1150 NW Maynard Rd · Cary, NC

Oral Surgery · Cary & Raleigh, NC

Oral Surgery

For the best dentist in Cary, NC, look no further than Smiles of Cary.

A patient having a 3D dental imaging scan at Smiles of Cary
Five Surgical Topics Call (919) 646-6538 to ask about oral surgery and what your treatment would involve.
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One practice, many procedures

Surgical Care In One Place

For the best dentist in Cary, NC, look no further than Smiles of Cary.

In addition to a full range of other dental services, Smiles of Cary is Cary, NC’s best choice dentist for dental surgery, dental implants, extractions, sedation dentistry, sinus grafts and more.

Extractions and sedation

What Oral Surgery Covers

Extractions

Tooth extraction may be necessary in order to prevent dental infection from spreading to gums and other teeth. The process is done with the help of local anesthesia. It may be a simple procedure where elevators and forceps are used to pull out the tooth. In some cases a surgery may be necessary to carefully extract the tooth which is a threat. The dentist may remove certain gum tissues and bone to be able to remove the tooth. Extraction of an impacted wisdom tooth may also involve sectioning of the tooth structure. Apart from wisdom teeth extraction there can be other complex conditions which require oral surgery. Some examples are teeth with curved roots, cracked tooth and broken tooth.

Sedation Dentistry

Fear of dental treatment is one of the reasons why patients avoid visiting dental practice. Although most of the treatments performed with the help of local anaesthesia relieve patients from pain, the anxiety in them is hard to combat. Sedation dentistry is a method of using special agents to ease patients during dental treatment. From moderate to deep sedation there are various levels which help dentists relieve patients from anxiety so that they can concentrate on treatment. Over-the-counter sedatives and nitrous oxide are commonly used by dentists. Other higher levels of sedation may require training, license and specialized equipment for monitoring patients. Irrespective of the type of sedation the patient should be constantly monitored during the treatment and for few hours after the treatment in order to ensure that the process is safe.

Replacing a lost tooth

Dental Implants

When you lose a tooth, the part of your jaw that housed the tooth begins to shrink in the area the tooth is lost. Neighboring teeth and opposing teeth begin to move into the space that that tooth once occupied. This can cause food lodgement, subsequent decay, and gum disease.

This shrinking can also cause changes in your mouth that might lead to fractures in your teeth. Those fractures may necessitate a root canal treatment or an extraction. Loss of teeth can also cause the cheek and lips to collapse making you look older than you need to look.

The good news is that these complications can be prevented by replacing the lost tooth in a timely manner.

Dr. Charles Ferzli pointing out a 3D scan on his monitor during a consultation at Smiles of Cary
Your options for replacing a missing tooth
Dental implants

While there are several options to replace a missing tooth, the best choice for replacing lost teeth are dental implants.

Implants are tiny titanium screws or posts that are surgically placed in the bone. Once placed, they act like roots onto which small posts are attached which protrude through the gums. These posts provide stable anchors for replacement teeth. Implants maintain the stimulation on the bone in your jaw, preventing the shrinking effect mentioned above. Since implant posts are titanium, there is no risk of decay on implants. Implants can serve you for years with regular professional cleaning and proper home care.

A fixed bridge

Many people who are missing a single tooth opt for a fixed bridge, but a bridge may require the cutting down of healthy, adjacent teeth that may or may not need to be restored in the future. There is also the additional cost of possibly having to replace the bridge once, twice, or more over the course of a lifetime due to decay or gum problems affecting the anchor teeth.

A removable denture

Another option to replace missing teeth is a removable partial denture, or a complete denture depending on the number of teeth missing. When a denture is removed, however, chewing efficiency is less than half of that of natural teeth. The teeth that support the partial denture are weakened due to the excessive loads acting on them and may eventually be lost. A denture rests on the gums causing tissue abrasion and bone loss. Removable dentures may even slip or cause embarrassing clicking sounds while eating or speaking.

What the studies show

Studies show that, within five to seven years, there is a failure rate of up to 30% in teeth located next to a fixed bridge or removable partial denture.

What this means for you is that if you have a missing tooth, implants are likely the very best choice. And the best dentist in Cary, NC for dental implants is Smiles of Cary.

Suitability

Who is a candidate for Implants?

Anyone who is missing one or more teeth is a candidate for implants. With the exception of growing children, dental implants are the solution of choice for people of all ages, even those with the following health concerns:

  • Existing Medical Conditions: If you can have routine dental treatment, you can generally have a dental implant placed. While precautions are advisable for certain conditions, patients with such chronic diseases as high blood pressure and diabetes are usually successful candidates for dental implant treatment.
  • Gum Disease or Problem Teeth: Almost all dental implants placed in patients who have lost their teeth to periodontal disease or decay have been successful.
  • Currently Wearing Partials or Dentures: Dental implants can replace removable bridges or dentures, or they can be used to stabilize and secure the denture, making it much more comfortable.
  • Smokers: Although smoking lowers the success rate of dental implants, it doesn’t eliminate the possibility of getting them.
  • Bone Loss: Bone loss is not uncommon for people who have lost teeth or had periodontal disease. Oral and maxillofacial surgeons are trained and experienced in grafting bone to safely and permanently secure a dental implant.

Dental implants for children are usually deferred until their jaw growth is complete. There are, however, some instances when a dental implant may be appropriate, such as when it is part of the child’s orthodontic treatment plan. Smiles of Cary, or your orthodontist can guide you in this instance.

Procedure

Dental implant placement usually takes two surgical appointments:

  • During the first dental surgery appointment the implant site is prepared to receive the dental implant following strict aseptic procedures. The selected size of the implant is placed in the prepared site. The gum tissue is sutured over the implant. The implant takes 4 to 6 months to fuse with the bone.
  • During the second surgical appointment the dental implant is uncovered and the appropriate post is attached to which the replacement tooth is anchored. An impression of the post is taken and sent to the lab for the fabrication of the implant crown. During this time a temporary crown is placed. Once the final crown is back it is cemented with permanent cement.
Illustration of an implant-supported overdenture lifted above four implants fixed in the lower jaw
Bone for the upper jaw

Sinus Grafts

Sinus graft is a surgery performed to add bone to help replace a missing back tooth in the upper jaw. Tooth loss may lead to shrinkage of jaw bone in the maxillary sinus floor. A dental implant surgery requires enough bone volume to hold the implant. Sinus graft is a complex surgery where a lateral opening is made and the soft skin of the maxillary sinus is separated from the bone in order to build the bone using substitute material. The process requires exceptional skills from the dentist.

After an extraction

Bone Grafts

Extraction of a tooth causes resorption of the supporting bone. Bone resorption causes a 40 to 60% decrease in its width during the first three years following extraction. Bone resorption occurs at the expense of the outer plate of bone reducing the width of bone. Then over time the height of bone is reduced. This becomes critical for anterior implants where ideal aesthetics, phonetics and function is desired. In the upper jaw following extraction the sinus floor begins to expand further decreasing the available bone to place implants in the posterior maxilla. In the lower jaw the mandibular nerve runs in the bone limiting the length of the implant placed.

Bone grafting can be used as a socket preservation procedure when it is placed following extraction of a tooth or to augment an atrophied or reabsorbed site.

Bone Grafting Procedures
Ridge Augmentation

In severe cases of ridge resorption bone graft is placed to increase the ridge height and or width.

Sinus Lift and Graft Procedure

This procedure involves elevating the sinus membrane and placing the bone graft onto the sinus floor, allowing implants to be placed in the back part of the upper jaw.

Nerve Repositioning

The mandibular nerve may need to be moved in order to make room for placement of dental implants in the lower jaw.

These procedures may be performed separately or together, depending upon the individual’s condition. There are several areas of the body which 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.

Several bone augmentation materials are available to stimulate and encourage bone growth in areas where it is lost as a result of pathological or physiological processes.

Bone grafting materials can be derived from various sources:

  • Allograft materials derived from cadaver bone of the same species
  • Autogeneous material derived from the recipient’s intra-oral or extra-oral site
  • Alloplastic materials are exclusively derived from synthetic sources
  • Xenografts derived from the inorganic portion of animal bone

Bone grafting will help to place larger diameter implants in ideal locations that are stable and serviceable for a long time. It also helps to establish normal volume and dimensions of bone for ideal aesthetics, lip support and phonetics.

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Testimonials

Real Stories, Real Care

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Aleks Korda
67 days ago
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Just had my initial visit with Alicia and Dr. Lee and I have nothing but good things to say. The front staff, hygienist, and dentist mentioned above were welcoming, thorough, and put me at ease. They listened and actually cared!
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Jorge Rendon Pineda
110 days ago
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Super profesionales
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Jessica Ekstrom
118 days ago
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Such a great experience! Dr. Ferzli is the best.
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Stacy
132 days ago
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Great staff! Always kind and patient! I will recommend them to anyone
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Marko Sun
133 days ago
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Been coming here for years and all the dentists and staff are super helpful and knowledgeable. Highly Recommend!
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MaverickSuper
142 days ago
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I am writing to share my excellent experience at your practice today. The professionalism and empathy displayed by your staff completely alleviated my concerns. The treatment was exceptional, and the clear communication regarding my care plan was greatly appreciated. Please extend my thanks to the team for their outstanding service.
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kenneth Arcudia
143 days ago
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Great service and attention on detail!
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Daniel Osborne
143 days ago
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Excellent service, the hygienist was friendly and efficient with time. They didn't seem to push unneeded services
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Chaithanya Pundru
143 days ago
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Wonderful care of us our teeth.
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Bill Harris profile picture
Bill Harris
178 days ago
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My hygienist is the best ever. Lauren is the top notch 10/10! Thank you!