of the oral cavity fall in its purview.
Why is it called a "Wisdom tooth"?
The most common oral surgical procedure is Wisdom Tooth Removal, also known as “Disimpaction”. It is called the wisdom tooth because it was believed that by the age of 18, one becomes wiser and that is when the tooth erupts.
Wisdom Tooth Removal
Also known as disimpaction.
What is the disimpaction of a wisdom tooth?
It is the surgical removal of the embedded or malposed wisdom tooth. The severity of it is in the position, the amount of bone coverage over it and the proximity to vital structures.
It is a high-skill job to remove the wisdom tooth with minimal trauma. The following diagram shows the various depth, location and angles.
The following signs indicate that you need to get it removed:
- Decaying and malposed wisdom teeth
- Pain across the jaw or radiating to the ear, neck, or head
- Causing cavities in the tooth ahead of it (the second molar).
- Pericoronitis: Recurrent inflammation of the gum flap over the malposed wisdom tooth.
- Swelling of the area around the tooth
- Difficulting in swallowing
- Cheek bite: Wisdom teeth grow towards the cheek, causing recurrent ulcers.
- Supra-erupting wisdom teeth that cause deflection of the biting pattern often go undiagnosed and can affect the entire set of teeth.
- Globally, it’s done as a preventive measure.
BIOPSY
Needle biopsy: It involves using a fine needle that is introduced into a swelling or hollowed area, and the contents are aspirated. The “aspirate” is sent to a laboratory to study the contents and determine the course of treatment.
Tissue biopsy: A small (2–3 mm) section of tissue is removed from the periphery of a lesion and sent to the lab for histopathologic examination—to study the cells under a microscope. This tells us about the changes in the tissue and the treatment to be given.
The procedure is usually done under a simple local anaesthetic, and a simple painkiller can be used post-surgery.
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Apicoectomy
What is it?
Apicoectomy is a surgical procedure in which a flap is reflected and the infection associated with a certain tooth is removed along the root tip. A bone substitute is placed. The flap is closed and stitched.
Who needs it?
- When a previous root canal treatment has gotten reinfected.
- When all atraumatic methods of removing the infection have been exhausted.
- When a cyst is formed due to a long-standing abscess.
Bone Augmentation
What is it?
Bone augmentation is the changing of the anatomy of the jaw bone by adding a bone graft (artificial bone) in certain areas that are deficient.
Who needs it?
- Insufficient bone for placement of implants.
- The sinus pneumatized, causing insufficient bone height.
- Insufficient facial bone in the esthetic zone.
- To restore facial contour when bone loss occurs due to lesions.
Gum Bulking
What is it?
Gum bulking is a surgical procedure in which the area with a deficiency in the gum contour is corrected by adding soft tissue or artificial bone underneath.
Who needs it?
- Insufficient bone in the area of interest
- Food getting stuck under or next to caps