What is Oral Surgery?
According to the Portuguese Dental Association, Oral Surgery is the area of Dentistry dedicated to the diagnosis and surgical treatment of diseases, injuries and anomalies of the teeth, mouth, jaws and attached structures.
This field covers various procedures, such as:
- Extraction of teeth for which there is no treatment option;
- Extraction of root remnants (dental roots);
- Partially included and unincluded teeth;
- Endodontic surgery, indicated when conventional endodontic treatment is not enough;
- Surgery of cystic or tumor pathology;
- Periodontal surgery;
- Oral Implantology;
- Pre-prosthetic surgery, which consists of preparing the jaws to produce a prosthesis;
- Surgery of infectious lesions;
- Oral Traumatology.
At the service of oral health and dental aesthetics
The goal of Oral Surgery is the treatment of oral diseases, but it can also serve the purpose of dental aesthetics. The following are examples of both cases.
Oral Health Treatments
- Elimination of infectious foci by draining abscesses;
- Extraction of teeth that cannot be restored or rehabilitated;
- Extraction of wisdom teeth or unerupted teeth;
- Exposure of impacted teeth for orthodontic traction;
- Removal of lesions from the oral cavity (cysts) and biopsy of potentially malignant lesions (oral cancer), for anatomopathological examination;
- Regeneration or grafting of hard (bone) or soft (gum) tissues;
- Placement of dental implants in edentulous spaces (without teeth), in order to replace lost teeth.
Aesthetic Dental Treatments
- Soft tissue (gingiva) grafting for aesthetic smile harmonization and treatment of gingival recession;
- Gingivectomy (removal of excess gum) or coronal lengthening (removal of excess gum and bone) to improve aesthetic patterns and harmonize the gingival level in the smile;
- Removal of aesthetically unpleasing gingival lesions.
Is Oral Surgery painful?
In the last decades, dentistry has evolved so much that, nowadays, the discomfort associated with treatments is less and less.
The application of an adequate anesthetic technique, an atraumatic surgical technique (without trauma) and the adoption of an effective postoperative therapy will allow for a high level of comfort during and after the surgical act.
Therefore, thanks to anesthesia, Oral Surgery treatments are painless. In the post-operative period, the medication will help to alleviate any pain or discomfort symptoms.
The extraction (removal) of dental parts is the most common act in the field of oral surgery.
This procedure can be simpler or more complex, but is always performed under local anesthesia. In the simplest cases, the extraction is performed without having to wear away the alveolar supporting bone. In more complex cases, surgical acts such as osteotomy (wear of the bone) or odontosection (division of the roots to make extraction possible) may be necessary.
But, regardless of the complexity of the case, Dentists always try to cause as little trauma as possible, so that the post-operative period is less painful and with fewer symptoms.
How are dental implants placed?
The placement of dental implants offers a fixed rehabilitation of areas where one or more pieces of tooth have been lost. It allows the restitution of basic functions such as chewing and contributes to the balance of all the muscles and attached structures of the oral cavity.
In planning the surgical procedure, it is essential that the dental implant is prothetically guided. In this way, its final position will be ideal and in accordance with the bone anatomy and availability, but also in accordance with the rehabilitation that takes place afterwards. In other words, the dental implants are placed in the most favorable area for your rehabilitation.
To make all this possible, there are currently tools that help planning and allow for less invasive and better post-operative surgeries, such as surgical guides for more precise placement of dental implants.
Immediate loading protocol
Total Fixed Prosthesis is the procedure indicated in cases of total edentulousness or in cases in which the remaining dental pieces are reduced in number, with periodontal compromise and where the success of long-term rehabilitation is doubtful.
This procedure, performed under local anesthesia and the possibility of sedation, includes the extraction of all remaining dental pieces and immediate placement of dental implants for total rehabilitation.
In these cases, a temporary prosthesis is attached to the dental implants immediately after the surgery, and remains in place during the healing period – approximately 6 months. During this period, the soft tissues will adapt to the new condition and the dental implants will osseointegrate. That is, they will create a direct connection with the bone, as if it were a single structure. After this period, the definitive fixed prosthesis is placed.
The step by step of Oral Surgery treatments
Performed by demanding doctors, with the support of advanced technology and superior materials, Oral Surgeries are performed with comfort and safety.
This way, even the most complex surgical procedures become simpler, faster, more effective, and with a more comfortable and painless post-operative period for the patient.
In the first phase, the patient’s clinical history is analyzed, through clinical observation, photographic records, radiographs (orthopantomography, periapical radiography, and CBCT), photographs, and intraoral scan (which allows a three-dimensional visualization of the oral cavity).
With the help of these elements, the treatment plan is drawn up.
- Pre-surgical preparation
Explanation of the entire surgical process, post-surgical and medication recommendations.
The surgery is performed under local anesthesia and, if necessary, supplemented with anxiety control techniques or conscious sedation with nitrous oxide.
In this phase, minimally invasive techniques are used, using technologies such as laser, causing as little damage as possible to all the attached structures.
Patient follow-up is essential. This can be done by phone, through digital means, or in person at follow-up appointments. The goal is always to ensure as comfortable and safe a recovery period as possible.
Postoperative indications cut across most surgical acts. Thus, there are some key recommendations for minimizing post-surgical symptoms and a more comfortable post-operative period, such as:
- Ice plays a primary role in the first 24 to 48 hours. Besides the analgesic effect, it prevents edema (swelling);
- Avoid sun exposure and physical exertion until the day of suture (stitch) removal;
- Sleep with your head slightly elevated;
- For the first 24 to 48 hours, the diet should be liquid and cold. For example, liquid yogurt, seedless smoothie, gelatin, soup passed, milk, etc.. The aim is to create the best possible conditions for the formation of the blood clot that represents the first phase of healing;
- Vigorous mouthrinses and sucking movements, such as drinking through straws, should not be performed, so as not to disturb clot formation;
- The operative wound area should be disinfected daily by placing chlorohexidine gel;
- Maintain effective oral hygiene, and the surgical area should only be brushed after the first 24 hours and very carefully, using a surgical brush (very soft);
- Avoid smoking, especially in the first 24 to 48 hours;
- Medication includes painkillers and anti-inflammatories, and in situations of infection, in complex cases or for patients at risk, it also includes antibiotics.