Oral Surgery Procedures
No one enjoys hearing they need to undergo oral surgery. However, these treatments are usually necessary to preserve the health of your teeth and gums. At Norwalk Oral and Maxillofacial Surgery, we are committed to providing top-tier, compassionate care to those in our community. Dr. Michael F. Trofa and Dr. Kevin S. McLaughlin have received advanced training in oral and maxillofacial surgery which allows them to complete most procedures at our Norwalk, CT, practice, from simple wisdom tooth extractions to complex oral surgeries such as dental implants.
Bruxism is the sliding of the teeth back and forth over each other (grinding) or clenching and unclenching of the teeth. It can occur during the day or night, during sleep or while awake, so patients may not even be unaware that they are doing it. Bruxism can be caused or intensified by stress and can lead to significant dental problems if not addressed. Bruxism causes additional wear on the tooth and root structures, as well as surrounding tissues, due to the abnormal, frequent pressure. Bruxism can lead to both periodontal disease and problems with the temporomandibular joint (TMJ), as well as sleep disorders and damage to the teeth themselves. A custom removable acrylic appliance can be made to help protect teeth against wear, breakage, and other effects of bruxism. These appliances are usually worn at night during sleep.
Signs and symptoms of bruxism include:
• Headache • Insomnia • Gum Recession • Periodontal Disease • TMJ Disorders • Wear to Teeth • Broken or Fractured Teeth
A frenectomy is a simple surgical procedure performed to release the connection of the “frenum,” a connective muscle between two tissues. There are two types of oral frenectomies that are frequently performed on both adults and children for a variety of reasons.
A Labial Frenectomy is performed on the tissue that connects the lip to the gums. This may be performed on children or adults to aid with orthodontic treatment or even help with the proper fitting for a denture or appliance.
A Lingual Frenectomy may also be referred to as the release of tongue-ties (ankyloglossia). This procedure is performed on the connective tissue under the tongue. The procedure is often performed on neonatal patients to assist with nursing or on toddlers or older patients who need the surgery to help correct speech issues caused by limited movement due the the frenum.
Facial trauma involves injuries to the bone, teeth, skin, gums or other soft tissues.
Depending on the type of facial trauma sustained there are many different treatment options available. However, the goal of treatment is to stop any bleeding from occurring, create a clear airway, repair any broken or fractured bone, and or suture any damaged soft tissue. Treatment is immediate, as long as there are no neck fractures or life-threatening injuries.
If gum recession is present and tooth roots are exposed, a gum graft may be recommended. This procedure is used to control and prevent further gum recession and subsequent damage to the surrounding teeth and bone structure. Often, a soft tissue graft also improves the appearance of a patient’s smile and sensitivity to heat and cold.
During a soft tissue graft, tissue is surgically placed to cover as much of the exposed root area as possible. Often, a tissue flap is created to allow the added tissue to be joined to the existing gums to facilitate tissue growth and healing. This procedure may be used to treat one or several adjacent teeth at the time of the surgery.
The tissue used for the graft may be taken from the roof of the patient’s mouth or from a tissue bank. If taken from the roof of the patient’s mouth, the procedure may involve cutting a flap in order to use tissue beneath the outer layer and then stitching the flap back in place. This is known as a connective tissue graft and is the most common procedure used for gum grafting. There are times when the soft tissue of the patient does not allow for this and a free gingival graft is recommended in order to use the stronger tissue taken directly from the palate. A third technique, known as a pedicle graft, is sometimes possible in patients who have more gum tissue near the exposed area. For this procedure, gum tissue surrounding the exposed area is loosened and repositioned in order to cover the exposed root and encourage tissue growth and healing.
For any of these procedures, the gum graft will be stitched into place and healing will begin immediately following surgery. In order to facilitate healing, our office will sometimes choose to use Platelet Rich Growth Factors (PRGF) or Platelet Rich Fibrin (PRF). These new techniques are applied to the surgical site(s) in the form of a gel and can assist with tissue regeneration by using the patient’s own tissues and centrifugation to minimize healing time and maximize healing potential following procedures.
Why it may be recommended...
There are several reasons a gum grafting procedure may be recommended for a patient.
There are times when there are cosmetic reasons to perform a gum graft. In these cases, a soft tissue graft can improve the appearance of a smile even if the patient does not have a medical reason to perform the procedure. If gum tissue is uneven or not providing sufficient coverage of the tooth root, a patient may elect to have a gum graft to improve the appearance of their smile and make the teeth appear more proportionate or even.
The most common reason to perform a gum grafting procedure is to correct the effects of gum recession. Gum recession can be mild and is often a natural part of aging, but the receding gums can expose part of the tooth root and cause sensitivity to heat and cold. Patients may choose to have a gum graft to reduce the sensitivity they are experiencing as a result of gum recession.
More often, however, gum recession is the result of periodontal disease and there are important oral health and medical reasons to perform a gum graft procedure. The recession not only affects the aesthetics of the smile and tooth sensitivity, but overall oral health and wellness. Receding gums leave tooth roots exposed and vulnerable to decay, instability and tooth loss, which can then lead to loss of the bone structure supporting the teeth. Gum grafts are an effective way to cover and protect tooth roots, helping extend the health of the tooth and supporting bone structures.
Periodontal disease develops when plaque spreads below the gum line and causes the tissue and bone that support the teeth to decay. The gums then separate from the teeth and form what are known as periodontal pockets which can become infected, leading to loss of tissue and bone. Extensive bone loss due to periodontal disease can result in the loss of one or multiple teeth.
In order to rid the gums of bacteria, the periodontist can perform a procedure often referred to as pocket depth reduction. During this procedure, the periodontist will cut a flap into the gum and fold it back to temporarily expose the tooth root and bone. If necessary, the periodontist will smooth areas of damaged bone to limit the surfaces upon which bacteria can grow. After ridding the area of bacteria, the gum tissue is stitched back into place. This procedure minimizes the depth of periodontal pockets and gets rid of bacteria in order to minimize the effects of periodontal disease and limit its progression.
Platelet Rich Growth Factors and Platelet Rich Fibrin are new techniques used to assist with tissue regeneration using the patient’s own tissues and centrifugation to minimize healing time and maximize healing potential following procedures.
These growth factors are in the form of a mixed gel that can be applied directly into tooth sockets and other sites. Placing this material in tooth sockets after tooth extractions can improve soft tissue healing and positively influence bone regeneration.
These techniques offer a new approach to tissue regeneration. PRP derives from the centrifugation of a patient’s own blood and contains growth factors that influence wound healing. This is important in tissue repairing mechanisms. The use of PRP in surgical practice could have beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration.
There are certain clinical circumstances in which oral surgery procedures will be necessary to help prepare for or facilitate the prosthetic phase of patient treatment. These procedures may include either hard or soft tissue surgery, or even a combination of the two.
Patients receiving a full or partial denture or other prosthetic may require tooth extraction, bone grafting, or other preparatory treatments prior to the placement of their restoration.
Because a denture rests on the jaw bone, it is important to match the shape and size to a new prosthesis. For a comfortable fit, bone may need to be smoothed, reshaped or removed before other dental procedures. Your surgeon will consult with you to determine your specific needs.