Section 602.21 - Dental Surgery Treatments and Procedures(a) Oral surgery. (1) Extraction (removing teeth). (A) Dry socket (inflammation in the socket of a tooth).(B) Permanent or temporary numbness or altered sensation.(C) Sinus communication (opening from tooth socket into the sinus cavity).(D) Fracture of alveolus and/or mandible (upper and/or lower jaw).(2) Surgical exposure of tooth in order to facilitate orthodontics. (A) Injury to tooth or to adjacent teeth and structures.(B) Failure to get proper attachment to tooth requiring additional procedure.(b) Endodontics (deals with diseases of the dental pulp).(1) Apicoectomy (surgical removal of root tip or end of the tooth, with or without sealing it). (A) Shrinkage of the gums and crown margin exposure.(B) Sinus communication (opening from tooth socket into the sinus cavity).(C) Displacement of teeth or foreign bodies into nearby tissues, spaces, and cavities.(2) Root amputation (surgical removal of portion of one root of a multi-rooted tooth). (A) Shrinkage of the gums and crown margin exposure.(B) Sinus communication (opening from tooth socket into the sinus cavity).(C) Displacement of teeth or foreign bodies into nearby tissues, spaces, and cavities.(3) Root canal therapy (from an occlusal access in order to clean and fill the canal system). (A) Instrument separation (tiny files which break within the tooth canal system).(B) Fenestration (penetration of walls of tooth into adjacent tissue).(C) Failure to find and/or adequately fill all canals.(D) Expression of irrigants or filling material past the apex of the tooth (chemicals used to clean or materials used to fill a root may go out the end of the root and cause pain or swelling).(E) Damage to adjacent tissues from irrigants or clamps.(F) Fracture or loss of tooth.(c) Periodontal surgery (surgery of the gums). (1) Gingivectomy and gingivoplasty (involves the removal of soft tissue). (A) Tooth sensitivity to hot, cold, sweet, or acid foods.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(2) Anatomical crown exposure (removal of enlarged gingival tissue and supporting bone to provide an anatomically correct gingival relationship). (A) Tooth sensitivity to hot, cold, sweet, or acid foods.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(3) Gingival flap procedure, including root planing (soft tissue flap is laid back or removed to allow debridement (cleaning) of the root surface and the removal of granulation tissue (unhealthy soft tissue)). (A) Permanent or temporary numbness or altered sensation.(B) Tooth sensitivity to hot, cold, sweet, or acidfoods.(C) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(4) Apically positioned flap (used to preserve keratinized gingival (attached gum tissue) in conjunction with osseous resection (removal) and second stage implant procedure). (A) Permanent or temporary numbness or altered sensation.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(5) Clinical crown lengthening (removal of gum tissue and/or bone from around tooth). (A) Permanent or temporary numbness or altered sensation.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(6) Osseous surgery-including flap entry and closure (modification of the bony support of the teeth).(A) Permanent or temporary numbness or altered sensation.(B) Tooth sensitivity to hot, cold, sweet, or acid foods.(D) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(7) Guided tissue regeneration-resorbable barrier.(A) Permanent or temporary numbness or altered sensation.(B) Accidental aspiration (into the lungs) of foreign matter.(C) Rejection of donor materials.(8) Guided tissue regeneration-nonresorbable barrier (includes membrane removal). (A) Permanent or temporary numbness or altered sensation.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(C) Accidental aspiration (into the lungs) of foreign matter.(D) Rejection of donor materials.(9) Pedicle soft tissue graft procedure. (A) Permanent or temporary numbness or altered sensation.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(C) Rejection of donor materials.(10) Free soft tissue graft protection-including donor site surgery. (A) Permanent or temporary numbness or altered sensation.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(11) Sub epithelial connective tissue graft procedures. (A) Permanent or temporary numbness or altered sensation.(B) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(12) Distal or proximal wedge procedure (taking off gum tissue from the very back of the last tooth or between teeth). Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(13) Soft tissue allograft and connective tissue double pedicle graft from below (creates or augments gum tissue). (A) Permanent or temporary numbness or altered sensation.(B) Tooth sensitivity to hot, cold, sweet, or acid foods.(C) Shrinkage of the gums upon healing resulting in teeth appearing longer and greater spaces between some teeth.(d) Implant procedures. (1) Bone grafting (replacing missing bone). (A) Permanent or temporary numbness or altered sensation.(B) Rejection of bone particles or graft from donor or recipient sites.(C) Damage to adjacent teeth or bone.(2) Surgical placement of implant body. (A) Blood vessel or nerve injury.(B) Damage to adjacent teeth or bone fracture.(C) Sinus communication (opening from tooth socket into the sinus cavity).(D) Failure of implant requiring corrective surgery.(E) Cyst formation, bone loss, or gum disease around the implant.25 Tex. Admin. Code § 602.21
Adopted by Texas Register, Volume 48, Number 51, December 22, 2023, TexReg 7985, eff. 12/26/2023