Surgical

Extractions

You and Dr. Meister may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed. Others may have advanced periodontal disease or are broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth) or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, Dr. Meister will discuss alternatives to extractions as well as replacement of the extracted tooth.

The Extraction Process

At the time of extraction the doctor will need to numb your tooth, jawbone, and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. It is normal to feel pressure during the procedure, however if you feel any pinching, more anesthetic will be added to ensure your comfort.

If you do feel pain at any time during the extraction, please let us know right away.

Sectioning A Tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can't expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

Options for Replacing Missing Teeth

• The #1 reason for the loss of a tooth is a missing tooth next to that tooth. That is why anytime a tooth is lost (except in the instance of wisdom teeth removal, or for orthodontic purposes) it is imperative that the missing tooth be replaced. Options for replacing missing teeth include, Implants, Bridges, and Removable Partial Dentures.
• Non-Removable Dental Implants: Implants are the most permanent way to replace missing teeth. Implants can replace single or multiple missing teeth. With proper care, implants have the potential to last a lifetime.
• Non-Removable Bridges: Bridges are a non-removable way to replace single or multiple teeth. Typically, bridges last between 8-15 years. Bridges require that the teeth adjacent to the missing tooth be shaped down to accept the non-removable restoration.
• Removable Partial Dentures: Partial dentures can replace single or multiple teeth. This is the least desirable replacement option because it is removable. Typically, partial dentures need to be replaced after 5 years.

Bone and Tissue Grafting

Major & Minor Bone Grafting

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.

Major Bone Grafting

Bone grafting can repair future implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone. Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Socket Grafting

Socket bone grafting is done at the time a tooth is removed. The void where tooth roots once were are filled in with the bone grafting to promote healing, minimize the risk of dry socket, maintain the structure of the bone, and provide a foundation for the future tooth replacement.

Bone replacement therapy benefits include but are not limited to:

• Preserving the integrity of the facial structures;
• Preventing the melting of the width of the bony ridge;
• Preventing the melting of the height of the bony ridge;
• Decreasing bleeding;
• Decreasing pain and risk of dry socket;
• Decreasing maintenance of the existing full or partial denture(s), which also minimizes the need for frequent relines or new dentures. Relines are recommended annually. Due to slow, progressive dissolution of the underlying denture-supporting jawbone, relines may need to be performed more often;
• Decreasing any present discomfort or chewing inefficiency with the existing partial or full denture, which may persist or worsen in time;
• Limiting drifting, tilting, or extrusion of the remaining teeth;
• Decreasing the looseness of remaining teeth, and periodontal disease (gum and bone disease);
• Decreasing a potential jaw joint problem (TMD) caused by a deficient, collapsed or otherwise improper bite

Sinus Grafting

The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

There is a solution and it’s called a sinus graft or sinus lift graft. Dr. Meister will enter the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.

The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

CT Technology

CT Technology provides digital information making it possible to virtually plan your treatment. When CT Technology is utilized, your surgical plan and treatment can often be performed in fewer visits and in a shorter period of time.