EXTRACTIONS
Sometimes despite all best efforts to treat and preserve the teeth, they will require extractions.
In some cases, due to the complex anatomy and shape of the roots or even due to the particular type of tooth fracture, the extraction can no be done as a straightforward procedure, therefore a surgical approach will be required.
WISDOM TOOTH EXTRACTION
This is the most common situation when surgical protocol is used for extraction. This does refer to the wisdom teeth that are fully or partially impacted in the jaw bone.
The wisdom teeth grow at the back of your gums and are the last teeth to come through. Most people have four wisdom teeth, one in each corner.
Wisdom teeth usually grow through the gums during the late teens or early twenties. By this time, the other 28 adult teeth are usually in place, so there isn’t always enough room in the mouth for the wisdom teeth to grow properly.
Because of the lack of space, wisdom teeth can sometimes emerge at an angle or get stuck and only partially emerge. Wisdom teeth that grow through like this are known as impacted.
In this instance the the wisdom tooth can be removed completely or in cases of high risk of nerve injury only the crown of the wisdom tooth can be removed (coronectomy).
WHY DOES A WISDOM TOOTH NEED EXTRACTING?
The wisdom teeth require extraction in case of:
- tooth decay (dental caries)
- gum disease (also called gingivitis or periodontal disease)
- pericoronitis when plaque causes an infection of the soft tissue that surrounds the tooth
- cellulitis a bacterial infection in the cheek, tongue or throat
- abscess a collection of pus in your wisdom teeth or the surrounding tissue as a result of a bacterial infection
- cysts and benign growths very rarely, a wisdom tooth that hasn’t cut through the gum develops a cyst (a fluid-filled swelling)
CORONECTOMY
In some cases the entire extraction carries a high risk ,when the wisdom tooth roots are in close vicinity with the inferior alveolar nerve.
In case of nerve injury this can lead to temporary or permanent impairment as loss of sensation on the chin and lip.
Therefore, as to avoid possible nerve injury, a coronectomy will remove the crown of the wisdom tooth and leave the tooth’s roots in your jaw, intact.
A coronectomy isn’t recommended if the wisdom tooth or the root are infected.
APICECTOMY
An apicectomy also known as root surgery is the removal of the tip of the root of the tooth, known as the apex. This minor surgical operation, usually carried out under a local anaesthetic, is performed if infection or cysts persist after root canal treatment or if your dentist is unable to seal the root tip with a normal root filling.
This allows for the removal of the root apex infection and preserving the tooth versus the extraction of the tooth.
Local anaesthesia is used to numb the area around the tooth. The gum tissue is then gently raised away from the tooth to allow access to the infection and this area is thoroughly cleaned out.
The tip of the tooth root is then removed and special cement placed over the new end of the root. This sets very hard and seals off the root canal which could lead to another infection. The gum tissue is then put back into place to allow for healing. Sutures (stitches) are used to hold the gum in place.
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