Oral Surgery Gdańsk

Yes, all surgical procedures at Prodent are performed completely painlessly. We use modern local anesthetics that effectively block pain sensation during the procedure. Before administering the anesthetic, we apply a topical numbing gel, making even the needle prick virtually imperceptible. During the procedure, you may feel a gentle touch of instruments or slight pressure, but no pain. For patients with high dental anxiety, we offer sedation with nitrous oxide or intravenous sedation administered by an anesthesiologist, which induces a state of deep relaxation while maintaining consciousness. After the procedure, we prescribe appropriate painkillers to alleviate discomfort during the healing period. Most patients are surprised by how little pain they experience after procedures performed at Prodent – often comparing it to the discomfort after a routine cavity filling.

The healing time after extraction depends on the type of tooth removed and individual predispositions. After a simple extraction (e.g., an upper front tooth), the wound heals relatively quickly – the blood clot stabilizes within the first 24 hours, acute discomfort subsides within 2-3 days, and full gum closure occurs after approximately 2 weeks. The bone fills the socket within 6-8 weeks. After more complex procedures, such as surgical removal of an impacted wisdom tooth, the healing process takes a little longer – swelling peaks on the second or third day and gradually decreases over the next 5-7 days, pain subsides within 4-5 days, and full soft tissue healing occurs after 3-4 weeks. Strict adherence to post-operative recommendations is crucial for quick and uncomplicated healing: do not rinse your mouth for the first 24 hours, apply cold compresses, avoid physical exertion, do not smoke, eat soft and lukewarm food, and take prescribed medications. At Prodent, we use atraumatic techniques that significantly shorten recovery time.

The waiting time for implantation after tooth extraction depends on the method and clinical situation. At Prodent, we offer three scenarios. Immediate implantation involves placing the implant directly after tooth removal in the same session – this is possible when the tooth socket is intact, there is no infection, and sufficient bone is available for implant stabilization. Benefits include reduced treatment time and prevention of bone atrophy. Early implantation is performed 6-8 weeks after extraction, when the soft tissue has healed, but the bone has not yet undergone significant atrophy – this is often a compromise between immediate implantation and classic waiting. Classic (delayed) implantation occurs 3-6 months after tooth removal, when the bone has completely remodeled and the socket has been filled with new bone tissue – this is the safest method offering the highest predictability. In cases of inflammatory extraction with bone loss, we always perform bone augmentation first, wait 4-6 months for integration, and only then place the implant. The decision on the optimal time for implantation is made based on 3D tomography and clinical assessment during consultation.

The difficulty level of wisdom tooth removal depends on their position and degree of eruption. Fully erupted wisdom teeth, positioned straight, are removed in a standard manner, similar to other teeth – the procedure takes 20-30 minutes, proceeds smoothly, and healing is quick. Partially erupted teeth, which are breaking through the gum but are not fully accessible, require a small gum incision and sometimes removal of a fragment of bone covering the crown – the procedure takes 30-45 minutes, and the healing period is about a week. Wisdom teeth completely impacted in the bone, positioned horizontally or at an angle, are the most demanding – they require a mucoperiosteal flap, removal of bone covering the tooth, sectioning the tooth into parts, and removing it piece by piece, which takes 45-90 minutes and requires greater precision. Before each wisdom tooth removal, we perform 3D CBCT tomography, which shows the exact position of the roots relative to the mandibular nerve and maxillary sinus, allowing us to plan the safest access route. The procedure is always performed under full local anesthesia, is completely painless, and after the procedure, we prescribe effective painkillers and anti-inflammatory medications. Most patients return to normal activity after 2-3 days.

Root end resection (apicoectomy) is a microsurgical procedure that saves a tooth which, despite properly performed root canal treatment, still has an inflammatory process around the apex. This occurs when bacteria become lodged in highly branched lateral canals or root curvatures inaccessible to endodontic instruments, or when a cyst or granuloma has formed around the apex that does not resolve despite re-treatment. During resection, we expose the root apex by incising the gum and removing a fragment of bone, cut off the terminal part of the root (about 3 mm) along with the inflammatory tissue, clean the entire space, fill the canal from the apex side with biologically active material (MTA or Biodentine) that stimulates bone regeneration and seals the canal tightly, fill the bone defect with bone substitute material, and suture the gum. The procedure is performed under a surgical microscope, which provides high magnification and excellent illumination, guaranteeing precision and effectiveness at 85-90%. Resection allows saving a tooth that would otherwise have to be extracted and replaced with an implant. The procedure takes about an hour, is performed painlessly under local anesthesia, and healing proceeds standardly – sutures are removed after 7-10 days.

Maxillary sinus lift is a specialized procedure performed in the posterior part of the upper jaw when, after the loss of molars, bone atrophy has occurred, and the maxillary sinus floor has lowered, leaving too little space for safe implant placement. The upper jaw naturally has thinner and less dense bone than the mandible, and after tooth loss, atrophy progresses bidirectionally – from the oral cavity and from the sinus. During an open sinus lift, we create a small window in the lateral bone of the sinus, gently elevate the Schneiderian membrane (sinus lining) to create space, fill it with the highest quality bone substitute material, which transforms into solid bone within 6-9 months, and close the window and the wound in the oral cavity. There are two techniques: open sinus lift, performed when atrophy is significant (less than 3-4 mm of bone) and requires greater augmentation, and closed sinus lift (Summers technique), used when there is at least 4-5 mm of bone and the sinus floor can be elevated through the implant drill hole – sometimes simultaneously with implantation. The procedure requires extensive experience, precision, and anatomical knowledge, which our surgeons possess. It is safe when performed by a specialist using 3D tomography for planning and microscopic surgical techniques. The most common complication is sinus membrane perforation, but in our hands, it occurs rarely, and even if it does, it is immediately repaired with collagen membranes. The success rate of sinus lift is over 95%, and an implant placed in a lifted sinus has the same longevity as in natural bone.

Bone augmentation (bone reconstruction) is necessary when, after tooth loss, significant atrophy of the alveolar ridge has occurred, and there is insufficient bone for stable implant placement. Bone atrophies in areas without chewing load – after tooth extraction, approximately 25% of the ridge width is lost within the first 6 months, and after a year, atrophy can reach 40-60%. We perform augmentation when bone height or width is insufficient for implants (we need a minimum of 10 mm height and 6 mm width), when significant bone loss has occurred after inflammatory extraction, when planning implant-supported bridges requiring an even bone level, or when the patient desires optimal aesthetics in the anterior region. We use various techniques depending on the extent of the defect: autogenous bone blocks harvested from the area of the lower wisdom tooth or the patient's chin, which we fix with titanium screws; bone substitute materials (xenografts, allografts, alloplasts) in granular or block form; collagen or titanium membranes protecting the material from soft tissue ingrowth; GBR (Guided Bone Regeneration) technique involving guided bone regeneration; or the split-crest technique for minor atrophy. After augmentation, a healing period of 4-6 months (autograft) or 6-9 months (bone substitutes) is necessary, during which the material transforms into new, hard bone capable of supporting an implant. The procedure is performed painlessly under local anesthesia, lasts 60-120 minutes depending on the extent, and healing proceeds standardly. Not every implantation requires augmentation – if you have enough good quality bone, the implant is placed directly without additional procedures.

There are few absolute contraindications to oral surgery, but there are situations requiring special caution or modification of treatment. Absolute contraindications include untreated severe systemic diseases in an acute phase (recent heart attack within the last 6 months, unstable angina, uncontrolled hypertension above 180/110 mmHg, uncontrolled diabetes with glucose levels above 250 mg/dl), severe kidney or liver failure, recent chemotherapy or radiotherapy in the head and neck area, intravenous bisphosphonate use (increases risk of osteonecrosis), pregnancy in the first trimester (procedures are postponed until the second trimester or after childbirth), and active neoplastic processes in the planned surgical area. Relative contraindications requiring consultation and modification of treatment include controlled diabetes (we require HbA1c below 7%), cardiovascular diseases controlled by medication, osteoporosis treated with oral bisphosphonates (temporary discontinuation before the procedure), anticoagulant medication use (dosage modification in consultation with a cardiologist), smoking (increases risk of healing complications by 300-400%), immunosuppression, or long-term steroid therapy. At Prodent, before each procedure, we conduct a detailed medical history, and in case of doubt, we consult with the patient's primary physician to ensure maximum safety. Many contraindications can be mitigated through appropriate patient preparation, therapy modification, and prophylactic antibiotic therapy.

Proper preparation for a surgical procedure increases its safety and promotes uncomplicated healing. A few days before the procedure: undergo professional dental hygiene to remove calculus and bacteria from the oral cavity (recommended 7-14 days before the procedure), do not discontinue medications for chronic diseases without consulting your doctor, inform the surgeon about all medications, supplements, and herbs you are taking, reduce or completely stop smoking (nicotine slows healing), avoid alcohol for 48 hours before the procedure. On the day of the procedure: eat a light meal 2-3 hours before your appointment (do not come on an empty stomach unless intravenous sedation is planned), thoroughly brush your teeth and rinse your mouth with an antibacterial mouthwash, wear comfortable, loose clothing without a high collar, do not use makeup or perfume, if you wear contact lenses, consider removing them, if the procedure will be under sedation – come with an accompanying person who will drive you home. Diabetic patients should measure their glucose level before the procedure and inform the doctor of the result; patients taking anticoagulants should consult a cardiologist regarding possible dosage changes; patients with a history of endocarditis will receive prophylactic antibiotics before the procedure. At Prodent, during the qualification visit, we thoroughly discuss all recommendations tailored to your individual situation.

Most surgical procedures at Prodent proceed without complications, but it is important to know when to seek help. Normal symptoms in the first few days after the procedure include: mild to moderate pain well-controlled with medication, swelling peaking on the second or third day, slight blood oozing in the first few hours, jaw stiffness and difficulty opening the mouth (especially after lower wisdom tooth removal), temporary numbness of the lip or tongue (if the tooth was close to a nerve), slightly elevated temperature up to 38°C. Situations requiring immediate contact with the clinic include: severe, increasing pain not relieved by painkillers, intense bleeding lasting more than 6-8 hours, rapidly increasing swelling making breathing or swallowing difficult, fever above 38.5°C lasting more than 24 hours, appearance of pus or a very unpleasant odor from the wound, dry socket (intense throbbing pain 2-4 days after the procedure, often radiating to the ear), premature suture dehiscence, increasing numbness lasting more than a week. In the case of dry socket (alveolitis sicca), an additional procedure to clean the wound and apply an analgesic-anti-inflammatory dressing is required. Other complications such as hematoma or infection also require medical intervention. At Prodent, every patient receives a card with detailed recommendations and the clinic's contact number after the procedure – we are available by phone during business hours, and in urgent situations outside of reception hours, the patient receives the on-call doctor's phone number. Most alarming symptoms can be quickly resolved during a short intervention visit, so do not hesitate to contact us if you have any doubts.