Extractions (With or without ridge preservation)
There are many reasons for the extraction of teeth including Periodontal disease or advanced decay. Often times, patients present with severe pain and just want immediate relief. All treatment options to replace the extracted tooth must be discussed prior to tooth removal. A tooth abscess could result in a large amount of infection at the end of the root which would leave a significant bone defect if the site was not preserved.
When a tooth is removed, changes immediately occur to the fresh extraction site. When the blood clot forms on the bone, the site begins to heal. During the normal healing process, up to 50% atrophy or shrinkage can occur to the site within 3 months. The goal of ridge preservation is to reduce the amount of this shrinkage to the site. If there was infection at the root apex, complete removal of it is required prior to the placement of bone graft material. With grafting, the site will heal with less shrinkage and will provide greater support for a fixed bridge, partial, or dental implant.
There are many types of grafting materials including: Bovine, Cadaver and harvesting the patient’s bone from a secondary surgical site. All products that are used in Dentistry are processed very meticulously and are very safe for our use. Your body uses these materials to build new bone but most importantly, their function is to hold and maintain space. When the extraction site is grafted, it is ready for implants or restorative options within 3-6 months depending on the amount of original infection and quality of bone that was present.
When tooth decay or a tooth fracture occurs below the gumline, it may be necessary to remove a small amount of bone and gum tissue prior to completing restorative care. This is procedure becomes necessary so that the final crown can be placed in a healthy environment without impinging on either the gum or bone.
Crown lengthening is recommended because the decay or broken segment of the tooth extends below the gum line. Biological width is the distance between the crown margin and the bone. The distance between the crown margin and the marginal crest of the bone needs to be up to 3 mm. If the new crown margin violates this principle, then gingival inflammation or pain could occur over time.
The procedure can be completed without much discomfort and usually only takes a short while to complete. Within 6 weeks after crown lengthening, your Dentist can begin final impressions for your new crown.
Besides having a gummy smile, this patient had teeth that were too short for her face. The gums were corrected with crown lengthening surgery and 8 porcelain veneers were placed to establish the proper tooth length.