Surgical intervention

Surgical intervention

Tooth extraction or removal of residual tooth root

Each dental extraction is a minor surgical intervention, so it is important for the patient to answer honestly each question related to his/her general health status (hematologic diseases – leukaemia, agranulocytosis, myocardial infarction, haemophilia, anaemia, diabetes, drug allergy, pregnancy etc.). These can be some contraindications to tooth extraction.

Indications for tooth extraction:

  • Teeth/dental roots can represent dental foci
  • Because of the large caries it is not possible to save it through a conservative dental treatment
  • In the case of the intense mobility of the tooth that cannot be saved through a periodontologic treatment
  • In the case of very inclined and impacted teeth and in those cases when we need more space for orthodontic treatments
  • When the perfect treatment of the dental root is not possible in the case of inflammation (anatomical reasons – very curved root, traumas etc.)
  • In the case of primary teeth when they stay too long in the mouth of the child and so they hinder the eruption of the definitive teeth

Shortly about the intervention:

The intervention takes places with local anesthetization. After this (approximately 3-8 minutes) we separate the gingiva of the tooth and we remove the tooth using a forceps. After the removal of the tooth we check the open and closed status of the maxillary sinus and we put a piece of sterilized gauze in the patient’s mouth, he/she has to bite on it for several times in order to stop bleeding. It sometimes happens that there is more blood, in this case we stitch the gingiva together.

Care after the treatment:

  • We tell the patient not to bite until he/she still feels the effects of the anesthetic in order not to hurt soft tissues
  • In the case of the extraction of an upper tooth you should avoid nose-blowing for a few days
  • In order to avoid subsequent bleedings on the day of the extraction do not rinse your mouth and do not suck the wound
  • From the day of extraction on clean profoundly the place of the removed tooth as well, with care, this helps the wound heal faster
  • After the intervention your face can swell, in order to reduce it use some ice
  • Take some painkillers if you really need them
  • Avoid the consumption of dairy products and alcoholic drinks
  • Avoid physical work

Surgical removal of impacted teeth and their exploration for orthodontic treatments

During orthodontic treatments we often explore some permanent teeth that could not erupt and remained stuck in the bone. In these cases we need to surgically explore them and – according to the orthodontic treatment – to remove them or to pull them into the dental arch. During this intervention we remove the bone-tissue surrounding the crown of the tooth and the orthodontist fixes a gold chain to the dental crown which remains visible after the closure of the wound, it will be fixed to the orthodontic arch and slowly will be pulled into the right position.

Apical resection with retrograde obturation

It sometimes happens that even in the case of a root canal obturation that – according to the radiogram – seems to be perfect the patient complains about permanent pain, periapical inflammation and swell. The reason for this can be a root canal obturation as well with inadequate closure. In all possible cases we repeat the root canal treatment, but there are some cases when this is not possible (anatomical reasons – „S” or „C” curvatures of the root) or would not be practical (the endodontically treated tooth is part of a well-functioning and expensive prosthesis). In these cases we need to surgically remove the root apex.

Shortly about the intervention:

The intervention takes places with local anesthetization. After the gingivectomy we prepare a window in the bone according to the root apex of the tooth and through this window we remove the root apex together with the infected tissue that surrounds it. If after the preparation the root canal obturation seems to be stable and adequate, there is no need for a retrograde filling, but this situation is very rare. In these cases we create a smaller cavity and we fill the canal using a filling material that induces the regeneration of the root cement (MTA – Mineral Trioxide Aggregate). After this we stitch the wound together. The stitches can be removed after 7 days.

Care after the treatment:

  • We prescribe painkillers in order to ease the pain
  • We tell the patient not to bite or chew until he/she still feels the effects of the anesthetic in order not to hurt soft tissues
  • The postoperative facial swelling reduces after 2-3 days, we recommend to use some ice