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ORAL SURGERY

Surgical wisdom tooth extraction

Surgical wisdom tooth extraction is a more complex procedure to remove a wisdom tooth that cannot be removed by the classic method due to its position, shape or condition of the surrounding bone. This procedure is usually performed when the wisdom teeth are impacted (stuck in the bone or in the gums) or when there is a risk of complications with a standard extraction.

FREQUENTLY ASKED QUESTIONS
When is wisdom tooth surgical extraction necessary?
  • Impacted wisdom teeth – Wisdom teeth that have not erupted or are partially erupted, often at an irregular angle.
  • Horizontally or obliquely placed teeth – If the wisdom tooth grows at an angle and presses on the adjacent tooth.
  • The tooth is surrounded by bone – When the wisdom tooth is completely or partially covered by bone and is not easily accessible.
  • Presence of a cyst or infection – If the wisdom tooth causes pain, swelling, inflammation of the gums or forms a cyst.
  • Weakened root structure – If the roots have an irregular shape and are difficult to remove by simple extraction.
What does the procedure look like?
  • Anesthesia – Local anesthesia is most often used, but in more complex cases, sedation or general anesthesia can be used.
  • Making an incision in the gums – The surgeon makes a small incision to gain access to the tooth and bone.
  • Bone removal (if needed) – Part of the bone may be removed to free the wisdom tooth.
  • Tooth Extraction – The tooth can be extracted in its entirety or first divided into smaller pieces for easier removal.
  • Suturing the wound – In most cases, the wound is sutured and a gauze pad is applied to control the bleeding.
Recovery and tips after extraction
  • The first 24-48 hours:
    • Ice packs reduce swelling.
    • Do not rinse your mouth aggressively for the first few hours to prevent blood clots from falling out (risk of dry alveolitis ).
    • Avoid hot food, dairy products and carbonated drinks.
    • Do not drink through a straw (because of the pressure that can dislodge the blood clot).

    The next few days:

    • Take prescribed analgesics and/or antibiotics if prescribed.
    • Soft food and plenty of fluids.
    • Maintain oral hygiene, but avoid direct washing of the extraction site for the first few days.
What are the possible complications?
  • Although surgical wisdom tooth extraction is a safe procedure, as with any surgical intervention, certain complications may occur:
    1. Infection- Can occur if bacteria get stuck in the wound.
      – Symptoms: Severe pain, swelling that does not go away, purulent discharge, high temperature.
      – How to prevent? Maintain hygiene according to the instructions, take antibiotics if the dentist prescribes them.
    2. Bleeding- May last for several hours after extraction.
      – If the bleeding does not stop after 24 hours, it is necessary to contact the dentist.
      – How to prevent? Avoid rinsing the mouth for the first few hours, do not drink through a straw and do not consume hot food/drinks.
    3. Dry socket – One of the most common complications – It happens when the blood clot that protects the wound falls out prematurely, thus exposing the bone and nerves.
      – Symptoms: Strong, throbbing pain that gets worse 3-5 days after the intervention, bad breath.
      – How to prevent? Do not rinse your mouth aggressively, do not drink through a straw, do not smoke and follow the dentist’s instructions.

    It is important to follow the dentist’s or surgeon’s instructions after the procedure and to attend regular check-ups. Our expert team is here to ensure that the intervention goes safely and fully resolves any potential complication.

APICOTOMY

Apicotomy is a surgical procedure that removes the top of the tooth root ( apex ) along with the infected tissue around it. This procedure is performed when classic endodontic therapy (root canal treatment) fails to eliminate the infection.

FREQUENTLY ASKED QUESTIONS
When is an apicotomy necessary?
  • When an infection or cyst develops at the apex of the root after treatment of the tooth.
  • If the infection persists despite properly performed root canal therapy.
  • When the tooth has a complex canal anatomy or a residual instrument in the canal.
  • If there is a chronic granuloma or cyst at the apex of the root.
  • When access to the root is difficult due to prosthetic work (crown, bridge) and repeated endodontic therapy is not possible.
What does the procedure look like?
  • Local anesthesia – The area around the tooth is anesthetized so that the intervention is painless.
  • Making an incision in the gums – The surgeon makes a small incision and lifts the tissue to access the apex of the root.
  • Removal of infection and root tip – The root tip is removed (about 2-3 mm) together with the infected tissue.
  • Canal Sealing – The root canal is filled with a biocompatible material (MTA or retrograde cement) to prevent reinfection.
  • Suturing the wound – The gums are put back in place and stitched up.
Recovery and possible complications
  • Swelling and mild pain are normal for the first few days – cold compresses and analgesics help.
  • Mild bleeding is possible, but should not last longer than 24 hours.
  • Avoid hard food and vigorous mouth rinsing for the first few days.
  • In rare cases, paresthesia (numbness) may occur if the nerves are close to the operated area.

BONE AUGMENTATION

Bone augmentation is a surgical procedure that restores or increases the volume of the jawbone. This procedure is crucial in patients who do not have enough bone for the installation of dental implants, either due to long-term missing teeth, periodontitis or natural bone resorption.

Benefits of bone augmentation
  • It enables the installation of implants even in complex cases.
  • It restores the functionality and aesthetics of the smile.
  • It prevents further bone resorption and deterioration of the facial structure.
FREQUENTLY ASKED QUESTIONS
When is bone augmentation needed?
  • Bone loss due to periodontal disease – Long-term gum inflammation can lead to bone recession.
  • A long period without teeth – When teeth are missing for a long time, the bone gradually decreases.
  • Anatomical defects or trauma – Injuries or the natural shape of the jaw sometimes do not provide enough support for implants.
What does the procedure look like?

The intervention is performed under local anesthesia, and depending on the situation, the following is used:

  • Artificial bone – A material that stimulates the growth of natural bone.
  • Autologous bone – The patient’s own bone tissue, usually taken from another region of the jaw.
  • Membranes for guided tissue regeneration – Help form new, healthy bone. After the procedure, it takes several months to regenerate, so that the bone becomes strong enough to safely place the implant.

SINUS LIFT

A sinus lift is a specific type of bone augmentation performed in the upper jaw, especially in the region of the lateral teeth, where the height of the jawbone is reduced due to the proximity of the maxillary sinus (sinus cavity).

The procedure is performed as follows:
  1. Sinus Access – The surgeon makes a small incision in the gums, exposes the bone and opens a window to the maxillary sinus.
  2. Sinus Membrane Lift – The Schneiderian membrane (the thin mucous membrane lining the sinus) is carefully lifted to make room for the bone graft (artificial bone).
  3. Adding bone material – The space under the membrane is filled with biocompatible material (artificial bone, autologous bone or a combination of the two).
  4. Closure of the incision – After the graft is placed, the area is closed with sutures, and the process of osseointegration begins.
FREQUENTLY ASKED QUESTIONS
How long after a sinus lift can I get an implant?

Bone maturation lasts from 4 to 9 months, depending on the size of the augmentation and individual healing of the patient. When the new bone is fully formed, a stable base is created for the installation of dental implants, even in cases where this would have been impossible before.

How should patients behave after a sinus lift intervention?
  1. Under no circumstances should you blow your nose or sneeze while holding your nose closed for the next 4 weeks, and longer if the surgeon deems it necessary.
  2. Sneezing with your mouth open.
  3. Anything that causes an increase in pressure in the nasal cavity must be avoided.
  4. Do not drink drinks through a straw and do not spit.
  5. Avoid diving and flying as they can increase intranasal pressure.
  6. Avoid bending over, lifting heavy objects, blowing up balloons, playing wind instruments, or any other activity that increases intranasal or intraoral pressure.
  7. If the patient is a smoker, it is mandatory to stop smoking at least 2 weeks after the operation. Smoking significantly increases the risk of bone graft rejection.
  8. Decongestants can be used, if the surgeon judges that there is a need.

JAW CYSTS REMOVAL

Surgical removal of jaw cysts is a procedure performed when cystic lesions — cavities filled with liquid or semi-solid contents — form in the jaw. Cysts are often caused by infections, trauma or unerupted teeth. If left untreated, they can weaken the surrounding bone and lead to more serious complications.

FREQUENTLY ASKED QUESTIONS
What is the recovery like after this intervention?

Slight swelling and discomfort are normal for the first few days, but most patients return to daily activities within a week. Complete bone healing may take several months, and in some cases augmentation may be required to replace the lost bone.

What does the procedure look like?
  • Diagnostics – First, a detailed dental examination is performed, with 3D image analysis (CBCT) to precisely determine the size and position of the cyst.
  • Anesthesia – The intervention is performed under local anesthesia, but in more complex cases it can also be done under general anesthesia.
  • Cystectomy or marsupialization :
    • Cystectomy – Complete removal of the cyst along with its capsule. This method is effective for small and medium cysts.
    • Marsupialization – If the cyst is large and at risk of weakening the jaw, a small opening is made to drain the contents of the cyst, and then the cyst is gradually reduced until it is safe to remove completely.
  • Suturing and Postoperative Care – After removal, sutures are placed to properly close the tissue, and the patient is given recovery instructions and antibiotics if needed.