CIRUGÍA ORAL
Oral Surgery
The specialty of oral surgery covers a wide range of treatments that can be performed in the oral cavity, such as: extraction of third molars or impacted teeth, exposure or traction of unerupted teeth (e.g. impacted canines), frenectomies (removal of oral frenula), apicoectomies (removal of infected root tips), cyst removal, and pre-prosthetic surgery.
Third molars, wisdom teeth, or posterior molars
The third molars, also known as wisdom teeth or posterior molars, usually erupt between the ages of 16 and 25, although in some cases they may never appear. Since they are located at the very back of the dental arch (at the end of the mouth), their position can sometimes affect the development of neighboring teeth.
Depending on their position, wisdom teeth can be erupted, partially erupted, or impacted in the mouth:
- Erupted: When the crown of the tooth is completely out of the gum. Sometimes, even though it is erupted, due to lack of space, it comes out in a more posterior position, causing biting problems, difficulty in cleaning, and consequently cavities between the teeth. For these reasons, extraction is performed in most cases.
- Partially erupted: When the crown has only partially erupted and therefore is barely visible. Since it does not fully emerge, a space is created between the crown and the gum that, over time, can fill with food debris or bacteria, leading to an infection called pericoronitis, which causes inflammation of the area, pain, limited mouth opening, and difficulty chewing. In these cases, it is important to treat the infection and remove the cause (the wisdom tooth).
- Impacted: When the crown does not erupt, usually because it grows in an abnormal position or becomes impacted against the tooth in front of it. In the case of an impacted wisdom tooth, the only treatment options are surgical extraction or monitoring its development to see if its position changes over time.
When are wisdom teeth extracted?
Extraction is performed in cases where:
- There are symptoms: abscesses, cavities, recurrent infections, severe or acute pain, pain in the face or even the ear, fever, etc.
- There is a pathological radiological sign: cyst or root resorption of other teeth.
- Orthodontic request: due to lack of space for proper tooth alignment or to prevent relapse.
- For prevention.
Impacted or unerupted tooth
Impacted teeth, also known as unerupted or embedded teeth, are those that, despite being fully formed, have not emerged into the mouth and remain partially or completely within the bone.
After the third molars, canines (fangs) are the teeth that most commonly present eruption problems due to lack of space or erupting in an incorrect position.
Due to the great functional and/or aesthetic importance of the canines, the most recommended treatment is their repositioning in the dental arch through a combined intervention between the surgeon and the orthodontist.
The procedure, performed under painless local anesthesia, involves making a small opening at the site where the canine is retained, also known as fenestración, y luego el ortodoncista coloca un bracket o soporte que ayuda en su tracción.
Frenectomy or Frenuloplasty
Frenula are bands of fibrous tissue, muscle, or both, usually located along the midline inside the mouth. They can attach to the lip, tongue, or gums. The most well-known are:
- Upper labial frenulum: The fibrous fold of mucosa along the midline that connects the inside of the upper lip to the gums, sometimes extending to the palate.
What problems can it cause?
- Separation of the incisors, causing what we call a diastema (link to the word “diastema closure in aesthetics”);
- Limitation of upper lip movements;
- Problems with swallowing saliva or brushing;
- Short lip;
- Problems with the functionality of removable prostheses.
Lower labial frenulum: The fibrous mucosal fold at the midline that connects the inner surface of the lower lip to the gum.
What problems can it cause?
- Gingival recession/retraction: The tension of the frenulum around the gums of the lower teeth causes them to retract or pull down, exposing part of the tooth root, leading to inflammation, periodontal pockets, and even tooth mobility in severe cases.
YOUR DOCTOR
Dra. Cristina Murtra
Postgraduate in Aesthetic Dentistry, UB 2016
Doctorate in Health Sciences, UIC 2014
Implant Dentistry Course, Clínica Aparicio & University of Gothenburg 2012
Conservative Dentistry Course, Studio Vanini 2010
Degree in Dentistry, UIC 2008
Medical Director specialized in aesthetics, oral rehabilitation, and occlusion / TMJ.
Being aware that there is nothing better than giving and receiving smiles, I work hard every day gathering and studying proportions, patterns, and measurements in order to restore them when they have been lost.