Oral Surgery

Dental Implants

What are dental implants?

A natural tooth consists of a root and a crown. If you compare natural teeth to implant-supported replacement teeth, you’ll see they have the same basic parts. Both have a crown (the visible part used to chew food). Both have a root that holds the tooth securely under the gum and is anchored into the jaw. The difference is that the implant is made of titanium – the same time-tested material used by surgeons for artificial joints. When you lose a tooth, you lose both the root and the crown. To replace the tooth, the surgeon first replaces the root with a small dental implant.

Time is allowed for bone to heal and grow around the dental implant. The bone bonds with the titanium, creating a strong foundation for artificial teeth. A support post (abutment) is then placed on the implant and a new replacement tooth (crown) is placed on top of the abutment. In many cases a temporary replacement tooth can be attached to the implant immediately after it is placed. If all of your teeth are missing, a variety of treatment options are available to support the replacement teeth.

Replacing Missing Teeth

Your teeth affect your whole body. When they’re healthy, you’re healthier too. A missing tooth can affect your bite, speech and eating choices. As you rely more on your remaining teeth, you increase the chance they will wear out prematurely, or be damaged or lost. You may also experience headaches and/or jaw pain.

Who would want their appearance and health to deteriorate? That’s the natural consequence of missing teeth – the jaw literally melts away. Generally, people will lose 25% of their supporting jawbone structure within the first year after tooth loss. Dental implants are more easily placed when teeth are first extracted because bone replacement becomes more complex as time passes. The great news? Implants act just like your natural teeth. They safeguard and preserve your bone structure, oral health and appearance. Your dentist and the implant surgeon will provide you with options so that you can make the most informed decision concerning tooth replacement.

Tooth Replacement Options

You can select from a number of different options to replace your missing teeth – from temporary to long-lasting solutions.

A good candidate is anyone missing one or more teeth, or who is unhappy with their dentures. Age is not a factor. However, smoking, diseases such as diabetes, and radiation therapy to the area, have been shown to lower the success rate of implant placement. X-rays of your jaw will be taken to evaluate whether they will accommodate implants. Detailed x-rays may also be required to determine if other tests or procedures are needed to place implants properly.

Dental Implant Surgical Procedure

The procedure to place a dental implant takes 30 to 60 minutes for one implant and only 2 to 3 hours for multiple implants. The number of appointments and time required, vary from patient to patient. The surgeon will bring great precision and attention to the details of your case.

Prior to surgery, you may receive antibiotics and for greater comfort, intravenous sedation or nitrous oxide (laughing gas). These options are discussed with you at your consultation appointment. A local anesthetic will be administered to numb the area where the dental implant will be placed.

When you are comfortable, the surgeon makes a small incision in the gum tissue to reveal the bone, creates space using special instruments, and gently inserts the titanium implant. The top of this implant is often visible through the gum. Sometimes it is better in the early stages of healing to have the implant covered by the gum tissue.

Healing after Dental Implant Surgery

Now the healing begins. The length of time varies from person to person, depending upon the quality and quantity of bone. In some cases, implants may be restored immediately after they are placed. The surgeon will advise you on follow-up care and timing. After the initial phase of healing, the surgeon places an abutment (support post) or a healing cap onto the dental implant during a brief follow-up visit. This allows gum tissue to mature and provides access to the implant.

Occasionally, impressions are made at the time the implant is placed. This enables the crown to be ready when the implants have healed. How long your mouth needs to heal is determined by a variety of factors. Follow-up care (one to four appointments) is usually needed to ensure that your mouth is healing well and to determine when you are ready for the restorative phase of your treatment.

It may be beneficial to perform a soft tissue graft to obtain stronger, more easily cleaned and natural appearing gum tissue in the area around the implant. This process involves moving a small amount of gum tissue from one part of your mouth to the area around the implant. Most often, it is a brief and relatively comfortable procedure.

Whether it’s one tooth or all of your teeth that are being replaced, your dentist will complete the restoration by fitting the replacement tooth (crown) to the dental implant.

Bone Grafting for Implants

Do I have enough bone for dental implants?

After tooth extraction, if the walls of the socket are very thick, they will usually fill naturally with bone in two to three months. However, when the walls of your socket are very thin (such as in your upper and lower front teeth), this type of healing will not be as predictable. In these situations, a bone graft is often placed at the time of tooth extraction to help your body fill in the empty socket with bone. This step will maintain the width and volume of bone you will need for implant placement several months later.

There may be inadequate bone for implant placement if your tooth was removed many years ago and your bony ridge is extremely thin. In this case, a bone graft can be placed next to the thin bone and allowed to heal for up to six months. After the graft has fused to your pre-existing bone, the ridge will be re-entered and the implant placed. Bone grafting is usually a relatively comfortable office procedure. Many different bone-grafting materials are available, including your own bone.

You may also need bone grafting if the sinus cavities in your upper jaw are very large, or very low, and extend into the tooth-bearing areas. This often occurs when teeth in the back of a person’s upper jaw have been removed many years before, and the amount of bone available for implant placement is limited. A “sinus grafting procedure” is then required. Most often, it is performed in the office with local anesthesia and perhaps sedation. During this procedure, the membrane that lines the sinus will be located and elevated. Bone will then be added to restore the bone height and ensure that dental implants of an adequate length can be placed. This procedure often can be performed at the time of implant placement.

Teeth-In-An-Hour^TM

TEETH-IN-AN-HOUR™ is a revolutionary concept providing patients with fully functioning teeth on dental implants in a single procedure that takes about an hour. This technology was developed by Nobel Biocare and utilizes collaboration between both the restorative doctor and the oral surgeon. This merging of knowledge and experience achieves not only increased safety, but also a more precise implant placement. In addition, the fabrication of a final prosthesis is completed prior to the surgery. The computer-guided implant surgery is done in an arthroscopic fashion without requiring any flap reflection. This benefits the patient in that there is less postoperative discomfort, less swelling, and less bruising. Patients can often resume their normal activities the next day.

The process begins when a CAT scan is taken of the patient’s jaw bone. This CAT scan allows for the generation of a three-dimensional model of the jaw bone that can then be used with virtual reality software to plan the implant placement without the presence of the patient. The results are a more accurate implant placement and less chair time for the patient.

Bone Grafting

What is Bone Grafting?

Over a period of time, the jaw bone associated with missing teeth atrophies and is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for the placement of dental implants. In these situations, most patients are not candidates for the placement of dental implants.

With bone grafting we now have the opportunity to not only replace bone where it is missing, but we also have the ability to promote new bone growth in that location. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.

Types of Bone Grafts:

Autogenous Bone Grafts
Autogenous bone grafts, also known as autografts, are made from your own bone, taken from somewhere else in the body. The bone is typically harvested from the chin, jaw, lower leg bone, hip, or the skull. Autogenous bone grafts are advantageous in that the graft material is your own live bone, meaning it contains living cellular elements that enhances bone growth, also eliminating the risk of your body rejecting the graft material since it comes from you.

However, one downside to the autograft is that it requires a second procedure to harvest bone from elsewhere in the body. Depending on your condition, a second procedure may not be recommended.

Allogenic Bone
Allogenic bone, or allograft, is dead bone harvested from a cadaver, then processed using a freeze-dry method to extract the water via a vacuum. Unlike autogenous bone, allogenic bone cannot produce new bone on it’s own. Rather, it serves as a framework, or scaffold, over which bone from the surrounding bony walls can grow to fill the defect or void.

Xenogenic Bone
Xenogenic bone is derived from non-living bone of another species, usually a cow. The bone is processed at very high temperatures to avoid the potential for immune rejection and contamination. Like allogenic grafts, xenogenic grafts serve as a framework for bone from the surrounding area to grow and fill the void.

Both allogenic and xenogenic bone grafting have an advantage of not requiring a second procedure to harvest your own bone, as with autografts. However, because these options lack autograft’s bone-forming properties, bone regeneration may take longer than with autografts, and have a less predictable outcome.

Jaw Bone Health

The Importance of Teeth for Jaw Bone Health

When one or more teeth are missing it can lead to bone loss at the site of the gap. This loss of jaw bone can develop into additional problems, both with your appearance and your overall health. You may experience pain, problems with your remaining teeth, altered facial appearance, and eventually even the inability to speak and/or eat normally.

In the same way that muscles are maintained through exercise, bone tissue is maintained by use. Natural teeth are embedded in the jaw bone and stimulate the jaw bone through activities such as chewing and biting. When teeth are missing, the alveolar bone, or the portion of the jaw bone that anchors the teeth into the mouth, no longer receives the necessary stimulation it needs and begins to break down, or resorb. The body no longer uses or “needs” the jaw bone, so it deteriorates.

Potential Consequences of Tooth and Jaw Bone Loss

Problems with remaining teeth, including misalignment, drifting, loosening, and loss
Collapsed facial profile
Limited lip support
Skin wrinkling around the mouth
Distortion of other facial features
Difficulty speaking and communicating
Inadequate nutrition as a result of the inability to chew properly and painlessly
Sinus expansion

Major and Minor Bone Grafting

Missing teeth over a period of time can cause your jaw bone to atrophy, or resorb. This often results in poor quality and quantity of bone suitable for the placement of dental implants as well as long term shifting of remaining teeth and changes to facial structure. Most patients, in these situations, are not candidates for dental implants.

Fortunately, today we have the ability to grow bone where it is needed. This not only gives us the opportunity to place implants of proper length and width, but it also gives us a chance to restore functionality and aesthetic appearance.

Major Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum to protect the bone graft, as well as encourage bone regeneration. This is called guided bone regeneration, or guided tissue regeneration.

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different areas depending on the size needed. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

Ridge Augmentation

What is a ridge augmentation?

A ridge augmentation is a common dental procedure often performed following a tooth extraction. This procedure helps recreate the natural contour of the gums and jaw that may have been lost due to bone loss from a tooth extraction, or for another reason.

The alveolar ridge of the jaw is the bone that surrounds the roots of teeth. When a tooth is removed an empty socket is left in the alveolar ridge bone. Usually this empty socket will heal on its own, filling with bone and tissue. Sometimes when a tooth is removed the bone surrounding the socket breaks and is unable to heal on its own. The previous height and width of the socket will continue to deteriorate.

Rebuilding the original height and width of the alveolar ridge is not always medically necessary, but may be required for dental implant placement or for aesthetic purposes. Dental implants require bone to support their structure and a ridge augmentation can help rebuild this bone to accommodate the implant.

How is a ridge augmentation accomplished?

A ridge augmentation is accomplished by placing bone graft material in the tooth socket. It is often done immediately after the tooth is removed to avoid the need for a second procedure later. Next, the gum tissue is placed over the socket and secured with sutures. Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker may choose to use a space-maintaining product over the top of the graft to facilitate new bone growth. Once the socket has healed, the alveolar ridge can be prepared for dental implant placement.

A ridge augmentation procedure is typically performed in Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker‘s office under local anesthesia. Some patients may also request sedative medication.

Sinus Lift

What is a sinus lift?

The maxillary sinuses are behind your cheeks and on top of the upper teeth. These sinuses are empty, air-filled spaces. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

The key to a successful and long-lasting dental implant is the quality and quantity of jaw bone to which the implant will be attached. If bone loss has occurred due to injury or periodontal disease, a sinus augmentation can raise the sinus floor and allow for new bone formation. A sinus lift is one of the most common bone grafting procedures for patients with bone loss in the upper jaw. The procedure seeks to grow bone in the floor of the maxillary sinus above the bony ridge of the gum line that anchors the teeth in the upper jaw. This enables dental implants to be placed and secured in the new bone growth.

Am I a candidate for a sinus lift procedure?

A sinus lift may be necessary if you:

are missing more than one tooth in the back of your jaw
are missing a significant amount of bone in the back of your jaw
are missing teeth due to a birth defect or condition
are missing most of the maxillary teeth and require support for dental implants

How is a sinus lift accomplished?

Most commonly, a small incision is made on the premolar or molar region to expose the jaw bone. A small opening is cut into the bone, and the membrane lining the sinus is pushed upward. The underlying space is filled with bone grafting material, either from your own body or from a other sources. Sometimes, synthetic materials that imitate bone formation are used. After the bone is implanted, the incision is sutured and the healing process begins. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in the newly formed sinus bone.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to sufficiently stabilize the implant, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the sinus augmentation will have to be performed first, then the graft will have to mature for up to several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.

The sinus graft makes it possible for many patients to have dental implants that previously had no other option besides wearing loose dentures.

A sinus augmentation is generally performed at Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker‘s office, under local anesthesia. Some patients may request oral or intravenous sedative medication as well.

Nerve Repositioning

The inferior alveolar nerve, which gives feeling to the lower lip and chin, may need to be moved in order to make room for the placement of dental implants in the lower jaw. A nerve repositioning procedure is limited to the lower jaw and may be indicated when teeth are missing in the area of the two back molars and/or second premolars. This procedure is considered a very aggressive approach since there is almost always some postoperative numbness of the lower lip and jaw area, which typically dissipates very slowly, but may be permanent. Usually other, less aggressive options are considered first (placement of blade implants, etc).

Typically, we remove an outer section of the cheek on the side of the lower jaw bone in order to expose the nerve and vessel canal. We then isolate the nerve and vessel bundle in that area and slightly pull it out to the side. We then place the implants while tracking the neuro-vascular bundle. Then the bundle is released and placed back over the implants. The surgical access is refilled with bone graft material of the surgeon’s choice and the area is closed.

These procedures may be performed separately or together depending upon the individual’s condition. As stated earlier, there are several areas of the body that are suitable for attaining bone grafts. In the maxillofacial region bone grafts can be taken from inside the mouth, in the area of the chin or third molar region, or in the upper jaw behind the last tooth. In more extensive situations a greater quantity of bone can be attained from the hip or the outer aspect of the tibia at the knee. When we use the patient’s own bone for repairs or additions, we generally get the best results.

In many cases, we can use allograft material to implement bone grafting for dental implants. This bone is prepared from cadavers and is used to get the patient’s own bone to grow into the repair site. It is quite effective and very safe. Synthetic materials can also be used to stimulate bone formation. We even use factors from your own blood to accelerate and promote bone formation in graft areas.

These surgeries are performed in the out-office surgical suite under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day, as well as limited physical activity for one week.

Wisdom Teeth

What are wisdom teeth?

Third molars are commonly referred to as wisdom teeth. They are usually the last teeth to develop and are located in the back of your mouth, behind your second molars. Their development is usually completed between the middle teenage years and early twenties, a time traditionally associated with the onset of maturity and the attainment of wisdom

Impacted Wisdom Teeth

Types Of Impactions

We will need to see you for a consultation to determine if you will benefit from wisdom tooth removal. A special x-ray of your mouth and jaws (panorex) will be taken to determine if your wisdom teeth are impacted, if there is room for them to erupt, and how difficult it will be to have them removed.

Soft Tissue Impaction: There is not enough room to allow the gum tissue to retract for adequate cleaning of the tooth.
Partial Bony Impaction: There is enough space to allow the wisdom tooth to partially erupt. However, the tooth cannot function properly in the chewing process, and creates cleaning problems, among others.
Complete Bony Impaction: There is NO space for the tooth to erupt. It remains embedded in the jaw bone or if even partially visible requires complex surgical techniques for removal.The impacted wisdom tooth may also be in an unusual position and difficult to remove. This situation can also arise when the shape or size of the jaw bone and other facial structures make removal of this tooth significantly more complex.

Wisdom Teeth Removal

Oral Examination for Extraction of Wisdom Teeth

With an oral examination and x-rays of the mouth, Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker can evaluate the position of the wisdom teeth and predict if there are present or future potential problems. Studies have shown that early evaluation and treatment result in a superior outcome for the patient. Patients are generally first evaluated in the mid-teenage years by their dentist, orthodontist, or by an oral and maxillofacial surgeon.

All outpatient surgery is performed under appropriate anesthesia to maximize patient comfort. Our doctors are trained, licensed, and highly experienced in providing various types of anesthesia for patients.

Why should I have my wisdom teeth removed?

If you do not have enough room in your mouth for your third molars to fully erupt, a number of problems can happen. Impacted wisdom teeth should be removed before their root structure is fully developed. In some patients it is as early as 12 or 13, and in others it may not be until the early twenties. Problems tend to occur with increasing frequency after the age of 30. Some of the possible problems related to not removing your wisdom teeth include:

Infection
Cyst Formation
Possible Crowding
Damage to Adjacent Teeth

What if I don’t have my wisdom teeth removed as a teenager or young adult?

As wisdom teeth develop, the roots become longer and the jaw bone more dense. When it is necessary to remove impacted wisdom teeth in your thirties, forties or beyond, the post-operative course can be prolonged and there is a higher complication rate. Treating these complications is often more difficult and less predictable than with a younger patient. Healing may be slower and the chance of infection can be increased. If your impacted wisdom teeth are not removed in your teenage years or early in your twenties and they are completely impacted in bone, it may be advisable to wait until a localized problem (such as cyst formation or localized gum disease and bone loss) develops. In general, you will heal faster, more predictably and have fewer complications if treated in your teens or early twenties.

After Extraction

In most cases, the removal of wisdom teeth is performed under local anesthesia, laughing gas (nitrous oxide/oxygen analgesia), or general anesthesia. These options, as well as the surgical risks (i.e., sensory nerve damage, sinus complications), will be discussed with you before the procedure is performed. Once the teeth are removed, the gum is sutured. To help control bleeding bite down on the gauze placed in your mouth. You will rest under our supervision in the office until you are ready to be taken home. Upon discharge your postoperative kit will include postoperative instructions, a prescription for pain medication, antibiotics, and a follow-up appointment in one week for suture removal. If you have any questions, please do not hesitate to call us.

Our services are provided in an environment of optimum safety. We utilize modern monitoring equipment and our staff are experienced in anesthesia techniques.

What will I feel like after wisdom teeth removal surgery?

On the first day after wisdom teeth removal surgery, you may experience some minor bleeding and pain. You should cover your pillowcase with something so that you don’t get any blood on it. Each individual’s reaction to surgery varies, and the sensation of pain can range from mild discomfort to severe pain. A variable amount of swelling can be expected following the surgery. This swelling usually peaks on the second day and should begin resolving on the third day. You can limit the amount of swelling you will have by using ice for the entire first day. The more ice you use the first day, the less swelling you are likely to have on the second day. Please remember to put ice on the first day even if it is somewhat uncomfortable to have the cold next to your skin. On the third day, you will notice that your jaw muscles are stiff, and it is difficult to open your mouth normally. You can apply moist heat to your face on the second and third day allowing your muscles to relax more and open wider. Most of the time you will want to limit your activities for a few days. We ask that you follow your post-operative instructions closely. Doing so will make you as comfortable as possible during the first few days following your procedure. Please allow time for your body to begin healing before resuming an active social, academic, or athletic schedule. Most patients feel like they are over the hump and on their way to recovery in 3 to 5 days.

Are there any problems after the extraction of wisdom teeth?

As with any medical procedure, there can be complications or an unanticipated result. Some complications that patients undergoing wisdom tooth extraction may experience include:

damage to the sensory nerve that supplies sensation to the lips and tongue
sinus communication
infections
dry sockets

After the procedure, our assistants will review your post-operative instructions with your escort. We ask that you follow these instructions closely, as they will make you most comfortable following your procedure. If you were sedated, you will be comfortable and drowsy when you leave the office. Most patients prefer to go home and rest with no other physical or scholastic activities planned for a few days. With any medical procedure, there can be unexpected results. These can include delayed healing, infection and post-operative numbness or tingling in your lip, chin, or tongue. Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker will review relevant post-operative events with you and answer any questions during your office visit.

Tooth Extractions

You and Drs. Hymovitch, Lally, Ahmed, Colorado, Gano, Elseed, Sather, Sadykov, Salazar, Heslington, Yabroudi, Velangi, Sorenson, Carroll, Taylor or Becker may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or have broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment.

The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health.

To avoid these complications, in most cases, Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker will discuss alternatives to extractions as well as replacement of the extracted tooth.

The Tooth Extraction Process

At the time of extraction the doctor will need to numb your tooth, jaw bone and gums that surround the area with a local anesthetic.

During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking the tooth in order to widen the socket for removal.

You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected.

If you do feel pain at any time during the extraction please let us know right away.

Sectioning a Tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

Platlet Rich Plasma

Platelet rich plasma (PRP) is a by-product of blood (plasma) that is rich in platelets. Until now, its use has been confined to the hospital setting. This was due mainly to the cost of separating the platelets from the blood and the large amount of blood needed to produce a suitable quantity of platelets. New technology permits doctors to harvest and produce a sufficient quantity of platelets from only 55 cc of blood, which is drawn from the patient while they are having outpatient surgery.

Why all the excitement about PRP?

PRP permits the body to take advantage of the normal healing pathways at a greatly accelerated rate. During the healing process, the body rushes many cells and cell-types to the wound in order to initiate the healing process. One of those cell types is platelets. Platelets perform many functions, including formation of a blood clot and release of growth factors (GF) into the wound. These growth factors; platelet derived growth factors (PDGF), transforming growth factor beta (TGF), and insulin-like growth factor (ILGF), function to assist the body in repairing itself by stimulating stem cells to regenerate new tissue. The more growth factors released and sequestered into the wound, the more stem cells are stimulated to produce new tissue. Thus, PRP permits the body to heal faster and more efficiently.

A subfamily of TGF, is bone morphogenic protein (BMP). BMP has been shown to induce the formation of new bone in research studies in both animals and humans. This is of great significance to the surgeon who places dental implants. By adding PRP, and BMP, to the implant site with bone substitute particles, the implant surgeon can now grow bone more predictably and faster than ever before.

3D Imaging

Cone Beam CT Scan

The CS 9300 system gives our oral and maxillofacial practice state-of-the-art technology to help Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker diagnose potential issues more accurately and provide treatment with unprecedented confidence. Unlike a traditional spiral CT scanner, this 3D system utilizes cone beam CT technology and provides precise, crystal-clear digital images while minimizing your exposure to radiation.

Our new 3D system enables us to perform a wider range of diagnoses and treatments in our office, helping to reduce multiple visits. The CS 9300 scanner allows us to choose the field of view, or scanning area, that best suits your specific treatment needs. This helps to limit your radiation exposure because we are focusing specifically on your area of concern.

The CS 9300 system brings the latest 3D technology to Valley Endodontics and Oral Surgery, providing unmatched visualization of anatomical detail which aids in treatment planning and helps us to better explain the particulars of your case, as well as address any questions you may have. Drs. Velangi, Sorensen, Carroll, Grousd, Nguyen, Taylor and Becker can use this innovative technology to quickly and easily share 3D images of the area of concern with your referring doctor – allowing the doctors to collaborate on your care, improving your experience, and delivering a positive treatment outcome.

Anesthesia

Several methods of anesthesia are available. The method of anesthesia that is chosen for or by a patient depends upon the nature of the surgical procedure and the patient’s level of apprehension.

Anesthesia Options

The following table illustrates the choices of anesthesia, a description of the anesthetic technique, and the usual indications for that technique.

Local Anesthetic
Nitrous Oxide Sedation with Local Anesthetic
Office Based General Anesthesia with Local Anesthetic*
Hospital or Surgery Center Based General Anesthesia

To administer general anesthesia in the office, an oral surgeon must have completed at least three months of hospital based anesthesia training. Qualified applicants will then undergo an in office evaluation by a state dental board appointed examiner. The examiner observes an actual surgical procedure during which general anesthesia is administered to the patient. The examiner also inspects all monitoring devices and emergency equipment and tests the doctor and the surgical staff on anesthesia related emergencies. If the examiner reports successful completion of the evaluation process, the state dental board will issue the doctor a license to perform general anesthesia. The license is renewable every two years if the doctor maintains the required amount of continuing education units related to anesthesia.

Again, when it comes to anesthesia, our first priority is the patient’s comfort and safety. If you have any concerns regarding the type of anesthesia that will be administered during your oral surgery procedure, please do not hesitate to discuss your concerns with your doctor at the time of your consultation.