Oral Surgery
Typical Oral Surgery procedures that I provide include:
Complex Extractions
Surgical Extractions
Dental Implants
Zygomatic Dental Implants
Tongue Tie and Lip Tie Release
Laser Removal of Gum/ Gingiva Discolourations/ Pigmentations
I perform a full range of oral surgery procedures. These include routine extractions, surgical removal of teeth, wisdom teeth, All on 4, impacted teeth, exposure and bonding of unerupted teeth, apicectomies, bone grafts and sinus lifts in preparation for dental implants.I will liaise very closely with your dentist regarding what you need and endeavour to keep both your dentist and doctor informed of your progress, unless requested otherwise.
During your consultation, I will evaluate your problems and inform you of various treatment options. If you wish to proceed, kindly let my team know and they will arrange a time and date for the procedure. Most surgical services at Nuffield Dental can be performed under Local Anaesthesia, General Anaesthesia or Intravenous Sedation. (as requested by nervous patients)
Wisdom Tooth Surgery
Wisdom teeth generally erupt anywhere from ages 18-26 years. They are commonly associated with gum swelling at the back of the mouth and frequently cause jaw pain or ache, commonly with redness and tenderness of the associated gum above the wisdom tooth. Treatment frequently begins with antibiotics and a mouthrinse to alleviate symptoms.
In most instances a panoramic radiograph (xray) is taken to ascertain the position of the tooth in relation to a particular nerve which is known to grown quite close to the roots of the wisdom tooth. I will assess the proximity of this using the xray and sometimes may have to do a CT scan should it be very close.
Removal of the wisdom tooth/ teeth may be done under Local Anaesthetic, IV Sedation or General Anaesthesia.
I am proficient in surgical removal of wisdom tooth/ teeth and have a particular interest in minimally invasive surgery for this purpose which in my opinion reduces downtime and subsequent postoperative pain and swelling.
Sinus Lift Surgery
The bones that make up your face are hollow and contain air spaces known as sinuses. The sinuses that sit above your upper back teeth are known as the maxillary sinuses. When an upper posterior tooth is lost, the floor of the maxillary sinus drops down into the space formerly occupied by the root of the lost tooth. In order to place an implant, it is sometimes necessary to put the sinus floor back up to where it originally was by adding a bone substitute. This procedure is called a sinus floor bone augmentation or a ‘sinus lift’.
In particular instances, I may opt to use an internal sinus lift or use Densah Burs to reduce the need for a more complex lateral window sinus lift surgery.
Bone Grafts
Socket Preservation using Particulate Bone and Resorbable Membrane
When we lose our teeth, the bone holding the teeth typically begin to resorb. In order to prevent this phenomenon, your implant surgeon may need to graft teeth sockets with bone materials immediately upon removal of the tooth. The purpose for bone preservation techniques is to prepare the jaw bone to receive a dental implant. If you have lost teeth for many years, typically more complex bone grafting techniques will need to be employed.
The assessment of your bone volume and shape will involve a CT scan of the jaw. A CT scan will allow us to assess the exact shape and amount of bone at the areas of interest. We can then plan the type of bone grafting techniques suitable for the case. All Nuffield Dental Clinics have low radiation CT scanners for your comfort and safety.
Types of bone graft materials that can be used:
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Autogenous bone grafts – taken from your own jaw
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Homologous bone grafts – from donor sources
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Xenografts – from other species e.g bovine sources
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Synthetic grafts – chemically created artificial materials
In some instances of All on 4 patients, bone grafts may need to be used at the surgeon’s discretion. There are multiple reasons for this including the need to ensure a safer long term prognosis for the implants.
Platelet Rich Plasma
Platelet rich plasma (PRP) is a procedure which involves the formulation and use of the patient’s own blood plasma. The PRP is therefore 100% biocompatible and safe to use in dental implant surgery. PRP contains growth factors, which are essential proteins in the process of cell proliferation and differentiation, extracellular matrix synthesis, remodelling and tissue regeneration. The proteins within PRP emit signals that accelerate the repair of damaged tissues by 40% over a period of time less than that obtained with traditional treatment.
The protocol for obtaining and processing of platelet rich plasma involves the collection of blood of the same patient. The blood is prepared through a process to form a yellowish gel like clot substance which is PRP. There are different types of formulations.
PRP liquid formulation
This can be used to enhance the surface of the implant with PRP in order to stimulate bone growth around the implant. PRP can speed up the healing by 40% when compared to traditional treatment protocols.
Clot
Activated liquid platelet rich plasma becomes a fibrin clot after 3-5 minutes. This gel like clot can be inserted into extraction sockets to promote healing, can be used in conjunction with other biomaterials to graft bone.
I am a fervent believer of the use of PRP and PRF in accelerating wound healing and typically use it in bone grafting and dental implantology.
