Oral Surgery and Extraction

Oral Surgery: Effective Treatments For Dental Disease, Injury and Deformities

 

At i2M Dental, we leverage a range of technologies and techniques to deliver the most optimal treatment outcomes.  Although we attempt to resolve dental concerns through non-invasive methods wherever possible, there are many cases where surgical remedies produce quicker and more aesthetically appealing results for our patients.  In certain situations, these procedures may be the only option available for restoring the functionality and stability of your oral environment.

While the idea of going under the knife might seem somewhat alarming, the majority of surgeries at i2M can be performed on an out-patient basis.

The board licensed surgical dentists at our clinics in Hyattsville and Maryland have successfully completed a wide variety of complex oral surgery procedures over the years. Our team is also trained in the latest anesthetic and pain control management methods, so they can work to minimize any possible discomfort during and after the treatment process. As a result, most patients are able to return to normal activities within a couple of days of their surgery.

Alongside these expertise, we offer comprehensive consultations and diagnostic services to ensure that each individual receives tailored care that is ideally suited to their needs. Ultimately, our focus is to keep your gums, jawbone and natural teeth healthy and beautiful over the long-term.  

Types of Oral Surgery

We offer a number of treatment options depending on the oral health and specific requirements of the patient.

  • Tooth Extractions

  • Bone Grafts

  • Corrective Jaw Surgery

  • Dry Socket Treatment

  • Treatment of Advanced Oral Infections/Abscesses

 

Simple Extraction

While we do not recommend tooth extraction as a frontline treatment, when patients are suffering from advanced periodontitis, severe infections, overcrowding, and traumatic facial injuries, a dental removal can be the best way to preserve the structure and stability of their oral environment.  Extractions are also the preferred method for dealing with impacted wisdom teeth.

In routine situations where the tooth is intact, loose and visible above the gumline a tooth extraction can be performed with localized anesthetic and a pair of forceps.

However, even the simplest removals can be complicated by factors:

  • Dense bone matter surrounding the affected tooth will make simple extraction far more difficult.

  • If teeth are cracked or fragile then the dentist will need to prevent fragments from breaking loose during the extraction.

  • More force will need to be applied to extract long or curved tooth roots. Fragile roots may even break off during a simple extraction.

  • Impacted teeth may be only partially visible above the gumline. In some cases they may even be buried completely underneath the gum tissue. This will necessitate further excavation before the tooth can be safely removed.

 

Oral Surgery Procedure: Tooth Extraction

 

  1. During the initial consultation the surgical dentist will take an x-ray of the affected teeth to assess whether a simple or surgical tooth extraction is required.

  2. A local anesthetic is applied to the extraction site.

  3. A flap is created in the gum tissue. This will allow easier access to the underlying root and jawbone.

  4. An elevator device is used to peel away the flap.

  5. Surrounding bone may be trimmed away using a dental drill. This will facilitate easier extraction.

  6. The tooth may be extracted in one piece, or the surgical dentist may decide to break it up into smaller parts.


Most tooth extractions are very simple and the procedure can be completed easily under local anesthetics when the person is fully awake. Simple tooth extraction is a non-surgical process to tooth removal, which can be accomplished from above the gums using traditional forceps.


Local anesthetics are more commonly known as "Novacaine" but there are wide varieties of local anesthetics which serve different purposes. The most common is Lidocaine, while Mepivacaine is the best choice in pregnancy.

i2m Dental has one of your best local dentist to perform effortless tooth extractions. We suggest extraction if the tooth cannot be salvaged using other endodontic, cosmetic and orthodontic treatment.

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Bone Grafts

Jawbones develop to support the constant activity of our teeth. When we lose teeth, the underlying alveolar bone is no longer stimulated. Eventually this bone matter begins to atrophy as calcium and other minerals are reabsorbed for use in other areas of the body. Over time, the remaining teeth will shift to compensate for these structural deficiencies. This process will affect the stability of your teeth, as well as your ability to bite and chew effectively. 

Dental implants can replicate the functionality of natural teeth and help to prevent the many of the harmful effects of tooth loss. However, orthodontics can only be installed in places where adequate supporting bone structure already exists. Grafting can help to stimulate regrowth of bone volume in targeted areas, creating a solid foundation for dental implants.

Oral Surgery Procedure: Bone Grafts

Minor Bone Grafts

 

Minor bone grafts are usually performed directly in anticipation of dental implants, either directly after a tooth extraction or several months before the placement of an orthodontic device. In the past, grafts were sourced directly from processed human or animal bone matter. Today, these maxillofacial surgeries can be performed with lab-produced materials. After the material is placed in an open socket, it will usually take anywhere from 3-6 months before adequate bone mass has been generated.

Major Bone Grafts

In certain areas, more extensive reconstruction may be required:

  • Sockets may have been left open for several years before treatment causing extensive resorption.

  • Infections, cysts or tumors may have penetrated the jaw causing significant erosion of bone matter.

  • Congenital defects may have led to stunted growth in sections of the jaw where no permanent teeth developed.

  • Severe facial injuries can lead to the loss of large amounts of bone matter.

In these cases, bone matter must be sourced from the patient themselves (autogenous grafts). This material is usually sourced from the hip, chin or other areas of the jaw. A small block of bone is taken from these areas and harvested in the targeted area. It is then secured with small screws. The site is then covered with particulate bone matter to assist natural bonding. Once the surgical area is sealed, the implant can be installed within 4-6 months.

Sinus Lifts

The sinus lift procedure is used to add additional bone mass to the back region of the upper jaw bone (near the molars). In this oral surgery, sinus tissue is lifted to expose the upper jawbone. A small incision is then made, and the cavity is filled with particulate bone matter. The surgical site is sealed and left to grow for 6-9 months, after which the dental implant can be applied.

 

Dry Sockets and Socket Preservation

Socket preservation or preservation of alveolar ridge is a procedure of choice to reduce bone loss after extraction and to preserve bone loss from the socket.

 

After tooth extraction, a blood clot usually develops over the surgical site. This helps to prevent bacteria and other particles from infiltrating the underlying bone matter and nerves. However, in certain cases these blood clots do not form correctly due to bacterial infections, deficient blood supply, or physical dislodgement. This leaves your jawbone and nerves exposed to external influences.

If left unchecked, dry socket will begin to cause severe throbbing pain across your jaw and face. It may also lead to symptoms such as constant bad breath and a sour mouth taste.

Dry socket can be treated through a number of minimally invasive procedures:

  • Your surgical dentist can prescribe NSAIDs or antibiotics to reduce pain.

 

  • We can prescribe antibiotics to remove any infections in the dry socket.

 

  • We can treat the area by flushing out any food or debris that has become lodged in the socket. The site is then dressed with gauze and filled with a medicated gel. This will help to numb the area and promote more effective healing. The gauze needs to be regularly changed, so further appointments will be required.

After a tooth is extracted the socket has to be preserved in its original shape and bone needs to be preserved. The bone quickly starts to resorb  after extraction while healing occurs.   

 

Corrective Jaw Surgery

Also known as orthognathic surgery, these oral surgery procedures are used to improve the functionality and alignment of the maxilla (upper jaw) and mandible (lower jaw). Jaw surgery will also help to create a more natural smile and facial structure.

If you experience from any of the following issues then you could be a good candidate for corrective jaw surgery.

  • You have an open bite (space between teeth when the mouth is fully closed)

 

  • Your teeth come together at improper positions (malocclusion). This can wear away your teeth and cause chronic migraines, headaches, temporomandibular jaw disorders (pain in the joints of your lower jaw), extreme tooth sensitivity, and loose teeth due to sustained pressure on the soft tissue surrounding the tooth.

 

  • You suffer from sleep apnea

 

  • You have difficulty breathing.

 

  • You have difficulty biting and chewing.

 

  • You have congenital defects in the jaw and facial structure.

 

  • You have a small or receded chin/lower jaw.

 

Oral Surgery Procedure: Corrective Jaw Surgery

 

  1. Surgery is usually preceded by X-rays and extensive 3D imaging. This helps us to construct a working digital model of your oral structure which we can then use to plan a course of treatment that will align your bite and improve your overall facial symmetry.

  2. We generally apply braces to align the teeth in preparation of the surgery. This process takes anywhere from 12-18 months.

  3. Depending on the issues identified the surgical dentist may remove sections of your upper or lower jaw, lengthen sections with additional bone grafts, or lower/raise certain sections in our out to promote better alignment. Adjusted sections are usually fixed into placed with specialized plates and screws.

 

Treatment of Advanced Oral Infections and Abscesses

Dental abscesses occur when bacterial infections develop in the tooth and spread to the surrounding gum tissue and bone. This will lead to swelling and yellowish-pus in the affected area. If this fluid is not drained, then the site will continue to become progressively more painful. Other symptoms include:

  • Fever

  • Nausea

  • Chills

  • Redness in the mouth and face.

  • Unchecked abscesses can even grow to block vital airways, in rare cases these restrictions can lead to death.

Thankfully, these infections are generally quite simple to treat. If your surgical dentist is able to identify a drainable abscess during your initial assessment then they can cut open and drain the abscess during the appointment. After the pus has cleared, your oral surgeon will prescribe a course of antibiotics to prevent further infection.

 

Hyattsville, MD

Hyattsville, MD 20782 

Ph: 240-696-7842

Toll-Free Number : 1-844-i2m-DENT

[1-844-426-3368]  Press 1 for Hyattsville

Monday: 9:00 AM - 5:00 PM

Tuesday: 9:00 AM - 5:00 PM

Wednesday: 9:00 AM - 5:00 PM

Thursday: 9:00 AM - 5:00 PM

Friday: 9:00 AM - 5:00 PM

Saturday: 9:00 AM - 1:00 PM

Silver Spring, MD

             Ste B Silver Spring, MD 20901 

Ph: 301-789-7938

Toll-Free Number : 1-844-i2m-DENT

[1-844-426-3368Press 2 for FourCorners

Monday: 10:00 AM - 5:00 PM

Tuesday: 10:00 AM - 5:00 PM

Wednesday: 11:00 AM - 5:00 PM

Thursday: 11:00 AM - 5:00 PM

Friday: 10:00 AM - 3:00 PM

Saturday: 9:00 AM - 1:00 PM

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