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Orthognathic surgery is typically performed by oral and maxillofacial surgeon or a craniofacial surgeon, with an orthodontist assisting. The purpose of Orthognathic surgery is to ensure that the necessary structure exists in the mouth so that the orthodontic treatment will be successful. Orthognathic surgery usually involves the jawbones, where modifications are done by cutting the bones of the mandible or maxilla and putting them back together properly aligned. The surgery is performed under general anesthetic, and the teeth are wired together after surgery so the jaw can heal correctly. Usually, the incisions are made inside the mouth and not in the skin.
Osseous surgery is a procedure that reshapes the bone which holds your teeth in place. Osseous surgery commonly treats periodontitis. Patients with periodontitis experience defects in the bone around their teeth. The osseous surgery removes those defects. Prior to the surgery, the patient undergoes a periodontal treatment that consists or scaling and root planing. A local anesthetic is administered to minimize the pain. Once the roots are cleaned, the dentist uses a drill and sharp dental tool to reshape the bone surrounding the teeth. Depending on the extent of the defects, the deformed bone is removed, and the rest is shaped. Bone grafting material is used where the defects are too large to be treated with only reshaping. Once the bones are back to their original state, the gums are stitched back into place. Osseous Grafting is a routine procedure, with a high success rate.
Sometimes the effects of periodontal disease create permanent changes in the tooth and gum structure that will cause issues in the future. Enlarged gum pockets between the tooth and the gum line are common after having advanced gum disease. Sometimes these gaps are cosmetic in nature and affect the appearance of the gums. More commonly, the gaps put the teeth at future risk for tooth and gum disease, as they are just one more place that plaque and bacteria can collect. Pocket reduction surgery is designed to thwart the after-effects of periodontal disease and restore your mouth to a healthy state.
The goal of periodontal surgery to gain access to the tooth root and to clean the damaged areas. Once the dentist can visually see the damage, it can be removed completely. Removing the plaque and decayed gum tissue leaves a pocket between the gum and the tooth. Sometimes the gum returns to its original position, but still, the pocket is present. The pocket requires more frequent cleanings as the patient is unable to get to the pockets with regular brushing and flossing. Once the swelling from the periodontal treatment has subsided, the dentist may need to suture the gum to where the bone has resorbed. The goal is to create a space large enough so it can be reached through daily oral hygiene, but small enough that it is not a breeding ground for plaque and bacteria.
A soft tissue graft is used when there has been a significant amount of gum recession in a particular area. Slight gum recession can usually be fixed with a few changes to your oral hygiene routine to take better care of your teeth and gums. When the gingiva recedes further, it exposes you to greater risk for infection and bacterial penetration. You will likely be more sensitive to hot and cold foods when you have receding gums. If the gums recede enough as to expose the root, you can set yourself up for more serious problems. The root is softer than the enamel making it more vulnerable to bacteria and plaque.
To restore proper gum level and functionality, a soft tissue graft can be performed. This is done by either removing soft tissue from the roof of the mouth or repositioning healthy gum tissue from adjacent teeth. This procedure is very predictable and has a high success rate. This procedure should be performed before more serious problems develop, and periodontal surgery is necessary.
A frenulum is a piece of tissue that prevents an organ from moving. There is a frenulum that attaches your upper lip to the gums, while another connects the lower lip to the gums. A frenulum that is too short or thick will cause problems in speech patterns and tooth misalignment. In infants, a shortened frenulum underneath the tongue will inhibit breastfeeding. When the frenulum disrupts movement, growth, or development, corrective action is necessary to resolve the situation.
A frenectomy is a minor surgical procedure that is performed in your dentist’s office. It can be performed with either a scalpel or laser and takes less than 15 minutes. Using a laser causes very little bleeding and does not require stitches. A laser also results in less postoperative discomfort and a shorter healing time. Young children and infants are put under general anesthesia for the procedure and adults have the procedure performed using local anesthesia. If your child needs a frenectomy, there is nothing to worry about. The procedure is very successful and causes minimal discomfort.