Half Moon Bay Marina Dentists
09-535-1074
info@marinadentists.co.nz

Pine Harbour Marina Dentists
09-536-4361
pineharbour@marinadentists.co.nz

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Laser

Currently, lasers are quite common in dentistry. Our clinic was one of the first in Auckland to purchase and start using dental lasers. At Marina Dentists, our clinicians are specialized to work with dental lasers.

Lasers used in the dentistry field can be utilized for many different procedures relating to diseases of the teeth, gums and oral mucosa, in surgical dentistry, implantology and aesthetic dentistry, as well as during hygiene procedures. The advantages of the laser have already been seen by not only dentists, but also by many patients.

At Marina Dentists, we use lasers for the following procedures:

  • Cutting the frenulum of the tongue, and upper and lower lip.
  • Resection of the apex of the tooth root.
  • Removal of the cysts.

Cutting the frenulum of the upper, lower lip and tongue

In the mouth, there are three thin films - the frenulum of both lips and the frenulum of the tongue. They play a huge role in the performance of the entire dental system. As an example, the lingual frenulum aids in various sound pronunciations, it is responsible for proper articulation and the ability to move the tongue. The frenulum of the lips form the correct bite and position of the front teeth, as well as the shape of the gums.

Why trim the bridle?

Depending on the frenulum structure, it can promote quite serious consequences to the patient.

If the tongue frenulum is tight/short, the tongue will struggle to perform movements, which means that the patient cannot fully eat, and speech therapy problems appear. In infancy, the baby will have difficulty fully suck on mother's milk. Therefore, if this is the case, clinicians advise the frenulum to be trimmed in the first weeks or months of life.

If trimming the frenulum of the tongue is performed in infancy, then problems with the short mucosa of the lips (usually the upper lip) may not be so obvious. Shortened and inelastic films can lead to gingival tension, reduction of its volume and exposure of the roots of the front teeth. The consequence of exposure are increased sensitivity of the enamel, soreness and active development of caries. While, too voluminous frenulum leads to overhanging of the mucosa over the surface of the teeth, which primarily affects the aesthetics of the smile.

Thus, the indications for surgery are as follows:

  • shortened frenulum,
  • speech and pronunciation disorders of certain sounds,
  • excessive tooth exposure due to gum volume reduction,
  • problems with nipple latching in infants,
  • malocclusion caused by the position of the labial frenulum.

The dentist is able to determine consequences of frenulum size even when only the first signs appear. For infants, the procedure only takes a couple of minutes, does not cause any pain and does not require long-term rehabilitation. This is because the film is still very thin. Adult patients can also undergo a smile correction procedure, but usually involves a longer recovery period, since the mucous membrane is denser and more sensitive to injury. Additionally, in adult patients, additional problems are observed in the form of tooth exposure, reduction in mucosal volume, which also needs to be addressed.

How does frenulum trimming work?

Trimming a baby's frenulum is quick and completely painless, taking only a couple of minutes. In adolescents and adults, the operation can take 20-30 minutes. Carrying out laser surgery in a dental clinic by the hands of professionals guarantees the absence of complications and minimizes the chances of surgical consequences.

EXPERT OPINION

The possibility of using painkillers during frenulum cutting depends on the condition of the frenulum, the age of the patient and his or her sensitivity. In children, the film is very thin, so the procedure takes only a few seconds, but in adult patients, anesthesia may be required, as the frenulum becomes tighter, and the operation can cause unpleasant and even painful sensations.

Alex Mechkov

Surgeon
Work experience 35+

Stages of the operation:

  • injection of an anesthetic,
  • dissection of the frenulum using a laser device, surgical instruments,
  • suturing, which usually dissolve on their own 4-5 days after the operation.

ADDITIONAL TREATMENTS

After the operation of the tongue frenulum, speech therapy may be required. As it aids the child to speak and move the tongue again - this will also solve any pre-existing speech problems.

If the shortened labial mucosa has caused aesthetic problems with the shape of the gums, an additional flap plastic surgery can be performed. Its purpose is the formation of a new gingival contour by dissection and displacement of the mucosa.

After surgery

In most cases, there are no complications after trimming the frenulum of the upper, lower lip or tongue, and the recovery takes only a few days. For a baby, it is best to feed him/her immediately, since the mother's milk acts as an anesthetic. While, adult patients should temporarily avoid solid and viscous food. If there are problems with speech, then special classes with a speech therapist should be scheduled. There may be a slight discomfort to adult patients if stitches are placed, this will resolve after their resorption, which occurs usually after 4-5 days.

Resection of the apex of the tooth root

Resection of the apex of the root is a tooth-preserving procedures, since it is actually the “last hope” for a tooth whose root has formed a cyst or granuloma. This operation involves the removal of the tumor along with a small part of the tooth root - in this way the tooth itself is preserved and can even be used as the basis for fixing the prosthesis.

Indications

  • cyst or granuloma more than one cm in diameter1,
  • tooth with a crown, canals - sealed,
  • the presence of a pin in the tooth roots,
  • root canals are poorly sealed,
  • therapeutic treatment cyst or granuloma through the canals of the tooth is impossible.

Contraindications

  • tooth mobility, when it is not necessary to save it, a
  • completely destroyed crown - in this case, a prosthesis cannot be fixed on the tooth,
  • the size of the tumor is too large, the
  • damage to the root of the tooth is large,
  • general body problems: the cardiovascular system, infectious diseases, malignant tumors, diabetes mellitus,
  • it is impossible to use anesthesia.

Technology of the operation

Duration of resection of the apex of the tooth root - about an hour. It is necessarily carried out under anesthesia - even when drilling bone tissue, the patient is completely pain-free, only slight discomfort is possible from the fact that the doctor performs some manipulations in the mouth.

The stages of treatment are as follows

  • diagnosis: the presence of a cyst or granuloma can often be determined only on x-rays, since there are no symptoms. In the picture, the tumors look like blackouts near the tooth root,
  • the removal of the nerve and the filling of the dental canals are carried out a couple of days before the operation, but not earlier, since there is a high risk of purulent inflammation as a reaction to the filling. The nerve must be removed without fail, since its inflammation and damage is possible,
  • anesthesia is a mandatory procedure before treatment, since without anesthesia the operation is not possible, the
  • gum is dissected, a small flap is exfoliated - the surgeon forms a cavity in the bone tissue through the hole by drilling
  • through the hole in the gum and bone tissue, the doctor detects a tumor, carefully removes it together with the cut-off tip of the tooth root (sawed off with a drill),
  • a part of the bone tissue extracted during the operation is replaced with an artificial material, which allows not to lose bone volumes. A protective membrane is applied on top, which dissolves on its own after a few weeks, the
  • gum is sutured, if necessary, drainage is applied between the seams to drain the pus - it is removed after 2-4 days.

This operation requires the patient to carefully prepare and strictly follow the rules of rehabilitation. Before and after the manipulations, anti-inflammatory and analgesic drugs, as well as antibiotics, can be prescribed, which will relieve the inflammatory process and accelerate tissue repair. Drug therapy is mandatory, since the formation of a cyst is often accompanied by purulent inflammation and it is important to prevent the spread of pus throughout the body.

Disadvantages of the operation

Resection of the apex of the tooth root is an operation that requires maximum attention from the patient and professionalism from the doctor. Among the shortcomings, one can single out the need for surgical intervention, as well as a rather long rehabilitation period, which is associated with taking medications and a number of restrictions (they relate to changes in lifestyle and diet).

AFTER ROOT RESECTION EXPERT

After the operation, the patient must follow simple recommendations: stop eating for 2-3 hours, reduce physical activity for several days, limit smoking. All hygiene procedures must be carried out carefully, without touching the wound.

Alex Mechkov

Surgeon
Experience 35+

Many patients are interested in the question of how long the tooth will last after the operation: amputation of the root is not a hindrance to the service life. With a professionally performed procedure, a tooth, even with a prosthesis on top, can last 5-7 years or more.

According to official statistics, complications after resection occur in 1-3% of all cases. These operations at the Smile-at-Once Clinic are performed by experienced surgeons as safely and carefully as possible for the patient. The most important thing that our doctors pay attention to is the complete removal of the tumor from the jawbone along with the shell. In order to evaluate the result of treatment, a control x-ray is mandatory after the operation.

Alternative solutions

Root resection is an operation that can significantly extend the life of single-rooted teeth near which a cyst or granuloma has formed. Alternatively, endodontic root canal treatment and drug therapy can be used if the tumor is small, as well as complete root removal in cases where the tumor is too large to cause significant tooth decay.

Removal of a tooth

A tooth cyst is a tumor that forms in the area of ​​the tooth roots. Most often, it occurs as a reaction to inflammation in order to prevent further spread of the infection. A tooth cyst is a formation that is covered with a dense membrane. Treatment can be conservative or surgical (removal) - depending on the size of the tumor, its contents and the degree of impact on the entire body.

Diagnosis of a tooth

A tooth cyst, like a granuloma, practically does not manifest itself in any way - at the initial stages, the symptoms are completely absent. Only as the tumor grows, soreness, a lump on the gum, and an increase in body temperature occur. However, at regular preventive examinations, the doctor may suspect the presence of a tumor - with discomfort and soreness of previously treated teeth, it is they who fall into the “risk group”. The diagnosis is confirmed only by the results of an X-ray examination - in the picture, the cyst looks like a dark spot located around one or more tooth roots.

Conservative treatment

Conservative or therapeutic treatment is used in the presence of a small cyst. Since the tumor is directly related to the tooth root, endodontic treatment is performed at the first stage - the dental nerve is removed, the canals are thoroughly cleaned. A special drug is placed inside them, which promotes the resorption of the cyst, a temporary filling is installed. At the same time, the patient is prescribed drug therapy.

After 2-3 weeks, an X-ray examination is performed, which will show the condition of the cyst - during this time it should completely resolve. Gradually, its place will be filled with bone tissue cells. During the second visit, the temporary filling is removed, the root canals are sealed, and the top of the tooth is restored if necessary.

This method, unfortunately, is not always effective1 - often it is not possible to completely get rid of pathological tissues and there is a high risk of recurrence of the disease. Therefore, after therapeutic treatment, regular monitoring of the condition of the tooth and periodontal tissues is required.

Surgical removal of a tooth cyst: technologies

To date, surgical removal of a tumor is considered the most effective method of getting rid of the problem. And in 99% of cases, it is possible to save the tooth (upper, part of it), which later can even become a support for attaching dentures.

Any surgical intervention is performed under anesthesia, so the operation is completely painless. Unpleasant sensations occur only a few hours after it is carried out, when the anesthetic ends. But they are associated exclusively with tissue injury.

Tooth-preserving operations when removing a cyst

1. Cystectomy or resection of the root apex

The most popular, although one of the most difficult surgical operations is the treatment of a tooth cyst without removing it. It implies the removal of a cyst through a lateral incision in the gum and bone tissue, along with cutting off part of the tooth root - its top. The tooth nerve must first be removed and the canals are carefully sealed. Subsequently, such a tooth can last for several decades and even be used as a support for prosthetics.

2. Hemisection

This operation involves the removal of a cyst along with one of the roots and the crown of a multi-rooted tooth. To begin with, the crown is sawn, then it is removed along with the root of the tooth. All pathological foci are removed - to provide additional access, the osseous-gingival flap can be peeled from the side. After the operation, the site of the tooth root is filled with a synthetic material - artificial bone. The mucosa is sutured. A damaged tooth is necessarily restored by fixing a crown or bridge.

3. Cystotomy

This technology is used in the presence of a large tooth cyst, when its complete removal can lead to thinning of the jawbone. The operation involves extracting fluid from the tumor by removing its front wall and creating a small hole in the bone tissue. Through it, the outflow of the internal contents of the cyst will be carried out. After its reduction in size, a complete extraction of the neoplasm is carried out.

In our clinic, an exclusively individual approach is practiced - after a thorough diagnosis, we select a treatment method that is suitable for a particular patient. At the same time, his general condition is necessarily taken into account so that surgical intervention does not harm his health.

Mechkov Alexei

Surgeon with more than 35 years of practise

What to do if you had to extract a tooth

Modern technologies allow us to remove cysts as carefully as possible for the teeth and at a reasonable price for Moscow. Subsequently, a single crown or bridge can be attached to them. However, if the tooth still had to be removed, the patient needs to think about prosthetics, and it is not worth delaying the restoration of the tooth - due to the lack of load, atrophy of the bone tissue will be observed, and adjacent teeth may shift towards the empty space, which will lead to the formation of gaps along the row.

Bridges or implant-supported single crowns. True, implantation will not work at the same time as the tooth is removed - in the presence of a voluminous cyst, it will take some time to restore the bone tissue, after which a dental implant can be installed.