Park Slope Oral & Maxillofacial Surgery, PLLC

WHAT’S AN APICOECTOMY AND WHY DO I NEED IT? Occasionally, a root canal procedure is not sufficient to heal a tooth and surgery is required. The most common surgery used to save damaged teeth is called an apicoectomy. An apicoectomy procedure can be used to locate fractures or hidden canals that do not appear on x-rays, but still cause pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this particular type of procedure. WHAT TO EXPECT During an apicoectomy, an incision is made in the gum tissue to expose the bone and surrounding infected tissue. The damaged tissue is removed along with the end of the root tip and a root-end filling is then placed to prevent re-infection of the root. The bone will then naturally heal around the root. Following the procedure, there may be some discomfort or swelling as the incision heals. To alleviate any discomfort, appropriate medication will be prescribed. If the pain persists, please call our office at (718) 398-1969.

WHY DO I NEED AN ORAL BIOPSY? A biopsy is a surgical procedure in which a sample of soft or hard tissue is removed from the mouth and then sent to a laboratory for analysis. This allows our surgeons to diagnose potential periodontal disease, oral cancer, or other pathogenic dental conditions. During your procedure, your team at Park Slope Oral Surgery will minimize any possible discomfort. However, the site of the biopsy may be sore for a few days, so we recommend avoiding brushing the area until you can do so without pain.

WHY DO I NEED A BONE REPLACEMENT GRAFT Missing teeth over a period of time can cause your jaw bone to atrophy, or resorb. This often results in poor quality and quantity of bone suitable for the placement of dental implants, as well as long term shifting of remaining teeth and changes to facial profile.In the past, many patients in these situationswere not candidates for dental implants. Fortunately, through new advances in dentistry and surgery, we now can grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore function and aesthetic appearance. Bone grafts are also performed to reestablish lost jawbone due to trauma, periodontal disease, or an infection of an abscess. While bone grafting may sound scary, it is a very routine, predictable, and painless procedure.

WHAT IS A DENTAL IMPLANT? Dental implants are tiny titanium posts that are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes and are surgically placed into the jawbone. The bone bonds with the titanium, creating a strong foundation for replacement teeth, which look, feel, and function like natural teeth. Small posts are then attached to the implant, which protrude through the gum. These posts provide stable anchors for the replacement teeth or prosthetics. ARE DENTAL IMPLANTS AN OPTION FOR ME? If it is recommended to place a dental implant, you will undergo an oral evaluation and your dental and medical history will be reviewed to ensure that dental implants are appropriate. X-rays and, frequently, panoramic or 3D images will be taken to evaluate the quantity of your jawbone and to determine if it is adequate for placement of dental implants. Dental Implant Who performs the implant placement? Implants are typically a team effort between an oral and maxillofacial surgeon and a restorative dentist. While our oral surgeons perform the actual implant surgery, initial tooth extractions, and bone grafting (if necessary), your restorative dentist fits and makes the permanent prosthesis. The Surgical Procedure For most patients, the placement of dental implants involves two surgical procedures. First, the implants are placed within your jawbone. For the first three months following surgery, the implants are beneath the surface of the gum fusing with the jawbone. After the implant has fused to the jawbone, our oral surgeons will uncover the implants and place healing collars. These provide access to the implants and protrude through the gums. When the artificial teeth (crowns) are placed, the posts will not be seen. The entire procedure usually takes six to eight months, but it causes minimal disruption in daily life.

TREAT DENTAL & FACIAL TRAUMA AT PARK SLOPE ORAL SURGERY Park Slope Oral & Maxillofacial Surgery is uniquely qualified to manage and treat facial injuries. Our surgeons are well versed in emergency care, acute treatment, and long-term reconstruction and rehabilitation. We understand that injuries to the face impart a high degree of emotional and physical trauma to patients. Therefore, proper and individualized treatment is very important. EXAMPLES OF INJURIES WE TREAT Our oral surgeons have extensive training and experience treating facial injuries. They are trained to cover various facial traumas, which include the following conditions: Facial, lip, and intraoral lacerations Avulsed (knocked out) teeth Maxillary and mandibular fractures Management of head and neck injuries Soft tissue injuries Sinus injuries Salivary gland or facial nerve damage

WHAT IS TMJ? TMJ stands for temporomandibular joint, or the jaw joint. It is made up of the condylar process of the mandible (lower jaw) and the glenoid fossa of the temporal bone (part of the skull base). If you place your fingers just in front of your ears and open your mouth, you can feel the mandibular condyle moving in the joint. These joints are capable of both hinging and sliding movements. WHAT IS TMD? TMD stands for temporomandibular dysfunction and encompasses a range of facial pain conditions that include joint and muscular problems. One of the major problems with TMD is that there is still no consensus on the cause, how to prevent, or how to treat these disorders. Fortunately though, if we pay heed to the quality scientific evidence that is available to us, we can treat these problems successfully. For patients with acute injuries, resting the joint and performing simple treatment will resolve the problem in a short period of time. For others, the problem is chronic and requires more advanced treatment modalities. HOW ARE TMDs TREATED? Treatment varies for each patient. Your treatment plan and care will be customized and tailored to your specific needs and diagnosis. Part of your initial appointment will involve our oral surgeon formulating a special, individualized treatment plan that is made just for you. The doctor will offer you treatment options drawn from his or her knowledge base.

You and our oral surgeon may determine that you a need a tooth extraction for any number of reasons. Some teeth are extracted because they are decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired or restored. Other teeth may need removal because they are poorly positioned in the mouth (impacted teeth) or to prepare for orthodontic treatment. A toothache should not be ignored! Tooth infections can permanently damage nerves, so the treatment is either root canal therapy or extraction of the tooth. If there is enough tooth structure and the tooth has healthy gum tissue, then root canal therapy may be advisable. However, our practice does not perform root canal therapy, so if this is the case, we would refer you to an endodontist who specializes in this treatment. THE TOOTH EXTRACTION PROCESS At the time of extraction, the surgeon will numb your tooth, jawbone, and surrounding gums with a local anesthetic. During the extraction process, you will feel a lot of pressure from firmly rocking the tooth in order to widen the socket for removal. SECTIONING A TOOTH Some teeth require sectioning. Sectioning is a very common procedure done when a tooth is firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The surgeon simply cuts the tooth into sections then removes each section separately. AFTER TOOTH EXTRACTIONS You will receive post-op instructions from the doctor or staff after surgery and you will be given a packet with written instructions for home care.

WHAT IS A SINUS LIFT / SINUS AUGMENTATION? The maxillary sinuses are behind your cheeks and above the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the sinuses. When these upper teeth are removed there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone. The key to a successful and long-lasting dental implant is the quality and quantity of jaw bone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation. A sinus lift is one of the most common bone grafting procedures for patients with bone loss in the upper jaw. The procedure seeks to grow bone in the floor of the maxillary sinus, which enables dental implants to be placed and secured in the new bone growth. AM I A CANDIDATE? A sinus lift may be necessary if you are: missing more than one tooth in the back of your jaw missing a significant amount of bone in the back of your jaw missing teeth due to a birth defect or condition missing most of the maxillary teeth and require support for dental implants Sinus lifts make it possible for many patients to have dental implants that previously had no other option besides wearing loose dentures. WHAT TO EXPECT FROM SURGERY The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. For most patients, it is performed using local anesthesia.