Orthodontic Procedures
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Orthodontic Tooth Uncovery
The eye teeth (or canines) erupt into the mouth between the ages of 11 and 13. Sometimes they come in the wrong position, and in conjunction with your orthodontist, we need to help them erupt into the mouth. If the tooth is left alone, it will not erupt normally and could damage the roots of the adjacent teeth or even push them out of position.
Other teeth in the mouth, but less commonly, could have the same problem.
Procedure
To expose impacted teeth, anesthetic is placed in the tissues around them. The gum is pushed back to the surface of the tooth at the same time keep all the gum around it. Occasionally some of the bone surrounding the crown of the tooth is removed.
Once the tooth is exposed, your orthodontist will move it into position with a bracket and a chain that will be placed the day of the procedure, either by us or by your orthodontist.
As in any surgical procedure you may experience some soreness afterwards. Follow the postoperative instructions to minimize pain and swelling. A post-op visit will allow us to check the area treated. Further appointments will be necessary with your orthodontist for on-going orthodontic care.
Frenectomy
A frenum is a piece of tissue in the mouth that extends from the lips and the cheek to the gums. (You can probably detect one of your frenums by placing your tongue in the space between your upper lip and your upper front teeth.) There are several different frenums in the mouth and they can attach to the inside of the lip, inside of the cheek or to the bottom of the tongue.
In certain cases a frenum can prevent teeth from staying in place after they have been orthodontically moved together. For example, after a patient's central incisors have been brought together in order to close the space between them, an excessive frenum can possibly cause the teeth to separate again.
In your lower front teeth the frenum can actually pull the gum away from the teeth and cause recession. When a denture patient's lips move, the frenum pulls and loosens the denture, which can be quite upsetting. This surgery is often done to help dentures fit better.
Lingual frenectomy is the removal of the lingual frenum. The lingual frenum attaches the tongue to the floor of the mouth and if it is to short it will cause a tongue-tied patient.
Labial frenectomy is the removal of the frenum between the maxillae or mandibular central teeth.
Procedure
The area is anesthetized, then the frenum is released with an incision. Dissolvable sutures are placed that will dissolve within one week. For children and adolescents, oftentimes nitrous oxide ("laughing gas") is employed to help reduce the patient's anxiety. The frenectomy site will be sore for 24-48 hours, and medications will help alleviate any discomfort. The site will usually be observed a week later to ensure proper healing.
Fiberotomy
Fibers around the teeth hold it in position. These fibers are like rubber bands that are stretched during orthodontic therapy to achieve the alignment of the teeth. If the braces are removed, these fibers will tend to pull the tooth back to its original position. This is called relapse.
A fiberotomy is performed to detach the fibers that attach the tooth to the bone. It is typically done near the completion of the orthodontics and is shown to be effective preventing the relapse of teeth.
This procedure may be a routine component of a comprehensive retention regimen. Consultation with your orthodontist is required when making this decision.
Procedure
We will first anesthetize the area to be treated then we will detach the fibers that attach the tooth to the bone via the gum. No sutures are required.
Very little to no discomfort is expected after this procedure. Mild pain medication is used if necessary.