Randall LaFrom, DDS COSMETIC AND GENERAL DENTISTRY (408) 996-8595 PH randy@club2000.com

ORAL SURGERY - Treatment of extractions, implants and disorders of the jaw and bone.

Oral Surgery includes a lot more that simply the removal of teeth. It also involves repairing fractures of the jaw, TMJ treatment, skeletal discrepancies (in conjunction with the orthodontist) and implants.

Oral Surgery is a specialty of Dentistry. This means that when a procedure is complex, we would typically refer a patient to a Oral Surgeon. However, most of the time, a procedure can easily be performed in the general dentists office. Extractions are generally one of a few different types. They can be SIMPLE, SURGICAL, IMPACTED, or PARTIALLY IMPACTED. When a tooth is IMPACTED, it means that either the tooth is under the tissue (tissue impacted) or deeper, under the bone (bony impacted). When teeth have had a root canal done on them, they tend to be a little more brittle and they could fracture in the process of removing them. Many baby teeth become "hollowed" out as they are in the process of being replaced by an adult tooth. During that time, the roots could become fragile and easily break off a root, since they are often very thin and fragile. For this reason, we generally prefer to let the baby teeth fall out on their own.

WISDOM TEETH The third molars are the most common teeth that people think of when they think of oral surgery. These teeth generally come out between the ages of 17 and 23, however, they could come out as late at 25 or so. Generally speaking, if your wisdom teeth haven't come out by age 26, then you are probably going to be one of the "lucky" ones who doesn't have to have their wisdom teeth out. Often the wisdom teeth are extracted for a number of reasons. The primary reasons include, they come in crooked, they get decay easily due to their difficult access for cleaning, they are coming in at such an angle that they are pushing the adjacent teeth and/or and they can develop a periodontal pocket easily. They often can become food traps and jeopardize the 2nd molar in front of the wisdom tooth.

PICTURES OF WISDOM TEETH and how they can be concerns... The back wisdom tooth is coming in nearly horizontally and not allowing proper cleansing of the back of the second molar. This can lead to decay on the 2nd molar - which is a more critical chewing tooth. Therefore, the wisdom tooth should be extracted and the 2nd molar restored. This shows another situation where the wisdom tooth is coming in at an angle and because of the slightly bulbous nature of the teeth, the back tooth on the right of the x-ray may never erupt fully. This can lead to a situation similar to the x-ray on the left showing decay getting in the back of the tooth.

IMPLANTS - Replacement for the roots of teeth. When teeth are lost due to decay, trauma, fracture or infection. Dr. LaFrom has been restoring implants for over 20 years. He is experienced in single tooth implants, bridges and overdentures. Our office works very closely with the oral surgeons and periodontists who actually place the implant fixture into the bone to make sure the process goes smoothly. We then come in after the fixture has had time to heal and the bone has had a chance to grow around the implant to hold it solidly in place. From this point, it is a matter of determining the type of restoration that best will serve your needs. The slides below show some of the steps involved in placing an implant. Initial evaluation showing the missing lower front tooth. The bone support is good and the adjacent teeth have no decay. Photo showing the implant fixture placed in the bone, just sticking up out of the tissue. It is placed central between the two teeth. X-ray showing the location of the implant in the bone, replacing the natural root. Photo showing the same patient with the porcelain crown placed over the implant fixture. They are either cemented or screwed into position on the root fixture.

Implant Slide Presentation
1. Showing the implants in the tissue and a regular tooth prepared adjacent to the area.
2. Shows an x-ray of the implants in place with the bone growing around them.
3. Shows an inside view of the actual crown portion of the implant.
4. Shows the implant seated on the fixtures in the mouth.
5. Shows the implant restoration with white composite filling in those holes.
6. Shows a side view of the implants in place (and adjacent crown) on the tissue.

LINKS TO PAGES OUTSIDE ON THE WEB: Wisdom Teeth Extractions - Brought to you by Proctor and Gamble.