Procedures performed in Estetica - Dental surgery
Dental surgery In our clinic we perform a wide range of procedures within the scope of dental surgery. They fall into: endodontic treatment - i.e.apicetomies, radisectomies and hemisections. We perform these procedures when the tooth root canal cannot be treated endodontically. It can happen for various reasons, among others due to unusual anatomy, canal obliteration, more frequently however it is related to failed root canal treatment. Then it happens that we run into a very hard cement inside the narrow canals, sometimes even instruments which had broken there. We always try to apply conservative treatment, but when it turns out impossible - we can only perform surgery, which allows to save the tooth in the oral cavity. There are also situations where we notice radiographically a very big periapical lesion or even a radicular cyst. Such lesions usually require combined treatment both endodontic and surgical one.
Apicoectomy The tip of a tooth root is removed under local anaesthesia, the canal is filled backwards that is from the side of the removed fragment and the lesion is cleaned or the cyst is removed. After such procedure it is advisable to fill in the resulting bone cavity with a material stimulating the bone growth e.g. Bio-Oss. This material is in the form of a granulated product which is poured into the bone cavity and then it is covered with a soluble Bio-Gide membrane. Then we suture the tissues back in places. The sutures are removed after a week. Resection can be performed in every tooth which needs it, not only in labial teeth. In our clinic resections are performed also in the event of saving premolars and molars if necessary. In some cases when e.g. a canal is blocked or contains a broken tool on all its length other procedure is necessary.
Radisectomy Root amputation refers to the removal of one root in a multi-rooted tooth. Most frequently it concerns upper molars.
Hemisection This procedure involves removal of one-half of a tooth together with one root ? in oral cavity the remaining half will be restored by means of a crown. This tooth can also be a post of a crown.

Dental surgery also deals with "difficult" extractions especially with wisdom teeth extractions, unerupted teeth etc. It is worth remembering that if you need to have a tooth removed we should prevent a bone atrophy in this area. And also we should take into account the possibility of filling the dental alveolus after the extraction with a biomaterial or with an immediate implant.
Periodontal surgery Another domain of dental surgery is periodontal surgery. These are number of various procedures designed to treat periodontal diseases, colloquially called "periodontitis".

The fundamental procedure includes an open flap curettage. During the procedure after lifting the gums, the surgeon removes the inflammatory granulation which destroys the structures of periodontium from the bone and the inner surface of the gingiva mucosa, removes the subgingival calculus containing numerous bacteria and their toxins and the outer layer of root cementum which is also pathologically changed. This procedure usually eliminates the inflammatory condition for many years, leads to minimizing the pocket depth and to improving the periodontium state, however usually the teeth 'lengthen' and reveal roots. The teeth movement also is not always smaller. That is why except for open flap curettage we utilize materials stimulating the lost bone reconstruction and sometimes materials stimulating the regeneration of all components of periodontium. Bio-Oss solution, in a form specially prepared to dress the bone pockets, belongs to such materials together with an absorbable membrane which encourages protection against ?recession? of the gum and Emdogein - a gel containing proteins of enamel matrix - that stimulate gum tissue growth. Recent years research have shown that the best results are achieved in case of a simultaneous application of Bio-Oss and Emdogein.

One should also remember that other producers' biomaterials are also available. Usually they are more attractive in terms of price but our experience with these materials is shorter. The choice belongs also to the patient.
Pre-implantation surgery These are procedures improving the amount of bone in the area of a planned implantation. Unfortunately, dressing the dental alveolus after extraction with a biomaterial or with an immediate implant is an achievement of the recent years. It is still not very popular among patients in our country therefore there are often situations when in area of the previously extracted tooth there are no conditions to place an implant. There is not sufficient bone to anchor the implant. Then we can take into account only procedures reconstructing the bone, among others:
  • augmentation of the alveolar process
  • distraction of the alveolar process
  • elevation of the maxillary sinus floor
These are procedures which by the use of a special biomaterial and/or devices increase the amount of bone in the area of the planned implantation procedure. The very implantation procedure can be performed after about 6 months.