Procedures

Voted One of America’s Top Dentists in 2009-2018 by Consumers’ Research Council of America

Experience, Excellence and Compassion

At Dr. Reubel’s Oral and Maxillofacial office we provide professional, comfortable, care for all of our patients. Our staff has extensive experience and unparalleled expertise in providing the best patient care.

Dr. Reubel has developed a quality of care which gives every patient, whatever their needs, a tremendous advantage in making a complete and rapid recovery; saving time and money on Oral and Maxillofacial Surgery Services.

In our practice we use a different, proven successful drilling system and smaller, less invasive instruments for tooth extraction than other surgeons in the greater Cincinnati area. Dr. Reubel believes this is the reason we rarely see”dry sockets” in our office.

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved. Patients with dental implants can smile with confidence.

Dental implants are stronger and more durable than their restorative counterparts (bridges and dentures). Implants offer a permanent solution to tooth loss. Additionally, implants may be used in conjunction with other restorative procedures for maximum effectiveness. For example, a single implant can serve to support a crown replacing a single missing tooth. Implants can also be used to support a dental bridge for the replacement of multiple missing teeth, and can be used with dentures to increase stability and reduce gum tissue irritation.

The implants themselves are tiny titanium posts that are e surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth.

Implants also help preserve facial structure, preventing bone deterioration that occurs when teeth are missing.

Surgical Advances

Using the most recent advances in dental implant technology, Dr. Reubel is often able to place single stage implants which requires only one round of surgery. Since these implants do not require a second procedure to uncover them there is less pain and discomfort. However, it does require a minimum of 8-12 weeks of healing time before the final teeth are placed.

Implants are a team effort between an oral and maxillofacial surgeon and a restorative dentist. While Dr. Reubel performs the actual implant surgery, initial tooth extractions, and bone grafting if necessary, the restorative dentist (your dentist) fits and makes the permanent prosthesis (crowns). Your dentist can also make any temporary prosthesis needed during the implant process.

Preprosthetic Surgery

The preparation of your mouth before the placement of a prosthesis is referred to as pre-prosthetic surgery.

Some patients require minor oral surgical procedures before receiving a partial or complete denture, in order to ensure the maximum level of comfort. A denture sits on the bone ridge, so it is very important that the bone is the proper shape and size. If a tooth needs to be extracted, the underlying bone might be left sharp and uneven. For the best fit of a denture, the bone might need to be smoothed out or reshaped. Occasionally, excess bone would need to be removed prior to denture insertion.

One or more of the following procedures might need to be performed in order to prepare your mouth for a denture:

  • Bone smoothing and reshaping
  • Removal of excess bone
  • Bone ridge reduction
  • Removal of excess gum tissue
  • Exposure of impacted teeth

Trauma

Dr. Reubel’s broad-based and extensive dental and medical training in the hospital-based environment uniquely qualify him as an oral and maxillofacial surgeon to treat and repair injuries to the face, jaw, mouth and teeth.

Surgical Removal of Wisdom Teeth

Third molars are commonly referred to as wisdom teeth. The wisdom teeth are located in the back of the mouth, one in each quadrant, behind the second or 12-year molars.

Although most people develop 32 permanent teeth, quite often the jaws are not large enough to accommodate the four wisdom teeth. When inadequate space prevents the teeth from erupting into the proper position, they are “impacted”. An impacted tooth remains embedded in soft gingiva (gum) tissue or bone beyond its normal eruption time. Because they are the last teeth to emerge, the most common teeth to become impacted are the wisdom teeth, which normally emerge between the ages of 17 and 21.

Problems that can develop from partially impacted teeth include pain, infection, crowding, and damage to adjacent teeth. More serious problems, such as damage to the jawbone caused by the formation of cysts, can occur with completely impacted teeth. As the wisdom teeth develop, the roots continue to grow longer and the jawbone becomes denser. So as you get older, it becomes more difficult to remove your teeth and complications are more likely. In addition, the problems associated with impacted teeth tend to occur with increasing frequency after the age of 30.

To prevent this from occurring, it is usually recommended to have wisdom teeth removed during the teenage years or early twenties before the root structure is fully developed. Although in some cases it is recommended that they are removed as early as 11 or 12 years of age.

Dr. Reubel has developed a quality of care which gives every patient, whatever their needs, a tremendous advantage in making a complete and rapid recovery; saving time and money on Oral and Maxillofacial Surgery Services.

In our practice we use a different, proven successful drilling system and smaller, less invasive instruments for tooth extraction than other surgeons in the greater Cincinnati area. Dr. Reubel believes this is the reason he rarely see”dry sockets”.

If your dentist has recently taken x-rays which show all of the teeth in question, please bring them with you to your appointment. Please bring a list of all medications you are currently taking with you to your first appointment.

Dental Extractions (Tooth Removal)

Teeth may need to be removed for a number of reasons, usually due to extensive decay, ‘gum’ disease, or trauma resulting in painful, abscessed and/or loose teeth. In some non-emergency situations, we will evaluate and treat you at the same visit.

If your dentist has recently taken x-rays which show all of the teeth in question, please bring them with you to your appointment.

Most patients prefer not to return to work on the day a tooth is extracted, usually because of minor post-extraction bleeding and discomfort. We will provide you with post-operative instructions, extra gauze and a prescription for pain medication or antibiotics (if indicated) after your treatment is complete. You can expect mild to moderate discomfort for a few days following the extraction. In general, you should start to feel better after 1-3 days.

If you prefer to be sedated or ‘go to sleep’, a preoperative appointment to evaluate you and discuss anesthesia options is preferred. This allows us the opportunity to review your medical history, determine what procedure(s) are needed.

Please bring a list of all medications you are currently taking with you to your first appointment. If your medical history is complex and you are taking a number of prescribed medications, we may need to discuss your dental treatment with your physician before we can treat you.

Apicoectomy

Periapical surgery, also known as apicoectomy, is a dental procedure performed at the tip of a tooth’s root to stop leakage of diseased tissue or bacteria into the surrounding area. The procedure is most frequently indicated when a patient has had endodontic (root canal) therapy on a tooth but continues to have pain or infection.

The diagram illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with a small amount of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function. If a fracture of the root or other evidence of a hopeless prognosis is found during surgery, the tooth can either be removed at that time or at a later date when adequate plans have been made to replace the tooth.

Overall, periapical surgery is often a good approach to save a tooth that has not responded well to root canal therapy. Feel free to contact our office to schedule a consultation to determine if you are a good candidate for this procedure.

If your dentist has recently taken x-rays which show all of the teeth in question, please bring them with you to your appointment. Please bring a list of all medications you are currently taking with you to your first appointment.

Impacted Canines

An impacted tooth simply means that it is “stuck” and cannot erupt into function. After wisdom teeth, the maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth in the dental arch and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth and have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite.

Normally, the maxillary cuspid teeth are the last of the “front” teeth to erupt into place. They usually come into place around age 13 and cause any space left between the upper front teeth to close tighter together. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch. The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper eye) teeth.

The surgery to expose and bracket an impacted tooth is a very straightforward surgical procedure that is performed in the oral surgeon’s office. The procedure can be performed with local anesthesia, however many patients, because of their young age, prefer IV Sedation. These issues will be discussed in detail at your preoperative consultation.

If your dentist has recently taken x-rays which show all of the teeth in question, please bring them with you to your appointment. Please bring a list of all medications you are currently taking with you to your first appointment.