The surgical removal of the operculum, or the flap of gum that partially conceals a tooth, is known as an operculectomy. Pericoronitis, a disorder marked by pain and operculum inflammation, is treated with this technique. Young adults are more likely than older persons to get pericoronitis, especially if their wisdom teeth are just beginning to erupt.
A mass of soft tissue called the dental operculum can be seen on a tooth that has not fully erupted. Although it can be found covering some baby teeth, it is more frequently associated with lower wisdom teeth. When a tooth starts to emerge and poke its head through the gum lining, it is extremely obvious. The gum tissue often recedes as the tooth continues to emerge and shifts into its ideal location.
What happens if an operculectomy is not done?
1. The condition, known medically as pericoronitis, results in inflammation of the soft tissues surrounding the crown of the partially erupted tooth. Teeth that emerge slowly or become impacted frequently experience it.
2. After bacteria enter the follicular space, an infection develops. This infection is exacerbated by food particles that become lodged near the operculum and by the opposing tooth’s occlusal damage to the pericoronal tissues.
When is an operculectomy recommended?
The dentist will recommend an operculectomy if you have pericoronitis, which can be acute or persistent.
Acute pericoronitis is marked by intense radiating pain, localized pericoronal tissue edema, purulence or drainage, trismus, regional lymphadenopathy, uncomfortable swallowing, pyrexia, and occasionally infection dissemination to nearby tissue spaces.
Chronic pericoronitis is characterized by dull pain or discomfort that lasts for a few days and is frequently accompanied by an unpleasant taste. Remission lasts for several weeks or months.
How is the procedure carried out?
Prior to surgery, the patient receives local anesthesia. The flap covering the afflicted tooth is then loosened by the dentist making one or more incisions on the operculum. The dentist will next proceed to remove the gum tissue with a knife. The operculum may also be eliminated by the dentist using a radio-surgical loop. The dentist can either use stitches to close the wound or leave it open so that it can heal naturally.
Electrocautery can also be used to conduct operculectomy. A tiny probe is used to apply a moderate electric current to the surgical site and into the tissue. The fragile tissue of the operculum may fall apart due to the heat produced by the alternating current. In doing so, the dentist is able to sever the gum tissue that was covering the tooth’s chewing surface and remove it. For this treatment, no dressing is needed.
An inflammatory operculum can also be removed by a dentist using a diode laser. The carbon dioxide laser is the most typical kind of laser utilized in this process. The laser handpiece is placed close to the target area after local anesthesia has been administered. The target tissue is ablated by laser pulses. To prevent tooth damage, the dentist must ensure that the laser pulse does not contact the tooth’s enamel. After removing all operculum tissue and achieving haemostasis, the handpiece is progressively withdrawn from the surgical area. The wound is kept open to heal
Potential dangers and difficulties
The lingual nerve, which supplies sensation to the tongue, may be damaged during an operculectomy, which poses the highest danger. Due to an injury, the patient might not be able to taste their food or drink. In some circumstances, tongue numbness may also be felt. This issue might get better on its own over time or might persist forever. Additional risks include bleeding and infection. Sepsis could result from an infection that enters the bloodstream. Given that the surgery site is close to the brain, this complication has the potential to be dangerous. The operculum could also grow again and develop an infection once more. Another therapy session would be required because of this.
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