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'Dental surgery' is any of a number of medical procedures which involve artificially modifying the dentition.

Contents

Types

Dental anesthesia

Agents

Blocks

See also

External links

Types

Some of the more common are:

★ Endodontic (surgery involving the pulp or root of the tooth)

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★ Root canal

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★ Pulpotomy The opening of the pulp chamber of the tooth to allow an infection to drain; Usually a precursor to a root canal

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★ Pulpectomy - The removal of the pulp from the pulp chamber to temporarily relieve pain; Usually a precursor to a root canal.

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★ Apicoectomy - A root-end resection. Occasionally a root canal alone will not be enough to relieve pain and the end of the tooth, called the apex, will be removed by entering through the gingiva and surgically extracting the diseased material.

★ Prosthodontic (dental prosthetics)

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★ Crowns (caps) — artificial coverings of the tooth made from a variety of materials, including CMC/PMC (ceramic/porcelain metal composite), gold or a tin/aluminum mixture. The underlying tooth must be reshaped to accommodate these

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★ Veneers — artificial coverings similar to above, except that they only cover the forward (labial or buccal) surface of the tooth. Usually for aesthetic purposes only.

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★ Bridges — a set of two or more fused crowns which bridge a missing tooth (teeth). Typically used after an extraction.

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★ Implants — a procedure in which a base is set into the bone (mandible or maxilla), allowed to heal, and months later an artificial tooth is screwed into place.

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★ Dentures (false teeth) — a partial or complete set of dentition which either attach to neighboring teeth by use of metal or plastic grasps or to the gingival or palatial surface by use of adhesive.

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★ Implant-supported prosthesis — a combination of dentures and implants, bases are placed into the bone, allowed to heal, and metal appliances are fixed to the gingival surface, following which dentures are placed atop and fixed into place.

★ Orthodontic treatment

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★ Implants and implant-supported prosthesis — also an orthodontic treatment as it involves bones

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★ Apiectomy — also an orthodontic treatment as part of the underlying bone structure must be removed.

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★ Extraction — a procedure in which a diseased, redundant, or problematic tooth is removed, either by pulling or cutting out. This procedure can be done under local or general anesthesia and is very common — many people have their wisdom teeth removed before they become problematic.

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★ Fiberotomy — a procedure to sever the fibers around a tooth, preventing it from relapsing.

Dental anesthesia

Dentists inject anesthetic to block sensory transmission by the alveolar nerves. The superior alveolar nerves are not usually anesthetized directly because they are difficult to approach with a needle. For this reason, the maxillary teeth are usually anesthetized locally by inserting the needle beneath the oral mucosa surrounding the teeth. The inferior alveolar nerve probably is anesthetized more often than any other nerve in the body. To anesthetize this nerve, the dentist inserts the needle somewhat posterior to the patient’s last molar.
Several nondental nerves are usually anesthetized during an inferior alveolar block. The mental nerve, which supplies cutaneous innervation to the anterior lip and chin, is a distal branch of the inferior alveolar nerve. When the inferior alveolar nerve is blocked, the mental nerve is blocked also, resulting in a numb lip and chin. Nerves lying near the point where the inferior alveolar nerve enters the mandible often are also anesthetized during inferior alveolar anesthesia. For example, the lingual nerve can be anesthetized to produce a numb tongue. The facial nerve lies some distance from the inferior alveolar nerve, but in rare cases anesthetic can diffuse far enough posteriorly to anesthetize that nerve. The result is a temporary facial palsy (paralysis or paresis), with the injected side of the face drooping because of flaccid muscles, which disappears when the anesthesia wears off. If the facial nerve is cut by an improperly inserted needle, permanent facial palsy may occur.

Agents

Forms of dental anesthesia are similar to general medical anesthesia except for the use of nitrous oxide, relatively uncommon outside of the dental field in the U.S.

★ Nitrous oxide (N2O), also known as "laughing gas", binds to the hemoglobin in the lungs, where it travels to the brain, leaving a disassociated and euphoric feeling for most patients. N2O is typically used in conjunction with Procaine.

★ Local anesthetics used are lidocaine or xylocaine (a modern replacement for novocaine, procaine), septocaine (a numbing medication which can overpower infection, which can make it difficult to get numb), and marcaine (a long-acting anesthetic). A combination of these may be used depending on the situation. Also, most agents come in two forms: with and without epinephrine.

★ Eugenol — made from clove oil, this is a topical anesthetic also used in the common dental material ZOE (zinc oxide eugenol).

★ Topical anastethics — benzocaine, eugenol, and forms of xylocaine are used topically to numb various areas before injections or other minor procedures

★ General anesthesia — drugs such as versed, ketamine, and fentanyl are used to put the patient in a twilight sleep or render them completely unconscious and unaware of pain.

Blocks

★ Electrical nerve blocks — a technology that involves using electrical current to block the reception or generation of pain signals.

★ Branch block — a common form of local dental anesthesia, blocks the reception of pain for one quadrant of the mouth at a time. Typically given in the buccal surface (cheek). (IAB, MNB are types of this block)

★ Dental block — given below the tooth in question. Used usually for minor procedures such as fillings.

★ Palatal block— given into the hard palate, useful in numbing the upper teeth.

★ Intraosseous — an injection of local anesthetic given directly into the osseous (bone) structure of the tooth.

★ Intrapulpal — an injection of local anesthetic given directly into the pulp of the tooth to completely desensitize the tooth.

★ An alternative to chemical or electrical blocks, acupuncture or acupressure is rarely used.

See also

★ Dentistry

★ Surgery

★ Wisdom tooth

★ Tooth extraction

External links

★ Dental Video

★ A Number of Conditions which May Require Oral Surgery