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Wisdom Teeth | Dental Implants | Trauma
Pathology | TMJ | Skin Resurfacing
Orthognathic Surgery | Endodontic Surgery

Wisdom Teeth

The average adult has thirty-two teeth by age eighteen: sixteen teeth on the top and sixteen teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces while the back teeth, or molar teeth, are used to grind food up into a consistency suitable for swallowing.

However, the average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as "wisdom teeth."

Why Should I Remove My Wisdom Teeth?

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain and illness. The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.

Oral Examination

With an oral examination and x-rays of the mouth, Drs. Regenye & Huberman can evaluate the position of the wisdom teeth and predict if there may be present or future problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid- teenage years by their dentist, orthodontist or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Drs. Regenye & Huberman has the training, license and experience to provide various types of anesthesia to allow patients to select the best alternative. These services are provided in an environment of optimum safety, utilizing modern monitoring equipment and staff experienced in anesthesia techniques.

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Dental Implants

Dental implants are changing the way people live! They are designed to provide a foundation for replacement teeth which look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved.

What are Dental Implants?

The implants themselves are tiny titanium posts which are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. They are surgically placed into the jawbone. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts are then attached to the implant which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

Implants also help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

The Surgical Procedure

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your dentist is forming new replacement teeth.

After the implant has bonded to the jawbone, the second phase begins. Drs. Regenye & Huberman will uncover the implants and attach small posts which will act as anchors for the artificial teeth. These posts protrude through the gums. When the artificial teeth are placed these posts will not be seen. The entire procedure usually takes six to eight months. Most patients experience minimal disruption in their daily life.

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Trauma & Facial Reconstruction

Oral and Maxillofacial Surgeons are trained, skilled and uniquely qualified to manage and treat Facial Trauma. Drs. Regenye & Huberman is on staff at your local hospital and provides emergency room coverage for facial injuries including:

  • Facial lacerations
  • Intra oral lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose, or eye socket)
  • Fractured jaws (upper and lower jaw)

Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a "hands on" experience and an understanding of how the treatment provided will influence the patient's long term function and appearance.

The Nature of Maxillofacial Trauma

There are a number of possible causes of facial trauma. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries account for many. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

The proper treatment of facial injuries is now the realm of specialists, such as Dr. Huberman & Dr. Regenye, well versed in the emergency care, acute treatment and long term reconstruction and rehabilitation of the patient.

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Endodontic Surgery

What Should You Know about Endodontic Surgery?

Endodontic treatment, commonly referred to as root canal therapy, is performed by either your general dentist or an endodontist (root canal specialist.) This treatment is performed to preserve teeth which have had or are about to have problems.

However, in some cases, nonsurgical endodontic therapy is either not indicated or may not be sufficient to correct al of the problems associated with a particular tooth. In those cases endodontic surgery (apicoectomy) may be indicated. This surgery is performed to eliminate or prevent any infection leaking from the tooth, supporting bone or gums or even other teeth.

This surgery can be performed painlessly using either local anesthesia (Novocain), sedation or general anesthesia in the oral and maxillofacial surgeon's office. This decision is discussed with the patient and surgeon . The surgery requires a small opening in the gum through which the surgeon can explore the problematic area. The infection, or problem area, if present at the root tip is then removed and then an amalgam is seal is placed in the tip of the root. The small gum opening will then be closed with fine sutures. A postoperative X-ray will then be taken and a copy will be sent to your dentist.

Post-Operative Instructions

Bleeding

Although sutures are placed at the end of the procedure a small amount of oozing is normal during the first day. A moistened gauze pad which will be provided for you may be placed at the surgical site. This may need to be replaced every hour for a few changes.

Swelling

Swelling is often seen following this type of surgery. The most common time for the development of swelling is from 24-48 hours following the procedure. The swelling usually begins to decrease after 48 hours and usually within one week no noticeable swelling is present. The help minimize swelling we recommend the use of ice for the first 24 hours. you should apply the ice for 20 minutes and remove it for 20 minutes. After the first 24 hours, ice is of little benefit.

Some discoloration of the skin tissues ma be noticed especially in the elderly population . Although this may be unsightly, it is of no concern and has no effect on the healing process and will resolve over time.

Pain

Some degree of discomfort following this procedure should be expected. The degree varies from patient to patient. Generally the worst discomfort will be in the first few hours after the local anesthetics have stopped working. The surgeon will always prescribe some medication for the control of this discomfort. We suggest after alight meal prior to the local anesthetic wearing off the prescribed medication is taken. This medication may be repeated as indicated and as needed. If only minor discomfort is present we recommend use of mild medication such as that used for the relief of headaches.

Home Care

No manipulation of the area should be performed until the day after the surgery. We recommend soft or liquid foods for the first 24 hours and then for the first week you should avoid hard to chew foods or very spicy or extremely hot foods. After the first day we recommend warm salt water rinses especially following eating. The teeth not in the area ma be brushed normally; while those in the area along the sutures can be cleaned with a Q-tip or a sponge brush that will be provided.

Antibiotics

The surgeon in almost all instances will prescribe a one week course of antibiotics. The antibiotic medication should be used exactly as prescribed and should be finished. If any reaction to the prescribed medication occurs such as itching, shortness of breath or stomach cramps, stop the medication and call the office.

Follow-Up Appointments

The first follow-up visit will be one week postoperatively, at which time the sutures will be removed. This visit is brief and no anesthetic is required. At approximately three weeks following surgery the second postoperative is scheduled at which time final inspection of the incision is performed and any problems the patient has encountered are discussed. The patient is then placed on a recall list for six month intervals, at which time a follow-up X-ray may be taken.

Surgical Treatment

This procedure will be performed using local anesthesia. There are usually no restrictions after the procedure concerning driving or returning to work. A doctor is available for consultation at all times should a problem arise after your treatment.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment. 2. Please eat a full breakfast or lunch as applicable. 3. If you have been advised by your physician or dentist to use antibiotic premedication because of mitral valve prolapse (MVP), heart murmur, hip, knee, cardiac or other prosthesis, or if you have rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment. 4. If you can take ibuprofen (Advil) or naproxen sodium (Aleve), it does help reduce inflammation when taken preoperatively. We recommend 2 tablets of either medication 2-4 hours before endodontic therapy.

General Instructions

Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and previous condition of your tooth. This tenderness is normal and is no cause for alarm. Do not chew food on the affected side until your endodontic therapy is completed and your tooth is covered with a protective restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. You may continue your regular dental hygiene regimen. Discomfort may be alleviated by taking ibuprofen (Advil), aspirin, or acetaminophen (Tylenol) as directed.

Note: Alcohol intake is not advised while taking any of these medications. Should you experience discomfort that cannot be controlled with the above listed medications, or should swelling develop, please contact this office immediately. The office telephone is answered day and night. If you need to call after hours, please have your pharmacy number available.

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