Pre-implant surgery

Before fitting a dental implant it may be necessary to perform a small pre-implant surgery to make the part of the mouth that is to be cured ready for the implants.

Our clinic offers outpatient services, carrying out the various types of surgical procedures necessary, including tooth and root extractions (simple or complex), in a painless way.We wish to remind you that immediate load implants have the advantage that they can be fitted in the same sitting as an extraction, using a single anesthetic (post-extraction implant). We also carry out cyst removal and, if necessary, histologic examinations, gum adjustment (gengivoplasty), root canal therapy, and grafts with synthetic material for bone augmentation, if the site where the implant is going to be placed is insufficient.

Surgery for the fitting of delayed load implants (osseointegrated implants) is also carried out in a limited number of cases, in which considerable bone augmentation with synthetic bone grafts is required (e.g. sinus lift, removal of voluminous cysts). In such cases, waiting times before the fitting of the final prothesis are extended by 4/7 months.

Below are the different types of surgical procedures that are carried out at our clinic:

EXTRACTION OF TEETH OR ROOTS AND THIRD MOLARS (WISDOM TEETH)

We carry out all types of tooth and root extraction both simple and complex, using the least invasive techniques possible with the aim of preserving the dental alveoulus (a socket or cavity in the bone which holds the tooth) as intact as possible, for the purpose of the implants.
We pay particular attention to the phases of anaethesia, reducing pain for the patient to a minimum by performing a pre-anaesthesia using a spray.
The extraction of wisdom teeth is common, as patients who don't have sufficient space for these teeth in their mouths are increasingly numerous.
After careful analysis of the X-rays and an orthodontic assessment, we consider possible problems that a wisdom tooth might cause to nearby teeth and whether extraction is necessary.

pre-implant surgery

CYST REMOVAL (CYSTECTOMY)

Cysts are pathological cavities which can increase in size, localized inside the bone or tissue. Covered by a membrane, they may be filled with fluid, semifluid or gaseous contents.

The majority of them (80%) are of an inflammatory origin, like radicular cysts which are the result of the death of the dental nerve (pulpal necrosis) which hasn't been treated, or follicular cysts (11%) which often contain the tooth inside.

The surgery for cyst removal (cystectomy) consists in the complete removal of the cyst sac and assessing, depending on its size, the need to fill the remaining cavity with a synthetic bone graft and closed with a membrane.

GUM ADJUSTMENT (GENGIVAL GRAFT)

To correct any imperfections of the gum which could compromise the aesthetic success of a fixed ceramic prosthesis, or for greater stability of a removable prosthesis, it may be necessary to adjust the contour of the gum, which is sometimes altered by post-extraction scarring.

This minor surgery is usually carried out using electroscalpels or by performing a small transplant of gum taken from the palate.

APICECTOMY

Apicectomy is the surgical removal of a dental root end (apex) together with the surrounding tissue affected by the infection. It is a surgical procedure which usually affects the front teeth (incisors), the canine teeth, both upper and lower premolars and the upper molars for external (vestibular) roots. Apicectomies of lower molars and the palatal roots of the upper molars are more complex because of their position and the difficulty of viewing them. Along with the removal of the apex, the root canal which contains the nerve is also closed.

Apicectomy is generally carried out as a result of an infection around the apex of the root (granuloma) or, in a minor number of cases, because of the presence of rotary instrumentation which have been left in the root canal during surgery.
As in the case of cysts, depending on the size of the granuloma, we assess the need to fill the residual cavity with a synthetic bone graft and close with a membrane.

BONE GRAFTS

When there is lack of adequate bone for the implants to be fitted, when a bone has “bony defects”, or the cavities remaining post-cystectomy or apicoectomy are particularly large, in all cases we resort to Tricalcium Phosphate(TCP)-based synthetic bone grafts.