General & Restorative | Preventative Dentistry | Pediatric Dentistry
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Periodontics | Prosthodontics | Root Canal Therapy
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Root canal treatment is performed on teeth where the nerve in the tooth becomes infected. The tooth may be painful and an abscess can develop in the bone round the root. Most teeth heal after root canal treatment has been done. In some cases however, an abscess develops around the root tip, even after root canal treatment. This usually occurs when all the infected bacteria could not be removed from within the root, or when the initial infection was severe. Surgery is usually required at this point to remove the bacteria around the root tip. An opening is created through the gum tissue and bone, and the abscess is cleaned out. The tip of the root is cut off, to ensure that the bacteria and any infected tissue is removed. The tip of the root is then sealed with a small filling, and the opening in the gum is closed. If all the bacteria was removed successfully, the bone eventually fills back into the opening. In some cases, the procedure is not successful and the tooth may need to be extracted.
Impacted Wisdom Teeth
Wisdom teeth are actually a third set of molars which usually grow into the mouth when we are young adults. In many cases, there is not enough room in the mouth to accommodate these teeth, and they end up becoming trapped within the jaw bone. In this example, we are looking at a wisdom tooth which is growing into the tooth in front of it and is now impacted. If this situation is not treated, the impacted tooth can become infected and develop an abscess. In many cases, the tooth in front becomes decayed from the bacteria which is trapped in between the teeth, and can require extensive treatment. Extraction of this wisdom tooth is the recommended treatment.
In this example, the wisdom tooth is laying on its side and is unable to grow into the mouth. It is impacted into the jaw bone. Once again, extraction will be required. In some cases, the roots of the wisdom teeth are close to the canal in the jaw bone which holds the nerves and blood vessels that supply the teeth and jaw bone. Your dentist will assess your specific situation and discuss any concerns with you. Impacted wisdom teeth are often best removed when they are first diagnosed, before they become painful and create other problems which compromise the health of the surrounding teeth, bone and tissue.
Impacted 3rd Molar – Crowding & Damage
Third Molar Extraction
Sinus Elevation and Grafting
The nasal sinuses exist within the upper jaw bone. They are close to the roots of the back teeth. In many cases, pain within the sinuses can be mistaken as tooth pain, because of their proximity.
When the back teeth are lost, the jaw bone shrinks and the sinuses may expand down into the area where the roots of the teeth once existed. If implants are desired, a sinus elevation with graft may be required.
The sinus can be elevated and grafting materials can be grafted under the sinus through the jaw bone, to rebuild the bone that
was lost. Depending on the amount of bone grafted, healing may be required prior to implant placement.
Once the graft has consolidated within the jaw bone, implants can be placed. After healing, crowns can be fabricated over the implants to replace the missing teeth.
Sinus Lift – Vertical (Summers Technique)
Sinus Lift – Lateral
Teeth help to preserve the surrounding bone and tissue. Once a tooth is lost, the bone and tissue shrink away, creating a defect. When a front tooth is lost, it is common for the bone to shrink inwards (as seen in this example). In many situations, if an implant is the treatment of choice for replacement of the missing tooth, there may not be enough bone to proceed with treatment.
Bone grafting procedures can be done to rebuild the bone enough to place an implant. Depending on the amount of bone required, grafting may be accomplished using a bone product or bone from another area in the mouth or body. In this individual, the grafting procedure provided enough bone to proceed with an implant supported restoration.
Bone Grafting – Socket Preservation
When a tooth is lost, a hole is left in the bone where the tooth existed. In some cases, the bone that surrounded the tooth may collapse. If an implant is desired to replace the tooth, the collapse may prevent
An allograft is placed in the socket to prevent collapse of the surrounding bone. An allograft is grafting material that is obtained from sources other than yourself. There are many sources – human, cow, and artificial substances are some examples.
The grafting material is left to heal within the jaw bone for several months. After the graft has consolidated and become firm, an implant can be placed into the bone.
An allograft helps to maintain the surrounding bone and rebuild the jaw bone so that implant treatment can be performed. Once an implant has been placed, a crown can be fabricated to replace the tooth.