Cosmetic Tooth Bonding (Restoration)

Cosmetic bonding The state-of-the-art bonding material offers possibilities to repair different imperfections of teeth, to correct the shape and size of teeth, and to change their color. Even the smallest changes can dramatically improve a person’s smile.
On a patient’s request, cosmetic bonding can be used to hide the misalignment of teeth, to change their color, and to close large gaps between teeth. This procedure can also be employed to replace old large fillings in the front teeth, to repair chipped or broken and decayed teeth, to restore eroded enamel, and to improve the color of a dark, discolored tooth when other methods of whitening are not effective.
At the initial consultation in the Clinic “Grožio chirurgija,” it is possible to preliminary model the desired outcome on a model. This helps the patient better visualize the future appearance of the teeth and helps the dentist perceive the patient’s expectations.

How is the Procedure Performed?

This procedure can be done in a single visit. During a single visit, usually 4–6 teeth are restored, and it takes 4–6 hours to complete.
Cosmetic bonding is carried out preserving the hard tissues of the patient’s teeth. There are several methods of cosmetic bonding. In all cases at the beginning, old fillings and decay-damaged tissues are removed under local anesthesia. Then the tooth is isolated by using a rubber dam to keep the tooth dry. It is specially prepared and then is restored in multiple thin layers by applying the bonding material of different translucency that mimics natural tooth tissues, color, surface texture, and gloss. A very important step, which completes the restoration, is tooth polishing. The properly polished teeth regain a natural appearance (texture and gloss), and dental plaque is easily removed from their surface with a regular toothbrush.

What Else Should Be Known About the Procedure?

*Sometimes marginal corrections are needed to be done after a few weeks following the cosmetic bonding procedure;
*It is necessary to look after and take care of the restored teeth in order to ensure the longest possible duration of the cosmetic bonding: the patient should avoid eating hard food or biting on large pieces of food and brush them carefully every day. It is recommended to polish teeth with a diamond polishing paste 1–2 times a year. With the proper care, cosmetic bonding will last for 7–10 years;
*If the restored tooth has fractured, it can be corrected easily, and no new cosmetic bonding is needed. .

Cosmetic Bonding for Teeth With an Unusual Shape or Discoloration

It is a procedure of cosmetic bonding (cosmetic bonding) used for patients who have discolored teeth, teeth with pigmentation spots and cracked enamel, misshaped and crooked teeth, or teeth that are irregularly alignedin the dental arch (for example, located too deeply, rotated around their axis, too much protruded).

How is the Procedure Performed?

The procedure usually takes 45–90 minutes to complete. A crooked, too much protruding tooth is polished, and the removed layer is restored by employing the cosmetic bonding procedure. Discoloration of the tooth is masked by selecting a brighter filling.

What Should Be Known About the Procedure?

It is not always possible to correct crooked teeth by cosmetic bonding; often patients need orthodontic treatment.
*is not allowed to eat and drink for 2 hours after the procedure;
*Sometimes marginal corrections are needed to be done after a few weeks following the cosmetic bonding procedure;
*is necessary to look after and take care of the restored teeth in order to ensure the longest possible duration of the cosmetic bonding: the patient should avoid eating hard food or biting on large pieces of food and brush them carefully every day. It is recommended to polish teeth with a diamond polishing paste 1–2 times a year. With the proper care, cosmetic bonding will last for 7–10 years;
*the restored tooth has fractured, it can be corrected easily, and no new cosmetic bonding is needed.

Direct Composite Veneers COMPONEER

Direct composite veneers COMPONEER or SMILE TO GO, are a product of the Swiss company Coltene/Whaledent designed to correct imperfections of the front teeth.
Direct composite veneers COMPONEER are high-quality, extremely thin special enamel shells produced from nanohybrid composite. They precisely cover the surface of the front teeth and give them a natural, beautiful shape and shine. Veneers COMPONEER can be fitted by the dentist in a single visit.

What Are the Advantages of Direct Composite Veneers COMPONEER?

*Direct composite veneers COMPONEER are manufactured industrially; therefore, their price is considerably lower than that of individually lab-made veneers;
*The procedure is not time-consuming; it can be done at a single visit (up to 12 teeth can be restored, 6 in each jaw);
*During the restoration, the healthy tissues of teeth are damaged minimally; The system provides a possibility to individually select veneers (according to tooth shape, color, etc.);
*High quality of veneers ensures the stability and excellent cosmetic appearance of teeth; With time, the shine of teeth can be refreshed by polishing them.

How is the Procedure Performed?

First, the condition of the front teeth is examined; an appropriate shade of veneers COMPONEER is selected, and special contour guides are used to select a proper shape of the veneers. The teeth to be treated are minimally shaved off. Then the veneers are bonded by using the same material they are made of. The shape and length of teeth are customized to individual patient’s requirements. The final step of the procedure involves tooth polishing.

Tooth Whitening

Tooth whitening is one of the most common procedures of cosmetic dental treatment that is continuously growing in popularity. It is one of the simplest and most easily accessible methods for everyone to improve a smile. A beautiful, shining smile is one of the first most noticeable facial features we notice when we meet new people; furthermore, it gives us more self-confidence and boosts self-esteem. Modern tooth whitening, when performed following all the recommendations for tooth whitening, is a safe and effective procedure and does not cause any damage to teeth.
There are many causes that can lead to tooth discoloration. Discoloration can be caused by several factors, such as individual hereditary characteristics of a tooth structure, advanced age, some chronic diseases, dental trauma, gum inflammation, untreated teeth and their canals, or those treated with older generation materials, and excessive use of fluoride-containing products or certain medications (for example, antibiotic tetracycline). A frequent consumption of stain-causing products, such as coffee, tea (especially black), red wine, and tobacco, has a huge impact as well.

What Are the Methods of Tooth Whitening Offered in the Clinic?

Endodontically Treated Tooth Whitening Endodontically treated (nonvital) tooth whitening differs from healthy tooth whitening. By applying a special whitening system for nonvital teeth, the dead teeth are whitened inside by placing a special bleaching agent into the tooth canal and sealing it with a temporary filing material. After a certain time period, the whitening material is replaced with a new one until the desired result is achieved.
Before any whitening procedure of the endodontically treated teeth, it is necessary to assess the quality of the root canal treatment. If endodontic treatment is questionable, it is recommended to retreat the root canals and fill them with a resin-like material called gutta percha in combination with an adhesive cement to ensure complete sealing of the root canal system.

• In-Office Tooth Whitening

This tooth whitening procedure is done in a dental practice, and it takes 30 to 60 minutes to complete. During in-office tooth whitening, a whitening material is applied to the teeth, and it is activated with an LED curing light. In order to achieve maximum whiteness it is recommended to perform 2-3 whitening procedures. In-office tooth whitening is a good option for refreshing the previously performed tooth whitening.

• At-Home Tray-Based Tooth Whitening

First, the dentist takes the impressions or moulds of the patient’s teeth that are used to cast custom-fitted models. In a dental laboratory, vacuum-molded whitening trays are made of transparent plastic by applying it over the models. During the next visit, the dentist adjusts the whitening trays as necessary to fit the patient’s teeth perfectly and gives instructions how to use them. ĮA bleaching gel is placed in the tray, and it is worn overnight or for 2 hours during the day. Such tooth whitening can take 7 to 14 days. PoIt is advisable to visit a dental practice after 2–3 weeks in order a dentist or a dental hygienist would evaluate the effectiveness of tooth whitening and the condition of teeth and mucosa. Tray-based tooth whitening can cause the teeth to become more sensitive, but this side effect is temporary and disappears over time.

Laser-Assisted Tooth Whitening

Unique monochromic laser characteristics and a wavelength-specific photon-activated gel allow gentle, safe, quick, and effective whitening of your teeth just in a single visit to your dentist or dental hygienist. The whitening gel used in laser-assisted tooth whitening an activator that is activated by light of a particular wavelength via a photochemical reaction. The main component of the bleaching gel is hydrogen peroxide that has been used in tooth whitening for more than 100 years. The gel contains approximately 35% hydrogen peroxide. The gel fully absorbs a monochromic laser light; therefore, all heat is eliminated, and there is not direct heating that could negatively affect dental tissues.
The laser energy emitted accelerates the generation of free radicals from hydrogen peroxide; therefore, the bleaching gel is applied only for 16–24 minutes. It is the most effective and fastest method of tooth whitening.

What Is Recommended Before the Procedure?

*Before the tooth whitening procedure, it is very important to consult with a dentist or a dental hygienist. Only a thorough oral examination of the condition of dental tissues and teeth and determination of the causes of tooth discoloration allow selecting the most suitable whitening method and predicting the possible results;
*Before the tooth whitening procedure, a professional hygiene treatment has to be done;
*Only healthy and filled teeth can be whitened; otherwise, the teeth may become very sensitive.

What Should Be Known After the Whitening Procedures?

*The efficiency of whitening depends on the thickness of enamel and its inherited shade, age, diet, bad habits, and oral hygiene.
*After the tooth whitening procedure, the teeth always become brighter and remain brighter as they were before. The patient can expect especially good results to last for 2 years if he/she practices proper oral hygiene, reduces consumption of stain-causing products, and quits smoking if he/she is a smoker;
*After the procedure, the teeth may become more sensitive. This side effect is temporary and usually disappears within a few days. If the sensitivity persists longer, it is recommended to use a fluoride-containing remineralizing toothpaste as well as a remineralizing gel placed in a tray;
*An improperly fitted tray or tooth whitening done without supervision of a dentist can cause damage to the gums. This complication is temporary and it disappears after a few days as soon as the whitening procedure is discontinued.

The procedure is not recommended for:

*Children under the age of 16 as the pulp chambers of their teeth, containing the nerves, are enlarged, and dentin tubules are very wide. Tooth whitening can damage the nerve of the tooth or cause permanent sensitivity;
*Persons wearing braces;
*Pregnant or breastfeeding women;
*Persons who have numerous fillings or crowns as the materials used in these restorations do not whiten. Therefore, it is advisable to perform the tooth whitening procedure first, then to fill and restore the teeth, and match the color of a new restorative material to the whitened teeth; otherwise, old restorative materials will likely need replacement after the tooth whitening procedure;
*Persons with hypersensitive teeth or receding gums. Whitening does not have any effect on the exposed roots of the teeth as they do not have any layer of enamel;
*Persons who are allergic to peroxide or other substances in a bleaching gel;
*Persons with gingival (gum) diseases or decay-damaged teeth.
Consultations are provided and procedures are performed by Sandra Burčikaitė a dental assistant and a dental hygienist

Prevention and Oral Health

The oral health of each of us is closely related to prevention and oral hygiene. Good oral care refers to healthy teeth and gums. Professional dental hygiene helps maintain the gums and teeth healthy, and prevention helps prevent serious diseases and conditions in time. A beautiful smile is a feature of a happy person. Entrust you smile to the dental professionals of the Clinic “Grožio chirurgija.”. Consultations on oral health care and prevention are provided and procedures are performed by Sandra Burčikaitė a dental assistant and a dental hygienist.

„One does not need much to provoke a smile, and one smile is enough to make everything possible.“ "Gilbert Cesbron"
Daily oral hygiene and regular professional checkups are an easy way to a healthy and beautiful smile. Oral hygiene involves oral care and the removal of tooth deposits to prevent plaque-associated diseases. It is a cornerstone in the prevention of tooth decay and periodontal diseases.
Many people think that regular tooth brushing is enough for the maintenance of good oral health. Unfortunately, it is not true.

Oral hygiene involves two areas:
•Professional oral hygiene procedures done in a dental practice.
•Personal oral hygiene.
Professional dental hygiene involves hygiene procedures that are aimed to remove mineralized and nonmineralized tooth deposits, to polish the surfaces of teeth and fillings, to evaluate the effectiveness of tooth brushing, to perform application of preventive materials (for example, fluoride), and to teach patients how to maintain good oral health.
Personal oral hygiene is daily oral care that is maintained by every person with the help of personal hygiene measures. It involves brushing the teeth with a toothbrush, toothpaste, floss and other measures. Once tartar has formed, a person cannot remove it on his/her own. It can be removed only by the professional dental cleaning procedure.
The main etiologic factor for periodontal diseases is the accumulation of plaque on the surface of the teeth. If the plaque accumulates on the teeth and is not removed, it turns into tartar (calculus) that can be removed only mechanically. Plaque forms on the teeth both above and below the gum line, in the fissures and defects, and around the dental fillings. The most common places for plaque to accumulate are the interproximal surfaces of the molar teeth and the lingual surfaces of the front teeth in the lower jaw.
Poor oral hygiene habits and deposits (plaque and tartar) on the teeth are related to the severity of gingivitis and periodontitis. It is known that gingivitis develops within 10-21 days if the teeth are not brushed. As soon as good oral care habits are resumed, the signs of gingivitis disappear within 1–8 days. Gingivitis occurs when tartar is not formed yet. It disappears once plaque and tartar have been removed.
If the causes are not eliminated, the inflammation progresses causing the damage to the gums, deep pockets form, bone dissolves, teeth become loose and shifting, and it can lead to tooth loss.

A professional dental cleaning should be done:
•To prevent decay, gingivitis, periodontitis, and oral mucosal diseases.
•Before the planned dental treatment: periodontal, endodontic, or orthodontic treatment, cosmetic bonding, prosthesis, implantation, tooth whitening, and oral surgery.
•As an initial stage of the complex treatment of periodontal diseases regardless of the severity of a periodontal disease.
•As a supportive treatment after a complex of therapeutic procedures in the treatment of periodontal diseases; as a supportive treatment in order to reduce the risks of complications during the orthodontic treatment in patients with nonremovable orthodontic appliances.
•As a supportive treatment in order to reduce the risk of complications after dental implant surgery to achieve long-term results.
Before the tooth whitening procedure for a maximal improvement in a color/shade.

The Clinic “Grožio chirurgija” offers a full range of professional dental hygiene services:
•Assessment of oral heath conditions.
•Scaling, i.e., removal of nonmineralized or mineralized deposits above and below the gum line with an ultrasonic scaler and handheld instruments.
•Root planing.
•Polishing of teeth with the AIR-FLOW treatment.
•Polishing of the surfaces of fillings and teeth with an abrasive paste.
•Desensitization of teeth with exposed root surfaces.
•Assessment of the condition of fillings, prostheses, and implants.
•Application of preventive materials to the teeth (for example, fluoride.
•Assessment of personal oral hygiene and effectiveness of tooth brushing.
•Education of patients on proper oral hygiene habits at home and assistance in choosing the proper oral care products: toothbrushes, dental floss, interdental toothpicks, interdental brushes, toothpastes, mouthwashes, and oral irrigators.

It is important to know:
•A healthy person with good dental care habits should undergo a professional dental cleaning 1–2 times a year.
•Plaque and tartar tend to accumulate much quicker in a person with poor dental care habits; therefore, a professional dental cleaning should be done every 2–3 months, and those persons who have periodontal diseases should undergo this procedure every 1–4 months.
•During orthodontic treatment, it is advisable to undergo a professional dental cleaning every 1–3 months; persons who have dental implants should undergo it every 4–6 months.
•It is very important to monitor the condition of the mouth and teeth during pregnancy.

Professional dental hygiene treatment is very important for children who wear nonremovable orthodontic appliances. It is not only difficult but also complicated to look after their teeth properly, and extra care should be taken to prevent the destruction of the hard tooth tissues – tooth decay –that can be caused by nonremoved or poorly removed dental plaque. More information about professional hygiene treatment.

Dental sealants, also known as tooth sealants, are an effective preventive measure that protects the newly erupted teeth from early tooth decay.
The first permanent teeth erupt at the age of 5–7 (sixth, molars). Children at this age still do not have good skills to brush their teeth properly. The fissures of newly erupted teeth are not completely mineralized and very often are extremely deep and narrow; therefore, this leads to favorable conditions for plaque to accumulate and for decay to develop.
Dental sealants are a specific fluoride-containing varnish that is applied to the chewing surfaces of teeth, where it fills the fissures and thus prevents the accumulation of plaque. Moreover, fluoride ions, which are released after sealant application, enhance the mineralization process of the fissures and strengthen tooth enamel, making it more resistant to decay.

How Is the Procedure Performed?
It is a painless procedure, and it takes usually about 20 minutes to complete.
First, the teeth are thoroughly cleaned with a special paste, then an acidic solution that helps the dental sealant better adhere to the surface of the tooth is applied, and the dental sealant is placed and hardened by using an LED curing light.

What Else Should Be Known About the Procedure?
During an oral examination, it is determined if a dental sealant is needed to be placed. It is contraindicated:
•If the teeth are already decay-damaged; first, the teeth have to be treated.
•If the fissures of the tooth are shallow and well mineralized.

Do you want a more sparkling and charming smile? Tooth jewelry is an excellent way to set you apart from the rest of the crowd!
Our Clinic offers tooth jewels that are made and certified in the European Union and come in different sizes and shapes. They can be made of gold, while gold, and Swarovski crystals.

How and When Is the Procedure Performed?
Tooth jewelry can also be used to mask small, noncarious lesions of the front teeth: pigmentation- or fluorosis-related spots, enamel hypoplasia, etc. However, no tooth jewelry should be placed on an unhealthy, decay-damaged tooth. Moreover, tooth jewelry is not recommended for persons with gum disorders, dental calculus, or oral mucosal diseases.
It is an easy, completely painless, and quick procedure that takes not longer than 20 minutes. Tooth jewelry is bonded to the enamel of a healthy, not damaged tooth and does not cause any harm to your teeth.
Tooth jewels are tiny and thin (about 0.5–1 mm) and usually are felt only during the first days. A few days after, it does not cause any discomfort while eating, speaking, or brushing the teeth.
The tooth jewel can be easily removed on a personal request. The placement as well as removal of tooth jewelry is a completely painless and quick procedure that has no effect on tooth enamel, i.e., it remains smooth and undamaged.

What Should Be Known After the Procedure?
•The jewel attached can stay on the tooth for a few months up to 1 year. If the tooth jewel comes off, the person should visit a dental practice where the remaining layer of the adhesive material will be removed (gently polished).
•In order that the jewel would not come off as long as possible, it is very important to practice good oral hygiene and to control dietary habits. The person is advised to avoid rough, coarse foods and touching the jewel with his/her hands.
•If a patient who wears a tooth jewel is a heavy coffee drinker or a heavy smoker and the tooth jewel is removed, a substantial color contrast can be seen at the place where the tooth jewel was bonded. In this case, it is recommended to whiten all the teeth to remove tooth discoloration.

General dentistry involves a nonsurgical approach of tooth treatment, applied to preserve healthy teeth and a beautiful smile as long as possible. Tooth decay and inflammatory processes are very common dental problems. The Clinic “Grožio chirurgija” offers some of the most needed procedures – dental filling and root canal treatment – carried out by highly skilled and experienced dental professionals.

Rūta Abloževičienė a general dental practitionertakes care of cosmetic tooth appearance.

Tooth bonding is a procedure in which an affected tooth (decayed, eroded, fractured, or worn) is filled and restored with composites. Recently, white fillings, also known as composite fillings, which get hard by curing them with an intensive light beam, have become increasingly popular.
The purpose of dental filling is to preserve the hard tissues of teeth and protect the inner structures of the tooth and bone from the invasion of bacteria. Moreover, the lost function and esthetics can be restored by the dental filling procedure (cosmetic bonding).
If teeth are left untreated, this may lead to the conditions favorable for decay to develop, teeth can become sensitive and sore, and a fracture may occur. Eventually this can result in tooth loss. Whether the procedure is needed, it is determined during a regular checkup.

How Is the Procedure Performed?
On a patient’s request, the procedure can be done under local anesthesia. Usually it takes from 30 to 60 minutes to complete depending on the extent and location of tooth damage.
First, the decay-damaged tissues of the tooth are removed, the walls of the tooth are etched with a special acid, washed out, dried, and a special adhesive system is applied to the surfaces. Then, the tooth is restored by applying the bonding agent in thin layers until the desired shape and natural surface texture are achieved. Each layer is hardened with a special light source. Once the filling has been placed, its excess is removed, and the restored tooth is checked for proper occlusion and polished.

What Should Be Known After the Procedure?
•The restored tooth sometimes can be very sensitive. Such sensitivity usually diminishes within a few weeks. If the tooth remains sensitive for more than 2–4 weeks, the patient has to see a dentist.
•Over time, fillings are worn, and cracks between the tooth and the filing can occur, leading to the conditions favorable for bacteria to accumulate and for secondary caries to develop. Therefore, it is important for the patient to see his/her dental hygienist and dentist regularly. During a routine checkup, old fillings can be polished.

The inner part of the tooth, known as the pulp chamber, contains nerves, blood vessels, and lymph vessels that enter the tooth through the root canals. If teeth are left untreated, this can lead to the conditions favorable for bacteria to enter the root canals where they can cause inflammation. Root canals should be treated when inflammation takes place in the soft tissue (pulp) inside the teeth. This treatment is directed toward the eradication of bacteria present there and the prevention of teeth and surrounding tissues from infection. Root canal treatment involves 2 steps: chemomechanical preparation of root canals and their filling.

Chemomechanical Preparation of Root Canals
The chemomechanical preparation of root canals is done when inflammation is present in root canals. It is the first step of root canal treatment.
The inner part of the tooth, known as the pulp chamber, contains nerves, blood vessels, and lymph vessels that enter the tooth through the root canals. Different teeth have a distinct number of root canals ranging from 1 to 4. If teeth are not treated, this can lead to the conditions favorable for bacteria to enter the root canals and bone at the root tip where they can cause inflammation. Then, in turn, the procedure of chemomechanical preparation of root canals, is needed to be performed during which the root canals are cleaned and washed out. The procedure is necessary due to several reasons:
•Inflammation in root canals often causes extreme pain, and it subsides only when the nerve is dead or it is removed from the canal;
•Contaminated root canals are a source of infection from which bacteria can spread to the bone supporting the tooth and cause more severe inflammation resulting in pain and swelling;
•Root canals are often very narrow and curved; therefore, they are needed to be precisely enlarged and given a shape so that medications could be delivered where needed, and root canals could be successfully sealed in the future.

How Is the Procedure Performed?
The procedure is done under local anesthesia. It takes 30–60 minutes.
First, the tooth is isolated by using a rubber dam to protect it from saliva and washing liquid. Then, all the canals in the tooth are identified; their length is determined by inserting needle-like instruments, so-called files, and taking x-rays. The canals are enlarged with a series of files, each of which has a larger diameter, and are irrigated with a disinfectant solution. Thus, the remnants of inflamed tissues and majority of bacteria are removed, and the root canal is properly shaped to be sealed. Until the next visit, the canals are filled with a calcium hydroxide paste, which has an antimicrobial effect.

What Else Should Be Known About the Procedure?
•After the procedure, the tooth can be very sensitive. Usually it diminishes in a few days;
•During the entire period of treatment, the patient is advised not to chew hard foods on the tooth being treated, as it may cause the tooth to fracture;
•Once the root canals have chemomechanically been prepared, they have to be filled;
•Sometimes inflammatory processes in the root canal can be asymptomatic. However, eventually this leads to the formation of infection sources; therefore, the root canals have inevitably to be treated. This is detected by taking an x-ray.

Filling of Root Canals
It is the second step of root canal treatment done after cleaning the root canals, i.e., after their chemomechanical preparation. The properly cleaned and prepared root canals are sealed with special materials.
Root canals are filled to prevent the recontamination by bacteria and eventual spreading of the infection to the bone at the root tip.
Materials used for filling the root canals have an antimicrobial effect. Once the root canals have been filled, the tooth should be restored and sealed by placing a restoration (filling, inlay, crown, or onlay).

How Is the Procedure Performed?
The procedure is done after the chemomechanical preparation of root canals, usually during the next visit. Time in procedure depends on the number of root canals; usually it takes 30–60 minutes to complete.
There are a few methods of root canal filling. During the procedure, the remaining calcium hydroxide is washed out, and the root canals are dried and then filled. Once the root canals have been filled, an x-ray is taken to ensure that the root canals are filled completely to the root tip.

What Should Be Known After the Procedure?
After the root canal treatment, the tooth can be sensitive for a short time period. Sensitivity usually remains for a half-day and less frequently, for a few days.

Glass fiber posts are a supportive means that helps restore the shape of the tooth when it lacks a sufficient tooth structure to retain the core. They are used in combination with a composite filling, which gets hard by curing it with a special light source.
Whether the procedure is needed, it is determined during a regular checkup. It is usually needed before restoration when two lateral walls of the tooth are missing. This approach of restoration is applicable only when at least 2 mm of the remaining tooth structure above the gum line is left – only then the restoration will be of high-quality and long-lasting. Then a dental crown is placed over the tooth.

How Is the Procedure Performed?
The procedure usually takes up to 1 hour; it can be done in a single visit.
Before this procedure, the patient should undergo root canal treatment. Then the posts are cemented, and the shape of the tooth is restored with a composite filling, which gets hard by curing it with a special light source. The posts are tightly anchored to the roots of the tooth and the filing – a compact, tight monoblock is obtained.

Oral surgery is a broad area of dentistry that deals with the diagnosis and surgical treatment of pathologies and tumors of not only teeth, but also tongue, oral mucosa, salivary glands, jaws, and sinuses.
Oral surgery is an integral part of complex treatment during tooth replacement and restoration, and orthodontic treatment.
Oral surgery is an integral part of complex treatment during tooth replacement and restoration, and orthodontic treatment. In the Clinic “Grožio chirurgija,” oral surgeons in a team with other specialists perform a wide range of simple procedures, such as tooth extraction or gum grafting, as well as complex surgeries, such as jaw reconstruction, vestibuloplasty, sinus lift, etc. Surgeries are performed under local or general anesthesia.
Consultations are provided and surgeries are performed by Eugenijus Čiuplevičius an oral and maxillofacial surgeon.

Alveolar bone grafting with an autologous bone graft refers to surgery when a bone fragment of an appropriate size is taken from the area of the chin or the jaw and is transplanted by a special technique to the place where it is necessary to augment the volume of the resorbed alveolar ridge for the future placement of dental implants. This surgery is performed when the alveolar ridge is too narrow to allow dental implants to be placed or is not high enough to allow dental implants to be screwed technically. Dental implants are placed after 6 months following this surgery.

After Alveolar Bone Grafting
After the bone grafting procedure, the oral surgeon will ask the patient to bite on a gauze pad placed over the treated area for 30 minutes. The purpose of this gauze pad is to absorb the blood and stop the bleeding. If the bleeding continues, blood pressure should be measured (reference range, 120/80 mm Hg). If blood pressure is higher than indicated, medications to lower it should be taken. High blood pressure can be a cause of bleeding. If bleeding persists and blood pressure is within the reference range, the patient should contact our clinic.
Any strenuous physical activities (exercise, lifting of heavy things), hot baths, and saunas should be avoided. The patient is advised to sleep on the side of his/her body that has not been operated on.

Diet
The patient should restrain from eating for 2 hours after the surgery. It is advisable to avoid coarse and hot foods on the same day. It is not recommended to drink coffee or alcohol as increased blood pressure can cause bleeding. To feel blood taste on the second day after the surgery is normal.

Smoking
It is strongly recommended to quit smoking as it restricts blood flow, wounds heal poorly, and the patient is at higher risk of acquiring an infection at the site treated.

Discomfort
Postoperative swelling is usually slight. To avoid or reduce it, cold therapy can be applied for 5-6 hours: the cheek is cooled for 15 minutes, then a 30-minute break is done, and the procedure is repeated again from the beginning. If ice is applied, it should be wrapped in a thin towel and then placed over the area treated.
For postoperative pain relief, all ordinary medications from a home first aid kit, such as Ibumax, Ibuprom, Nimesil, or Ketanov, can be used except aspirin as it has blood-thinning properties.

Personal Oral Hygiene
On the first day after the surgery, the teeth should be brushed gently with a soft toothbrush. It is necessary to rinse the mouth with special mouthwashes for 5-6 times a day (for example, Eludril, Listerine, Hexoral).
After the surgery, the edges of the gums are closed together with the sutures; they will be removed after 14-21 days. The sutures should be clean and free of debris to ensure proper wound healing. It is recommended to clean the sutures with a piece of gauze soaked in hydrogen peroxide until the sutures are removed.

After the procedure, the surgeon will place a gauze pad between the cheek and the teeth, which should be kept for approximately 30 minutes to absorb the blood. After the procedure or the next day, bleeding from the nose may occur. The patient should not be afraid of this; it is normal. All the blood that gathers in the sinus is cleared through the nose. If the bleeding is intensive and does not stop, the patient should contact our clinic.
The patient should avoid any nose blowing; any secretions accumulated in the nose can be expectorated if needed. The patient should sneeze with the mouth open! Any strenuous physical activities (exercise, lifting of heavy things), hot baths, and saunas should be avoided.
The patient is advised to sleep on the side of his/her body that has not been operated on. It is recommended to avoid scuba diving and travelling by plane for the next 3 weeks after the surgery.

Diet
The patient should restrain from eating for 2 hours after the surgery; if an anesthetic has been used, the area treated will be numb for this period, and the cheek and the tongue can be easily injured while chewing. It is advisable to avoid coarse and hot foods on the same day. It is not recommended to drink coffee or alcohol as increased blood pressure can cause bleeding. To feel blood taste on the second day after the surgery is normal.

Smoking
No smoking 1 week before and 3 weeks after the surgery. It restricts blood flow, wounds heal poorly, and the patient is at higher risk of acquiring an infection at the site treated. We strongly recommend quitting smoking at all.

Discomfort
Postoperative swelling after the maxillary sinus lift surgery is a normal reaction of the body to the procedure. The swelling will reach its maximum on the third day after the surgery and it will subside with every day. To reduce it, cold therapy can be applied: the cheek is cooled for 15 minutes, then a 30-minute break is done, and the procedure is repeated again from the beginning. If ice is applied, it should be wrapped in a thin towel and then placed over the treated area.
For postoperative pain relief, all ordinary medications from a home first aid kit, such as Ibumax, Ibuprom, Nimesil, or Ketanov, can be used, except aspirin as it has blood-thinning properties.

Personal Oral Hygiene
On the first day after the sinus lift surgery, the teeth should be brushed gently with a soft toothbrush. It is necessary to rinse the mouth with special mouthwashes for 5-6 times a day (for example, Eludril, Listerine, Hexoral).
After the surgery, the edges of the gums are closed together with the sutures; they will be removed after 14-21 days. The sutures should be clean and free of debris to ensure proper wound healing. It is recommended to clean the sutures with a piece of gauze soaked in hydrogen peroxide until the sutures are removed.

Prosthodontics is the branch of dentistry that deals with the replacement of missing teeth and surrounding hard tissues, done by a dentist together with a dental technician.
Missing teeth can be replaced with dental implants, bridges, or removable prostheses. The treatment of an edentulous patient is always callenging and requires special knowledge and skills in prosthodontics and implant dentistry.
The professional qualification of specialists in the Clinic “Grožio chirurgija,” their long-term experience, the newest methods, and the highest-quality materials allow achieving the best possible results.

Gingival recession, also known as receding gums, is a dental condition characterized by the retraction of the gum line from the crown or implant of the tooth leading to exposed tooth roots.
Gingival recession can be caused by orthodontic treatment with braces, functional overload on a tooth or a group of the teeth, and physiological or pathological bone loss in the area of teeth or dental implants. Gingival recession can lead to the increased sensitivity of teeth, elongated teeth, loss of the esthetic appearance of restored teeth or dental implants, and higher risk of root caries.
The strategy of surgical treatment depends on the severity of recession. The surgical treatment of gingival recession involves soft tissue and/or alveolar bone grafting. The surgical procedure prevents the progression of recession; the exposed tooth roots or dental implants are covered, tooth sensitivity is reduced, and esthetic appearance is restored.

Our Clinic offers atraumatic tooth extraction that aims to preserve the remaining alveolar bone and surrounding tissues. After the procedure, the bone regenerates at an extraction site, and usually the eventual placement of a dental implant is planned.

Postoperative period:
After the tooth extraction procedure, the oral surgeon will ask the patient to bite on a gauze pad placed over the area treated for 30 minutes. The purpose of this gauze pad is to absorb the blood and stop the bleeding. If the bleeding continues, the gauze pad should be replaced with the new one, which should be kept for 30 minutes again.
It is advisable to measure blood pressure (reference range, 120/80 mm Hg). If blood pressure is higher than indicated, medications to lower it should be taken. High blood pressure can be a cause of bleeding. If bleeding persists and blood pressure is within the reference range, the patient should contact our clinic.
After the tooth extraction procedure, any strenuous physical activities (exercise, lifting of heavy things), hot baths, and saunas should be avoide.

Diet
The patient should restrain from eating for 2 hours after the surgery; if an anesthetic has been used, the area treated will be numb for this period, and the cheek and the tongue can be easily injured while chewing. It is advisable to avoid coarse and hot foods on the same day. It is not recommended to drink coffee or alcohol as increased blood pressure can cause bleeding. To feel blood taste on the second day after the surgery is normal.

Smoking
The patient should refrain from smoking for at least 12 hours after the tooth extraction procedure as smoke and nicotine retard proper wound healing, and this can cause an abnormal blood clot to form.

Discomfort
Postoperative swelling after tooth extraction is usually slight. Cold therapy applied for 5-6 hours can help avoid or reduce it: the cheek is cooled for 15 minutes, then a 30-minute break is done, and the procedure is repeated again from the beginning. If ice is applied, it should be wrapped in a thin towel and then placed over the area treated.
For postoperative pain relief, all ordinary medications from a home first aid kit, such as Ibumax, Ibuprom, Nimesil, or Ketanov, can be used, except aspirin as it has blood-thinning properties.

Personal Oral Hygiene
On the first day after the tooth extraction procedure, the mouth should not be rinsed as the blood clot can be dislodged and this may cause pain. The teeth should be brushed gently with a soft toothbrush. On the next day, it is necessary to rinse the mouth with special mouthwashes for 5-6 times a day (for example, Eludril, Listerine, Hexoral) and to brush the teeth normally.
If after tooth extraction the edges of the gums were closed together with the absorbable sutures, they do not have be removed as they dissolve on their own in 30-35 days. The sutures should be free of debris to ensure proper wound healing. It is recommended to clean the sutures with a piece of gauze soaked in hydrogen peroxide until the debris is removed.

Due to a lack of the space in the dental arch or the jawbone, not all wisdom teeth erupt or they erupt misaligned. This can cause recurrent chronic infections and lead to complications during orthodontic treatment.
In complex cases, the surgical tooth extraction procedure is performed as follows: the unerupted tooth is completely exposed, the excess of the surrounding bone is cut away, the tooth is broken into smaller pieces, the inflamed tissues and mucosa are removed, and the edges of the incision are are sutured. Self-dissolving stitches are used so they do not need to be removed.

Postoperative Treatment
Postoperative treatment with antibiotics and anti-inflammatory medications is administered for patients.

An apicoectomy is a surgical removal of the tip of a tooth root (apex), applied after the failed retreatment of root canals. This procedure can be done in the area of the molar and premolar teeth as well as the front teeth. A hemisection and root amputation are dental procedures done on teeth with multiple roots, and they involve the removal of part of the root or the entire root, leaving the tooth anchored to the bone with the remaining roots.

How is the Surgery Performed?
Part of the root tip is removed through a small opening in the bone, the end of the root is sealed with a filling that prevents further reinfection, and the incision is sutured.

Benign bone and soft tissue tumors in the maxillofacial area are tumors that originate in the jawbone as well as soft tissues. Usually they are asymptomatic and found incidentally or in cases when larger lesions develop.
The treatment strategy depends on the localization, extent, and adverse inflammatory changes. All the tumors removed during the surgery are subjected to histological examination.

There are some clinical situations when it is difficult to remove tooth roots because of the anatomical shape and position of tooth roots and jawbone. Application of excessive force or inappropriate instrument can result in the displacement of the tooth root into the maxillary sinus or soft tissues, which can cause inflammation at the site affected.

Postoperative Period:
•After the procedure, the surgeon will place a gauze pad between the cheek and the teeth, which should be kept for approximately 30 minutes to absorb the blood. After the procedure or the next day, bleeding from the nose may occur. The patient should not be afraid of this; it is normal. All the blood that gathers in the sinus is cleared through the nose. If the bleeding is intensive and does not stop, the patient should contact our clinic.
•The patient should avoid any nose blowing; any secretions accumulated in the nose can be expectorated if needed. The patient should sneeze with the mouth open.
•Any strenuous physical activities (exercise, lifting of heavy things), hot baths, and saunas should be avoided.
•The patient is advised to sleep on the side of his/her body that has not been operated on. •It is recommended to avoid scuba diving and travelling by plane for the next 3 weeks after the surgery.

Diet
The patient should restrain from eating for 2 hours after the surgery; if an anesthetic has been used, the area treated will be numb for this period, and the cheek and the tongue can be easily injured while chewing. It is advisable to avoid coarse and hot foods on the same day. It is not recommended to drink coffee or alcohol as increased blood pressure can cause bleeding. To feel blood taste on the second day after the surgery is normal.

Smoking
No smoking 1 week before and 3 weeks after the surgery. It restricts blood flow, wounds heal poorly, and the patient is at higher risk of acquiring an infection at the site treated. We strongly recommend quitting smoking at all.

Discomfort
Postoperative swelling after this procedure is a normal reaction of the body to the procedure. The swelling will reach its maximum on the third day after the surgery and it will subside with every day. To reduce it, cold therapy can be applied: the cheek is cooled for 15 minutes, then a 30-minute break is done, and the procedure is repeated again from the beginning. If ice is applied, it should be wrapped in a thin towel and then placed over the treated area.
For postoperative pain relief, all ordinary medications from a home first aid kit, such as Ibumax, Ibuprom, Nimesil, or Ketanov, can be used, except aspirin as it has blood-thinning properties.

Personal Oral Hygiene
On the first day after the procedure, the teeth should be brushed gently with a soft toothbrush. It is necessary to rinse the mouth with special mouthwashes for 5-6 times a day (for example, Eludril, Listerin, Hexoral).
After the surgery, the edges of the gums are closed together with the sutures; they will be removed after 14-21 days. The sutures should be clean and free of debris to ensure proper wound healing. It is recommended to clean the sutures with a piece of gauze soaked in hydrogen peroxide until the sutures are removed.