As the name suggests, this specialty is all about surgical procedures in the area of the mouth, more specifically the teeth and tissues surrounding the teeth. Two sub-areas are distinguished here, namely general or dento-alveolar surgery and special, gingival or periodontal surgery. General oral surgery includes all surgical and non-surgical types of tooth removal, apicoectomy, and treatment of cystic or inflammatory processes in the jawbone. Gingival surgery is all about interventions around the gums and the reconstruction of periodontal and gingival defects.
Implantation surgery also represents a special position and its own discipline. In this process, artificial tooth roots made of titanium or ceramic, so-called implants, are inserted into the bone in order to anchor or attach a fixed or removable denture to them later. Furthermore, implants are also used to anchor epitheses (facial defect prostheses), as may be necessary after extensive tumor operations.
In the majority of cases, the conditions for implant placement are not particularly favorable, but this can usually be compensated for by simultaneous bone augmentation (building up of the local, implant-bearing bone) during implant placement. In particularly unfavorable cases, a two-stage procedure is necessary, which means that bone augmentation must take place first, usually in conjunction with bone grafting, in order to be able to perform an implantation at all at a later stage. Highly complex cases are often reconstructed with bone grafts from the hip region, which of course cannot be performed on an outpatient basis but requires a clinical stay. In these cases, we will refer you to the appropriate specialists, with whom we will plan and, if necessary, perform the procedure together.
Gingival surgery is all about interventions around the gums as well as reconstruction of periodontal and gingival defects, such as bone grafts and augmentations (bone augmentation) with own bone and/or bone substitutes as well as periodontal regeneration using enamel matrix proteins. An increasingly important point in gingival surgery are so-called recession coverings, which means covering exposed tooth necks with gum again (see below). Local osseous augmentation is also frequently performed in conjunction with implant placement or to preserve bone (ridge preservation and socket preservation) after tooth extraction to improve or optimize esthetic and functional parameters for subsequent delayed implant placement.
Furthermore, this field also includes the transplantation of mucosa and/or connective tissue for local soft tissue reconstruction and augmentation, for gingival relining for functional and esthetic reasons, and for tissue stabilization in very thin mucosa.
You could almost say that implants are already in everyone’s mouth today, at least when it comes to the level of awareness of these artificial tooth roots. In fact, the percentage of patients choosing an implant or implant-supported restoration is steadily increasing each year.
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As described above, in a large proportion of patients implants can only be inserted in conjunction with bone augmentation because the existing bone is no longer present or is no longer present to a sufficient degree.
In some bone augmentations and/or transplants, the regional soft tissue must be mobilized to such an extent that it unfortunately becomes even thinner in the process than it already was before. However, in order to achieve a good result after healing, a certain gum thickness is required.
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Free tooth necks are not only the result of advanced periodontal diseases, but are usually also a consequence of excessive and forced tooth brushing, often still in combination with the wrong brushing technique or wrong toothbrushes.
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