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Dr. Stier is a Certified Instructor of Implant & Dental Sleep Medicine For the American Academy of Facial Esthetics

 

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Oral Surgery

 

Extractions

Teeth are extracted (pulled) for a variety of reasons. In some cases, extraction may be necessary to remove teeth that are so badly decayed or broken, they cannot be restored. In certain instances this procedure is chosen as an inexpensive alternative to restorations that will actually save the tooth. Teeth may also be extracted prior to orthodontic treatment to make more room in the mouth prior to straightening the remaining teeth or to eliminate teeth that are so badly positioned that straightening is impossible. Tooth extraction is typically performed while the patient is under a local anesthesia such as Novocain and in most cases takes very little time.

When teeth are extracted, patients can and typically do lose 50% -60% of the bone surrounding the extracted tooth within the next year. Replacing that bone with a bone graft shortly after the extraction will eliminate the bone deformity, insure the best results and enable the patient to replace that tooth with subsequent procedures such as implants in less time, and with less expense. In some cases, without a bone graft after surgery, it may be impossible to replace the amount of bone lost over time that would be required for a successful implant thus making that option unavailable. We offer our patients the option of a bone graft to replace missing bone after every extraction for that very reason.

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Wisdom Teeth

What is an impacted wisdom tooth?
A wisdom tooth (or third molar) becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. A wisdom tooth may be partially impacted, which means a portion of it has broken through the gum, or totally impacted and unable to break through the gum at all.

How serious is an impacted wisdom tooth?
Impacted and partially impacted wisdom teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots. More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it. Despite the considerable concern regarding impacted third molars, a recent study sponsored by the American Association of Oral and Maxillofacial Surgeons and the Oral and Maxillofacial Surgery Foundation finds that third molars which have broken through the tissue and erupted into the mouth in a normal, upright position may be as prone to disease as those third molars that remain impacted.

Must a wisdom tooth be removed if it hasnít caused any problems?
Not all problems related to third molars are painful or visible. Damage can occur without your being aware of it. As wisdom teeth grow, their roots become longer, the teeth become more difficult to remove and complications become more likely. In addition, partially or totally impacted wisdom teeth are more likely to cause problems as patientsí age. No one can predict when third molar complications will occur, but when they do, the circumstances can be much more painful and the teeth more difficult to treat. It is estimated that about 85% of third molars will eventually need to be removed.

When should wisdom teeth be removed?
It isnít wise to wait until problems are experienced with wisdom teeth before removing them. In general, earlier removal of wisdom teeth results in a less complicated healing process. The AAOMS/OMSF study strongly recommends that wisdom teeth be removed by the time the patient is in their mid-teenage years in order to prevent future problems and to ensure optimal healing. The researchers found that older patients may be at greater risk for disease, including periodontitis, in the tissues surrounding the third molars and adjacent teeth. Periodontal infections, such as those observed in this study, may affect your general health.

What happens during surgery?
The relative ease with which a wisdom tooth may be removed depends on several conditions, including the position of the tooth and root development. Partially or totally impacted wisdom teeth may require a more involved surgical procedure. Most wisdom tooth extractions are performed under intravenous sedation or general anesthesia. This can essentially eliminate any pain felt during surgery. Your dentist will discuss the anesthetic option that is right for you.

What happens after surgery?
Following surgery, you may experience some swelling and discomfort, which are part of the normal healing process. Cold compresses may help decrease the swelling, and medication prescribed by your dentist can help manage the discomfort. You will be instructed to modify your diet following surgery and later progress to more normal foods.

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Peizosurgery

Piezosurgery brings an entirely new level of precision, finesse, efficiency and safety to oral surgery procedures that few dentists in the region are able to provide to their patients. Whether used for the most involved implant surgeries involving Sinus Grafting and Nerve repositioning or for simple tooth extractions, all surgical procedures performed at Arlington Dental are much easier for patients to go through because of this cutting edge surgical technology made available to them. Reduced chair-time for the patient- along with less post-treatment discomfort- combined with so many successful treatment outcomes has made Arlington Dental one of the most recognized and desirable Oral Surgery Centers between NYC and Albany.

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Bone Grafting

When periodontal disease, extractions or other surgical procedures creates a loss of bone in the jaw, bone grafting is used to increase the height and width of the jawbone and to fill in voids and defects with new bone. This is a key treatment that can be vital to retaining your dental health.
When teeth are extracted, patients can and typically do lose 50% -60% of the bone surrounding the extracted tooth within the next year. Replacing that bone with a bone graft shortly after the extraction will eliminate the bone deformity, insure the best results and enable the patient to replace that tooth with subsequent procedures such as implants in less time, and with less expense. In some cases, without a bone graft after surgery, it may be impossible to replace the amount of bone lost over time that would be required for a successful implant thus making that option unavailable. We offer our patients the option of a bone graft to replace missing bone after every extraction for that very reason.
Through the use of natural bone, synthetic materials, and PRGF technology, bone grafting is a highly successful and effective procedure. We fully examine and evaluate existing bone conditions using CT scan imaging for precision guidance and the procedure is performed in a timely fashion and with minimal if any discomfort.
Where implant surgery is indicated, bone grafting is typically a part of the process. We can perform this procedure in advance of the implant procedure which is highly recommended or during the procedure itself. As mentioned earlier, this procedure is typically more time consuming and more expensive during implant surgery so all steps should be taken to secure this treatment in advance if implant surgery is considered an option for you.

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Dental CT-Scans

Until recently, the only readily available source of Dental CT scans has been at Medical Radiology offices. At Arlington Dental Associates, we diagnose the majority of our patients using the i-Cat 3-D Dental Imaging System, the most advanced, in-office Dental CT scan available in the region. Reduced radiation, greater accuracy and better pre-surgical analysis are only a few of the important reasons our dentists utilize this leading edge equipment. CT scan 3-D views are also extremely valuable in the surgical removal of badly impacted wisdom teeth, cysts and tumors as well as in the treatment of complex root canal problems and patients with chronic jaw pain. But the most important reason of all, is of course, that
we are committed to providing our patients with the best possible treatment plans and utilizing the most up-to date technology available to
insure a successful outcome.

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PRGF

PRGF (Plasma Rich in Growth Factors) is a revolutionary bone and soft-tissue regeneration technique used during oral surgery by the dentists at Arlington Dental. GFs are proteins that play an essential role in the bodyís tissue formation and healing process. They are located in blood plasma and inside the platelets where there are high concentrations of growth factors. When used in oral surgeries, GFs promote a fast response that greatly accelerates the repair and regeneration of tissues and bone. Arlington Dental utilizes the first system in the world designed exclusively for obtaining autologous plasma rich in growth factors directly from small amounts of a patientís blood prior to treatment. During surgery these proteins are utilized to enhance the outcome of the procedure and promote faster healing. The entire process takes only 20 minutes and is completed in our office during preparation for your treatment. This user friendly and affordable process is one of a number of cutting edge technologies utilized at Arlington Dental to provide our patients with the best treatment outcomes possible.

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Perio-plastic Surgery

Perio-plastic surgery is used to restore receding gums, provide additional soft tissue for implants and reshape gum lines for esthetic reasons, particularly in the area of the front teeth. For various reasons, the gums in oneís mouth can recede (or shrink) considerablyórevealing a tooth or implant and exposing part of the dentin- causing sensitivity and perhaps pain. This condition can and usually will become progressively worse over time, leading to bone degeneration and tooth loss which will compromise the gum support around adjacent teeth. In such a situation, it is essential that surgery to reconstruct of the gum tissue be performed. During perio-plastic surgery, gum and connective tissues are taken from the adjacent areas of the mouth (or from a distant area in the mouth, usually from the palate) and placed in the position where the gums should normally be. The results can be dramatic, as your gums can be restored to their original healthy and vital condition. Maintaining good oral hygiene and regular cleanings should keep things

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Poughkeepsie Dental Office - ph. (845) 454-7023
Fishkill Dental Office - ph. (845) 896-4977