Reconstructive Dental Surgery
September 30th, 2009
The mouth is a sensitive area. As a result of poor hygiene, external physical trauma or even genetics, it can give rise to varying degrees of pain and can even be a source of poor self-image. Missing teeth, too much space between teeth (diastema), overcrowding of teeth, temporomandibular joint disorders, jaw injuries, deteriorated gums, mismatch between the upper teeth and the lower teeth are some of the problems that can arise. Reconstructive dental surgery is often required to correct these anomalies.
Reconstructive dentistry is the practice of reconstructing a person’s teeth, gums or jaws (or combinations of these). It is much more extensive than cosmetic dentistry and is usually performed under conscious sedation. The difference between cosmetic dentistry is that, if the dental procedures are not carried out, then the condition would impair the normal functioning of the mouth. Most insurance companies would cover reconstructive dentistry but not cosmetic dentistry.
Dental surgery is of four types: endodontic, prosthodontic, orthodontic and periodontic. Endodontic involves the pulp or the root of the tooth. Root canals form part of this type of intervention which also includes apicoectomy (a root-end resection). Root canals can be painful both during and after the intervention. Use of anesthetics reduces pain during the procedure but sensation is not completely lost.
Prosthodontics or dental prosthetics involve the fitting of crowns, bridges, implants and dentures. Crowns or caps are artificial coverings of the tooth usually made of ceramic, gold or a tin/aluminum mixture. Bridges is an artificial support structure designed to hold a false tooth. It is generally done to replace missing teeth.
Dental implant surgery or implants are also used to fix artificial teeth but the process is slightly different. A titanium implant is placed in the jawbone and allowed to heal. The artificial tooth is then attached to it at a later stage. Dentures, also called false teeth, replace the whole or part of the dentition through attachments to neighboring teeth. Orthodontic surgery involves the jawbones. Thus implants also form part of orthodontic treatment.
Extractions (removal of diseased teeth by pulling out or cutting out), and removal of wisdom teeth are also orthodontic treatments. These can be painful and can be performed under local or even general anesthesia. Periodontics refers to treatment of surrounding tissues such as the gums.
Gum grafting is a periodontic treatment. The purpose of gum grafting is to replace missing gingival tissues which has worn away from the necks of the teeth. Gum grafting halts recession of the gum. Recession of gums can also result in loss of bones as well, since the bones are found immediately below the gums. Thus bone grafting may also be carried out.
These cosmetic dental surgery procedures are typically done under anesthesia. Less serious periodontic treatments such as scaling and laser treatment of gums are not considered as reconstructive dental surgery.
In some grave cases of trauma such as serious accidents or severe genetic disorders, a full mouth reconstruction may be necessary. This is normally a series of dental plastic surgery procedures destined to restore the mouth’s original function as well as improve the aesthetics of the face. Such cases, however, cannot be considered as cosmetic dentistry.
Full mouth reconstruction usually involves numerous competencies around the same operation table. They are done under heavy sedation. A full mouth reconstruction takes numerous visits to the dentist and has a long treatment time (as much as 12 months).
New technology is improving the way dental surgery is being performed. In reconstructive implant surgery, traditional 2D radiographic images did not provide information on bone width, which often produced surprises during surgery (e.g. inadequate bone structures).
New 3D image slicing technologies have helped circumvent these problems. Tomography and CT-scans allow a detailed assessment in three dimensions, leading to a level of precision that was not possible just a few years ago. Dental surgical procedures are thus less invasive and can be done with much less discomfort and treatment time while producing better results.
Also modern surgery dentistry can be painful, the degree of pain is much less than what was being done a few years back. Dental professionals have gone a long way to improve the safety and reliability of the procedures they engage in. These are now established procedures than ensure the maintenance of our dental health.
Categories: Jaw and Bones, Teeth
Leave a Reply