Surgery
Normal Extractions

These are performed on teeth that are visible in the mouth. General dentists commonly do simple extractions, and most are usually done under a local anesthetic, with or without anti-anxiety medications or sedation.

Your dentist will grasp the tooth with specialized pliers called extraction forceps and move them back and forth to loosen the tooth before removing it. Sometimes, a surgical cutting instrument called a luxator - which fits between the tooth and the gum - is used to help loosen the tooth. Dentists also use “elevators,” which are levers that look similar to small screwdrivers. Usually a dentist will first use an elevator to wedge between the tooth and the surrounding bone. The elevator places pressure on the tooth, which helps to expand the tooth's socket and separate its ligament.

Transalveolar Extractions
Definition

Transalveolar extraction is commonly known as surgical extraction or an open extraction of a tooth. The method is employed when normal forceps extraction is not possible due to various difficulties. Generally if a tooth fractures during regular extraction, surgical approach is necessary to remove the root fragments.

Indications

A transalveolar extraction is conducted when :

● Any tooth that can not be extracted by normal use of forceps or elevators.

● A tooth with previous history of attempted and failed extraction.

● Extraction of the tooth that has undergone root canal therapy.

● Fractured or retained tooth that are not approachable to dental forceps.

● The tooth is ankylosed to the underlying bone (fused tooth).

● Tooth with irregular and curved roots that is more likely to fracture during a regular extraction.

● Sclerosis of bone.

● Impacted teeth or embedded teeth that are partially emerged in oral cavity- most commonly the wisdom tooth.

● Teeth associated with diseases such as dental cysts, tumors , periapical granulomas.

● Grossly decayed teeth with root caries or internal resorption

● Teeth lie very close to major dental nerves where the nerve damage is possible during a forceps extraction

Before Surgery

Pre-operative dental x-rays are mandatory before a surgical extraction. A dental x-ray gives the complete picture of the tooth anatomy, surrounding vital structures and presence of possible complications. The other pre-extraction assessments include identifying the presence of an infection, tooth accessibility and mouth opening assessment of the patient.

If an infection is present at the site of the surgery, the use of antibiotics is recommended and the surgery delayed until the infection is under control. Not only can an infection reduce the effects of anesthetics but there is also a possibility of the infection spreading and causing complications.

Procedure

Patients age and overall general health is also a major factor in determining the extraction method. The actual procedure of transalveolar extractions involves anesthetizing the operative site using local anesthetic agents such as lignocaine. An incision is made over the oral mucosa to access the bone forming the socket of the tooth. The approach of the incision depends on the location of the involved tooth, bone density and surrounding anatomical structures.

The bone surrounding the tooth is removed by using rotary instruments, chisels or instruments used for trimming the bone. Once tooth becomes completely accessible, it is removed either as a whole or by cutting it in to segments and removing them one by one. After the tooth is extracted the operation site is irrigated and the incision is closed by placing sutures.

After Surgery

The post extraction care includes the use of analgesics and antibiotics. The patient is advised to maintain good oral hygiene to avoid any infection at the site of incision. Immediate consumption of hot beverages or coarse foods is to be avoided as it may trigger bleeding. The patient is also advised to abstain from use of straws, vigorous tooth brushing and rinsing the mouth for next few hours. Smoking should also be avoided till the sutures are removed and wounds are healed as it may lead to delayed wound healing.

Fracture Surgery
Facial and Jaw Bone Fractures

Facial injuries include injuries involving the mouth, face and jaw. These range from facial cuts and lacerations to more serious problems, such as broken teeth and facial bones.

Bone fractures can involve the lower or upper jaw, palate, cheekbones and eye sockets. These injuries often occur during automobile accidents, sports or recreational activities, fights or assaults, work-related tasks, projects around the house or accidental falls.

Many patients with facial injuries are first seen in the emergency room and then referred to an oral and maxillofacial surgeon or a plastic surgeon for further treatment.

When making a diagnosis, your doctor will begin by asking about your medical history, including any events that may have caused your facial injury. A thorough physical and medical examination will also be conducted, to note any injuries to your face and other parts of your body. Many people with facial injuries also suffer from additional medical problems.

Treatment for facial injuries varies, depending on the location and severity of your injury. Patients with facial injuries may additional medical problems. Your doctor will coordinate the care of these medical conditions with the necessary specialists.

If you have broken bones in your face, the bones must be lined up and held in place long enough to heal properly. Depending on the severity of the injury and your age, this may take six or more weeks.

Repositioning and holding your broken bones in place may be achieved by a variety of techniques. For extensive facial injuries, incisions to expose the bones and then a combination of wiring and plating techniques may be used. Fractures of the upper and lower jaw may require metal braces that are fastened to your teeth with rubber bands or wires to hold your jaws together.

Orbital and Nasal Bone Fractures

Nose is the most prominent part of the face, hence it is likely to be the most common structure to be injured in the face. Although fractures involving the nasal bones are very common, it is often ignored by the patient. Patients with fractures of nasal bone will have deformity, tenderness, hemorrhage, edema, ecchymosis, instability, and crepitation. These features may be present in varying combinations.

If fractures of nasal bones are left uncorrected it could lead to loss of structural integrity and the soft tissue changes that follow may lead to both unfavorable appearance and function. The management of nasal fractures is based solely on the clinical assessment of function and appearance; therefore, a thorough physical examination of a decongested nose is paramount.

Patients with fractures involving nose will have intense bleeding from nose making assessment a little difficult. Bleeding must first be controlled by nasal packing. These patients also have considerable amount of swelling involving the dorsum of the nose, making assessment difficult. These patients must be conservatively managed for atleast 3 weeks for the oedema to subside to enable precise assessment of bony injury. According to Cummins Fracture reduction should be accomplished when accurate evaluation and manipulation of the mobile nasal bones can be performed; this is usually within 5-10 days in adults and 3-7 days in children.

Reduced Mouth Opening Surgery

This is a common condition but it has many causes and is a very complex issue due to involvement of the muscles, the jaw joint architecture and teeth and bite related issues. It can be the result of surgical complications after removal of wisdom teeth, or simply due to clenching as a result of stress etc.

Pre-existing joint related problems can sometimes get worse before getting better during correction therapy as in orthodontics.

Low Level Laser Therapy(LLLT)

This modality is something we have been working with for a long time and it helps to ease pain and stimulates natural healing efficiently. Different wavelengths are used with specific protocols.

There are no side effects as with medications and it is very safe in our hands. Lots of scientific research and data relating to this is now readily available.

Case 1 “Limited Opening”

This patient had difficulty opening her mouth and found it difficult to eat or even clean her teeth properly.

Site of pain Laser in action

LLLT was used on her TM Joint and Muscles

Increased opening within 10 minutes of treatment, mainly due to muscle relaxation, further treatment to find the exact cause can now be investigated and planned.

Before treatment After treatment

Esthetic Surgeries

We can ensure you have the smile and self-assurance you’ve always dreamt of!

Our complete smile makeover treatment includes Teeth Contouring, Porcelain Crowns & Veneers, Invisible Braces, Dental Implants and Teeth Whitening. We are honored to introduce a multi-corrective approach to esthetic dentistry. It doesn’t matter how discontented you are with your smile, here in Allahabad, India, we possesses the artistry and expertise that is backed by our total commitment to patient care to provide you with a Complete Smile Makeover that will change the way you smile and feel about yourself, forever.

You can look good and have a healthy smile!

Are you unhappy with the way your teeth look and feel? Do you realize that there are multiple ways modern esthetic dentistry can change your smile.Today, esthetic dentistry can rectify chipped or crooked teeth, fill gaps in your teeth, whiten stained or discolored teeth, replace missing or broken teeth and reduce a gum.

Our esthetic dentists at our hospital in Allahabad, India, develop a personalized treatment schedule for you, depending on your goals, age, time and financial budget.

Click on a Treatment Below to Learn More

Botox Treatment

Age brings with it significant changes in the human face and skin. Wrinkles, creases in the skin and facial lines are common after the age of 40. The medical fraternity offers a novel treatment to keep these lines at bay.

If you are frowning about the wrinkles and creases in your skin, let Botox move its magic wand on you and feel the difference! Botox is an excellent non-surgical esthetic procedure to relax facial muscles and iron out facial lines, grooves, wrinkles, frown lines, forehead furrows and even the glabellar lines between the eyebrows. Some doctors are even using Botox to treat wrinkles in the corner of the eyes popularly known as “crow’s feet”, “turkey gobble” neck, “marionette lines”, lip lines, and creases along the nose and mouth.



Botox is successful in diminishing the appearance of wrinkles caused by repeated contractions of the muscle because it acts as a paralytic. When injected directly into the muscle it actually arrests the muscle’s ability to contract by blocking the transmission of nerve impulses to the muscles. If a muscle cannot tighten, a wrinkle cannot be formed. Other less common uses of Botox include the treatment of excessive sweating in the armpits, hands, and feet as well as migraine headaches.

Botox may actually prevent new wrinkles from forming. Another possible benefit is that the botulinum toxin does not stay in the body indefinitely, so if there is an adverse effect, or a mistake is made, it is only temporary. There is also the likely possibility that with frequent treatments, the injected muscles will atrophy allowing the patient to go longer and longer between treatments.

Dental Implants (Replaces Missing Teeth or Dentures)

Implants are the new age method used to restore any missing teeth. It gives artificial teeth a more natural look and it is more secure. Titanium is used in implants, it is fixed in bone in place of the root. Once it is completely integrated with the jaw bone, an abutment is fixed to the implant then a bridge crown or denture is fitted on top of the abutment which replaces any missing teeth or a single tooth.At hospital our in-house Implantologist performs the Dental implants surgery.

A tooth implant is more advantageous compared to a bridge because it replaces the tooth without hampering any of the adjacent teeth. Bridged teeth are also joined together making flossing impossible. Implants crucially support multiple implant crowns or implant supported bridges especially. Sometimes there might not be sufficient adjoining teeth to support bridges for a long time.

For complete denture weaves, maintenance is a major issue as bone support decreases with age. Ultimately the most excellent fitting dentures tend to feel loose too. Complete upper dentures involve a wide surface over the palate for suction this hampers the taste of food which isn’t fun. On the other hand, Implant supported dentures are securely fixed in and do not need the palate to be covered. Dental implants are incorporated with other treatments such as crowns, bridges and veneers as part of full smile makeovers or full mouth reconstructions following the same processes of smile design.

Teeth Whitening (Same-day Service)

Time, smoking, tea and coffee are just a couple of the things that make your teeth to yellow and discolor. Whitening is similar to a facial, it helps to clean pores in your teeth gently removing stains, leaving your teeth cleaner and brighter. Whiter teeth can make you look younger and give you more confidence.


We offer teeth whiteningtreatments to fit in with your schedule and individual goals in two types:
Office bleach:-  Professional teeth whitening (whitening performed by a dentist in their office) may be the best choice for those people who need immediate teeth whitening results. In just an hour or two of appointment time a dentist can apply the bleaching gel, "activate" it with their light or a laser, and then you're finished. Your smile shows whitening results the very same day of your very first bleaching treatment

Home bleach:- The take home system. On your first visit we'll take an impression your upper & lower mouth arch - enclosing the teeth you wish to have whitened. We then create a tray that is molded to the scalloped lines of your gums. You try on the custom made tray we created for your mouth during your second appointment and if necessary adjustments can be made for a comfortable fit.

Veneers (For Discoloured and Uneven Teeth)

Veneers are new surfaces for damaged teeth, specially created using porcelain. Veneers are enormously versatile. They are used to line up protruding & crooked teeth, fill gaps or lighten the colour of your teeth. The appearance, longevity and strength of our porcelain veneers are similar to natural teeth and they're perfect to make lifelong alterations to a smile.

Shubham Dental Care’s porcelain veneers hold an exclusive  treatment.Porcelain veneers are used to mask a single dark tooth but more often are used as part of smile makeover. At the Shubham Dental Care, our smile makeovers starts with professional consultation where we learn what modifications our clients require to enhance their smile.
Porcelain veneers are then provided as planned over two main treatment appointments. During the first appointment the teeth are prepared. This procedure involves trimming a thin layer from the front surface and biting edge to make space for the veneer. These treatments are all carried out using our pain-free anesthetic techniques.

   

Porcelain veneers are then fixed during the second appointment. Our veneers are fitted with a multi-layer bonding system that links the veneers to the teeth with unmatched strength. The veneers are polished and bite checked before they are revealed to our patients. We also see our patients a few days later to check if all is well after they’ve had some time to use them and eat with them.

Crowns & Bridges (Natural Looking Teeth, or Caps)

It doesn’t matter how old you are if you desire to have straight teeth. Properly aligned teeth make your smile look beautiful and it helps your tongue, muscles, and jaws function correctly. Inappropriate alignment of teeth can result in tooth decay and gum disease. Our hospital offers comprehensive orthodontic treatments for adults and children.

Our porcelain crowns also have an exclusive five year guarantee.
Porcelain crowns may be used to cover a single dark tooth but in most cases it is used during complete smile makeovers. At our hospital our smile makeovers start in the consultation room where we find out what clients don't like about their teeth and what type of smile is required. “Mock design” is then used to design the smile and to fine tune the required tooth shapes and colour to the client's wishes.

Porcelain crowns are then fitted as intended over the next two sittings. During the first appointment damaged, broken down and decayed teeth are treated first. The teeth are then prepared for further treatments. Some of processes involve trimming a thin layer around the tooth to create room for the crown. The next step involves taking impressions to make temporary crowns.

Temporary crowns give our patients a chance to try their intended smile design before the permanent crowns are prepared. This also gives our dentist an opportunity to make any adjustments or changes to the temporaries before making the permanent crowns. At our hospital every crown is made using this method.

Shubham Dental Care uses pain-free anaesthetic techniques for every dental procedure.

During the second sitting Porcelain Crowns are fixed and fitted. Every crown is fixed using a multi-layer bonding system to strengthen the bond between the crown and the tooth with supreme strength. After this the crown is bite checked and polished before they are shown to our patients.

Our patients are called for checkups over the next few days to make sure everything feels fine.

Orthodontics / Invisible Braces (Straightens Teeth)

It doesn’t matter how old you are if you desire to have straight teeth. Properly aligned teeth make your smile look beautiful and it helps your tongue, muscles, and jaws function correctly. Inappropriate alignment of teeth can result in tooth decay and gum disease. Our hospital offers comprehensive orthodontic treatments for adults and children.

To correct crooked teeth, our specialists apply traditional metal or clear braces. If you don't want people to know that you're wearing braces, he may recommend lingual orthodontics or Invisalign. FFor children from six to ten years old, we can apply functional trainers, which remove the need for early orthodontics.
Going through instant orthodontics treatment does not need to be costly and uncomfortable to be effective. We can utilize the most advanced techniques in orthodontics to speed up major treatments and avoid surgery. If you want to straighten your smile, schedule a consultation today.

Apicoectomy

A Surgical Option When Root Canal Treatment Fails

What is it

Your teeth are held in place by roots that extend into your jawbone. Front teeth usually have one root. Other teeth, such as your premolars and molars, have two or more roots. The tip or end of each root is called the apex. Nerves and blood vessels enter the tooth through the apex. They travel through a canal inside the root, and into the pulp chamber. This chamber is inside the crown (the part of the tooth you can see in your mouth).

During root canal treatment, your dentist cleans the canals using special instruments called files. Inflamed or infected tissue is removed. An apicoectomy may be needed when an infection develops or won't go away after root canal treatment or retreatment.

Root canals can be very complex, with many tiny branches off the main canal. Sometimes, even after root canal treatment, infected tissue can remain in these branches. This can possibly prevent healing or cause re-infection later. Your dentist can do an apicoectomy to fix the problem so the tooth doesn't need to be extracted. In an apicoectomy, the root tip, or apex, is removed along with the infected tissue. A filling is then placed to seal the end of the root.

An apicoectomy is sometimes called endodontic microsurgery because it is often done using an operating microscope.

What its used for

If a root canal procedure has been done in the past and it becomes infected again, its often because of a problem near the apex of the root. In many cases, a second root canal treatment is considered before an apicoectomy. With advances in technology, dentists often can detect other canals that were not adequately treated. In this case, they may be able to clear up the infection by doing a second root canal procedure. This will avoid the need for an apicoectomy.

An apicoectomy is done only after a tooth has had at least one root canal procedure and retreatment has not been successful or is not possible. For example, retreatment is often not a good option when a tooth has a crown or is part of a bridge. Retreatment of the root canal would require cutting through the crown or bridge. That might destroy or weaken the crown or bridge. An apicoectomy is often considered in a situation like this.

An apicoectomy is not the same as a root resection. In a root resection, an entire root is removed, rather than just the tip.

Wisdom Tooth Surgical Extraction

Your dentist or oral surgeon may use one of three types of anesthesia, depending on the expected complexity of the wisdom tooth extraction and your comfort level. Options include:

Local anesthesia. Your dentist or oral surgeon administers local anesthesia with one or more injections near the site of each extraction. Before you receive an injection, your dentist or surgeon will likely apply a substance to your gums to numb them. You're awake during the tooth extraction. Although you'll feel some pressure and movement, you shouldn't experience pain.

Sedation anesthesia. Your dentist or oral surgeon gives you sedation anesthesia through an intravenous (IV) line in your arm. Sedation anesthesia suppresses your consciousness during the procedure. You don't feel any pain and will have limited memory of the procedure. You'll also receive local anesthesia to numb your gums.

General anesthesia. In special situations, you may be offered general anesthesia. You may inhale medication through your nose or have an IV line in your arm, or both. Then you lose consciousness. Your surgical team closely monitors your medication, breathing, temperature, fluids and blood pressure. You'll experience no pain and have no memory of the procedure. Local anesthesia is also given to help with postoperative discomfort.

During wisdom tooth extraction, your dentist or oral surgeon:

Makes an incision in the gum tissue to expose the tooth and bone

Removes bone that blocks access to the tooth root

Divides the tooth into sections if it's easier to remove in pieces

Removes the tooth

Cleans the site of the removed tooth of any debris from the tooth or bone

Stitches the wound closed to promote healing, though this isn't always necessary

Places gauze over the extraction site to control bleeding and to help a blood clot form

After the procedure

If you receive sedation anesthesia or general anesthesia, you're taken to a recovery room after the procedure. If you have local anesthesia, your brief recovery time is likely in the dental chair.

As you heal from your surgery, follow your dentist's instructions on:

Bleeding. Some oozing of blood may occur the first day after wisdom tooth removal. Try to avoid excessive spitting so that you don't dislodge the blood clot from the socket. Replace gauze over the extraction site as directed by your dentist or oral surgeon.

Pain management. You may be able to manage pain with an over-the-counter pain reliever, such as acetaminophen (Tylenol, others), or a prescription pain medication from your dentist or oral surgeon. Prescription pain medication may be especially helpful if bone has been removed during the procedure. Holding a cold pack against your jaw also may relieve pain.

Swelling and bruising. Use an ice pack as directed by your dentist or surgeon. Any swelling of your cheeks usually improves in two or three days. Bruising may take several more days to resolve.

Activity. After your surgery, plan to rest for the remainder of the day. Resume normal activities the next day, but for at least a week, avoid strenuous activity that might result in losing the blood clot from the socket.

Beverages. Drink lots of water after the surgery. Don't drink alcoholic, caffeinated, carbonated or hot beverages in the first 24 hours. Don't drink with a straw for at least a week because the sucking action can dislodge the blood clot from the socket.

Food. Eat only soft foods, such as yogurt or applesauce, for the first 24 hours. Start eating semisoft foods when you can tolerate them. Avoid hard, chewy, hot or spicy foods that might get stuck in the socket or irritate the wound.

Cleaning your mouth. Don't brush your teeth, rinse your mouth, spit or use mouthwash during the first 24 hours after surgery. Typically you'll be told to resume brushing your teeth after the first 24 hours. Be particularly gentle near the surgical wound when brushing and gently rinse your mouth with warm salt water every two hours and after meals for a week.

Tobacco use. If you smoke, don't do so for at least 72 hours after surgery — and wait longer than that if possible. If you chew tobacco, don't use it for at least a week. Using tobacco products after oral surgery can delay healing and increase the risk of complications.

Stitches. You may have stitches that dissolve within a few weeks or no stitches at all. If your stitches need to be removed, schedule an appointment to have them taken out.


When to call your dentist or surgeon

Call your dentist or oral surgeon if you experience any of the following signs or symptoms, which could indicate an infection, nerve damage or other serious complication:

Difficulty swallowing or breathing

Excessive bleeding

Fever

Severe pain not relieved by prescribed pain medications

Swelling that worsens after two or three days

A bad taste in your mouth not removed with saltwater rinsing

Pus in or oozing from the socket

Persistent numbness or loss of feeling

Blood or pus in nasal discharge