Wisdom tooth extraction is one of the most common types of oral surgery and involves the removal of impacted or “stuck” wisdom teeth. Alveoplasty is another commonly performed procedure which involves reshaping and contouring of bony areas in order to improve function and appearance. Vestibuloplasty is a procedure used to reduce gum recession by increasing the volume of tissue around teeth affected by periodontal disease. Lastly, enhancing bone density can be done through a variety of methods such as bone grafting or guided tissue regeneration.

Impacted wisdom teeth (i.e., those that have failed to erupt through the gum line) fall into one of several categories:

• Mesioangular impaction is the most common form (44%), and means the tooth is angled forward, towards the front of the mouth.
• Vertical impaction (38%) occurs when the formed tooth does not erupt fully through the gum line.
• Distoangular impaction (6%) means the tooth is angled backward, towards the rear of the mouth.
• Horizontal impaction (3%) is the least common form, which occurs when the tooth is angled fully 90 degrees sideways, growing into the roots of the second molar

Persons who wear dentures generally notice that, over time, the appliances becomes looser and looser, usually requiring relining of the denture plate or requiring the individual to undergo refitting for new dentures. Whether missing one tooth, the lower or upper teeth, or an entire mouthful of teeth, the gums and underlying bone typically deteriorate. After the loss of each tooth, the body reabsorbs the bone tissue causing shrinkage. The membranes and tissues covering the bone also diminish. This needs to be corrected to enables a better fit of dentures.

When one or more permanent teeth are lost due to extraction, injury or accident, each absent tooth leaves a hole in the jawbone. Although the gums will heal over the hole, the underlying jaw bone will inevitably have high and low points causing restorations such as dentures to rub against high points, create sore spots, and fit poorly. Furthermore, over time, the edentulous (toothless) area of the jaw will also lose a significant amount of bone, causing thinning of the top ridge and again making proper denture fit a nightmare. Finally, some people simply have a little extra bone jutting out from the main jawbone, preventing correct denture fitting as well.

We often perform alveoplasty during the same appointment with single or multiple extractions. In such cases, we’ll do the extractions first. Then, to begin the alveoplasty procedure, your surgeon will simply make a careful incision in the gum tissue, peel it back to expose the bone, remove excess bony areas with clippers and a rotary drill, then smooth the section with a file. After smoothing the bone, your surgeon will remove bone particles via irrigation, then suture the entire incision closed. Typically, we’ll use a locking-suture technique to minimize bleeding and seal the tissue efficiently.

Sometimes dentists will have taken an impression of your jaw and prepare a model (or stent) as a means of indicating precisely where bone must be removed. In such cases, the surgeon will replace the gum tissue over the smoothed bone, place the stent on top, and reshape the bone as needed to accommodate.