Specialty Procedures
Advanced Oral Surgery for Complex Dental Needs
At Carolina Oral & Facial Surgery, P.A., Dr. Bart Williams provides advanced specialty procedures that often complement other dental treatments. These services help restore oral health, support long-term function, and improve esthetics—working in coordination with your general dentist or specialist.
Apicoectomy (Endodontic Surgery)
Sometimes, a root canal alone may not be enough to fully heal an infected tooth. In these cases, your dentist or endodontist may recommend an apicoectomy—also known as root-end surgery.
During this minor procedure, Dr. Williams gently opens the gum tissue near the tooth to access and clean the tip of the root. Any inflamed or infected tissue is removed, and several millimeters of the root end are trimmed to eliminate the source of infection. The root canal is then sealed with a small biocompatible filling, and the gum is closed with resorbable sutures. Over the following months, the surrounding bone naturally heals.
If a large area of bone loss or a defect has developed around the root, Dr. Williams may recommend adding bone grafting material to restore bone structure and promote more complete healing.
Gum Grafting (Periodontal Procedures)
Gum Graft Surgery
Gum recession commonly occurs from orthodontic tooth movement, periodontal disease, or teeth grinding (bruxism). Receding gums expose the roots of teeth, which can increase sensitivity, risk of decay, and affect the appearance of your smile.
Gum graft surgery replaces or thickens the gum tissue to cover exposed roots and prevent further recession or bone loss. During gum graft surgery, gum tissue from your palate or another source is used to cover the exposed root. Gum graft surgery can be performed on multiple teeth.
When appropriate—such as for patients undergoing wisdom teeth extractions after orthodontic treatment— donor gum can easily be taken from extraction sites to eliminate a separate donor site and take advantage of combining the procedures.
In addition to protecting the teeth, gum grafting often reduces tooth sensitivity and improves the aesthetics of your smile.
Regenerative Procedures
If periodontal disease or peri-implantitis has damaged the bone around teeth or dental implants, regenerative procedures can help restore lost support. As gum pockets deepen, bacteria accumulate and cause progressive bone loss.
Dr. Williams performs regenerative treatments that fold back the gum to remove bacteria and place bone grafts, tissue-stimulating proteins, or membranes to encourage natural tissue and bone regeneration. This process supports long-term stability and helps preserve natural teeth and implants.
Gingivectomy and Crown Lengthening
Some people have what is known as a “gummy smile,” where the teeth appear short due to excess gum tissue. A gingivectomy reshapes the gum and bone to expose more of the natural tooth and create a more balanced, esthetic appearance.
In cases where a tooth is too short to support a dental crown, crown lengthening may be recommended. This procedure adjusts the gum and bone around the tooth to expose more structure, allowing your dentist to place a more secure and natural-looking crown.
Anesthesia Options Available for Surgery
Local Anesthesia
Patients who have undergone fillings or other minor dental procedures may have previous experience with local anesthesia. Local anesthesia is a numbing medication that is injected directly around the area to be treated.
IV Sedation
IV sedation allows patients to enter a deeply relaxed, sleep-like state during a procedure. It is commonly used for more complex surgical treatments or for individuals with significant dental anxiety.
General Anesthesia
Some people are best managed in a hospital or surgery center. This may be due to the complexity of the surgery, health of the patient, or in cases of severe anxiety, emotional immaturity, or developmental delay.
We Are Here to Help You Prepare
At Carolina Oral & Facial Surgery, we are committed to providing the highest level of care and treatment for every patient. See helpful information to guide you before and after your surgery.