ORAL SURGERY IN GRANADA HILLS
Surgical dentistry performed in-house by one clinician, from a simple extraction to zygomatic implants, with IV sedation available for every procedure.
Most general dental practices refer surgery out. A tooth that needs sectioning, a sinus that needs lifting, a jaw that needs bone before an implant can go in: these are sent to a surgeon across town, and the patient returns weeks later to a different office to have the work finished. At Viva Smile in Granada Hills, surgical dentistry is done here, by Dr. Káren Baghdasaryan, who also does the restorative work that follows. The extraction, the graft, the implant, and the crown are one plan under one clinician.
To be precise about what that means: Dr. Baghdasaryan is a cosmetic and implant dentist, not an oral and maxillofacial surgeon. His surgical training includes an oral and maxillofacial surgery internship at Yerevan State Medical University, implant surgery preceptorships at Loma Linda University, an advanced program in periodontics at Loma Linda, and Associate Fellowship in the American Academy of Implant Dentistry, a credential requiring 600 hours of implant training and examination before a specialist panel. The scope of what he performs in-house is wider than most general practices and includes procedures many surgical offices refer out. What he doesn't do is also stated plainly: jaw fractures, orthognathic (jaw repositioning) surgery, TMJ surgery, and pathology beyond a biopsy are referred to the appropriate specialist.
What's performed here
Extractions
Simple extractions of teeth that are visible and intact. Surgical extractions of teeth that are broken at the gumline, fused to bone, or need to be sectioned and removed in pieces. When an implant is planned to replace the tooth, grafting the socket at the same visit to preserve the bone is the default recommendation, and when conditions permit, which is often, the implant is placed immediately, in the same appointment as the extraction.
Wisdom teeth, including fully bony impactions, are handled in-house and have their own page: wisdom teeth removal.
Bone grafting and regeneration
Bone that's been lost to infection, extraction, or years without a tooth can be rebuilt. The practice performs the full range: socket preservation at extraction, ridge augmentation to widen or heighten a jaw that's too thin for an implant, guided bone regeneration with barrier membranes, and larger grafts for significant defects.
Graft material comes from two sources, chosen by the job it has to do. For socket preservation and sinus lifts, processed donor bone is used most of the time. For guided bone regeneration and larger defects, the patient's own bone gives the best result: it's harvested intraorally, from the back of the lower jaw or behind the upper molars, in the same surgery, sometimes combined with donor bone to extend it. There's no hip or other external harvesting, so recovery stays in the mouth.
With rare exceptions, PRF or PRP is added to every surgical site: a small amount of your blood, spun in a centrifuge at the appointment to concentrate your own platelets and growth factors. It speeds healing and improves how well the graft integrates.
Sinus lifts
For implants in the upper back jaw, where the sinus often sits too close to the ridge, the sinus floor is raised and bone is placed beneath it. Both approaches are performed here: the lateral window technique for larger lifts, and the less invasive crestal approach through the implant site when the gap is smaller.
Implant surgery, including the difficult cases
Implant placement is covered on its own page: dental implants. What belongs here is the surgical end of the spectrum, the cases where there isn't enough bone for conventional implants and most practices say no.
Zygomatic implants
For patients with severe upper jaw bone loss, long implants are anchored in the zygomatic bone, the cheekbone, bypassing the missing jawbone entirely. It allows a fixed full-arch restoration without months of grafting first, in patients who have often been told implants aren't possible for them.
Pterygoid implants
Anchored in the dense bone behind the upper molars, these support the back of a full-arch restoration where the sinus leaves no room for conventional implants.
Nerve repositioning
In the lower jaw, when the nerve that runs through the bone sits where an implant needs to go, it can be carefully moved aside so the implant can be placed at full length. It's a delicate procedure, performed in-house.
Removal of failed implants
Implants placed elsewhere that have failed, loosened, or become infected are removed, the site is rebuilt, and the case is replanned.
Surgery that supports orthodontics
Exposure of impacted teeth. A tooth that's stuck in the bone, commonly a canine, is surgically uncovered and fitted with an attachment so the orthodontist can guide it into place.
SFOT. Surgically facilitated orthodontic treatment reshapes the bone around the teeth and adds graft material so teeth move faster and further, and finish with more bone support than they started with. It's used with Invisalign cases where alignment alone would be slow or leave the roots thinly covered.
Other procedures
Apicoectomy. When a root canal hasn't resolved an infection at the root tip, the tip is removed surgically and the end of the root is sealed, saving a tooth that would otherwise be lost.
Alveoloplasty and tori removal. Smoothing an uneven jaw ridge, or removing the bony growths some people have on the palate or inside the lower jaw, so a denture fits or a restoration can be placed.
Lip reduction. Surgical reduction of an overly full or protruding lip, often combined with cosmetic planning. Lip repositioning for a gummy smile is covered on the cosmetic dentistry page.
Abscess drainage. Relief of an acute infection, with definitive treatment planned once it's controlled.
Biopsies and lesion removal. Suspicious spots, cysts, and growths are removed and sent for evaluation.
Periodontal surgery. Pocket reduction, osseous surgery, and gum grafting are covered on the gum disease treatment page.
How surgery is done here
Four things distinguish surgical care at Viva Smile, and each changes what you experience.
Planned in 3D
Complex cases are planned on a CBCT scan, a 3D X-ray of the jaws that shows bone volume, nerve position, and sinus anatomy before anything is cut. A simple extraction or a routine single implant rarely needs it; a sinus lift, a nerve repositioning, or a full-arch case always does. Every full-mouth case and any case placing two or more implants is executed with a surgical guide printed from the plan, so placement matches the design. A single implant is guided when bone is limited or a nerve or sinus sits close to the site.
Laser incisions
With rare exceptions, where an incision is needed the Solea laser is used as the scalpel. The cut is clean and nearly bloodless, which gives a clearer surgical field, less swelling afterward, and more comfortable healing.
Ultrasonic bone surgery
Bone is cut with piezoelectric instruments that work by micro-vibration and leave soft tissue, nerves, membranes, and vessels untouched. For sinus lifts, nerve repositioning, and bone harvesting, that precision is the difference between a routine recovery and a complicated one.
Your own growth factors
PRF and PRP, concentrated from your own blood at the appointment, are placed in extraction and graft sites to accelerate healing and reduce swelling, discomfort, and the risk of complications like dry socket.
Sedation for surgery
For the larger procedures, impacted wisdom teeth, sinus lifts, ridge augmentation and larger grafts, zygomatic and pterygoid implants, and full-mouth implant surgery, IV sedation is routine. You stay breathing on your own and respond if spoken to, but most patients remember little of the appointment. For simpler surgery, single or double implant placement, surgical extractions, apicoectomies, oral sedation is offered to patients who are anxious, and The Wand makes the numbing itself barely felt. Dr. Baghdasaryan trained in IV sedation at USC's Herman Ostrow School of Dentistry and serves as an evaluator for the Dental Board of California, conducting the site inspections and competency evaluations other dentists must pass to receive a moderate sedation permit. If you're sedated, someone needs to drive you home and the rest of the day is for resting.
After surgery
You leave with written instructions specific to your procedure, and within a day or two the practice calls to check on you. If something concerns you after hours, you can text the office; messages are answered and a plan is made quickly. For most extractions and grafts, expect soreness for two to three days, managed with over-the-counter or prescribed medication, soft foods, and no smoking or straws while the site heals. Larger procedures carry more swelling, peaking around day two. Follow-up visits are scheduled to confirm healing before any next stage begins.
Referred and out-of-area patients
Many surgical patients arrive because their dentist recommended a surgical consultation, and some travel from across Los Angeles for procedures few offices perform, zygomatic implants and nerve repositioning among them. If you've been referred, bring your records or have your dentist send them, and a dental exam here will give you a clear answer.
Does insurance cover oral surgery?
Most PPO-type dental insurances cover surgical procedures when they're medically necessary, including extractions, grafting to treat bone loss, and surgery to resolve infection. We verify your specific benefits before treatment so you know where you stand.
Surgery is where this practice's limits are widest
The cases most offices decline, whether for lack of bone, proximity to a nerve, or a previous failure, are the ones this practice was built to take on. If you've been told an implant isn't possible, that a tooth can't be saved, or that you'll need to see three different offices to get one problem solved, start with a dental exam. Book online or call (818) 900-2800.
Frequently asked questions
Is Dr. Baghdasaryan an oral surgeon?
No. He is a cosmetic and implant dentist with surgical training, including an oral and maxillofacial surgery internship, implant surgery preceptorships and an advanced periodontics program at Loma Linda University, and Associate Fellowship in the American Academy of Implant Dentistry. The procedures on this page are ones he performs routinely in-house. Jaw fractures, orthognathic surgery, TMJ surgery, and pathology beyond a biopsy are referred to a specialist.
Will I be asleep for surgery?
For the larger procedures, IV sedation is routine: you'll be deeply relaxed and most patients remember little or nothing, though you continue breathing on your own. For simpler surgery, oral sedation is available if you're anxious, and local anesthetic with The Wand is often enough.
Where does bone graft material come from?
For socket preservation and sinus lifts, mostly processed donor bone. For larger rebuilds and guided bone regeneration, your own bone, taken from inside your mouth, from the back of the lower jaw or behind the upper molars, in the same surgery, sometimes combined with donor bone. No hip or other external site is used.
What are zygomatic implants?
Long implants anchored in the cheekbone rather than the upper jaw, used when the jawbone has receded too far for conventional implants. They allow a fixed full-arch restoration without months of bone grafting first, and they're performed in-house here.
Can an implant be placed the same day a tooth is removed?
Frequently, yes. When the socket is healthy and there's enough bone to stabilize it, the implant is placed at the extraction visit. When it isn't, the socket is grafted, which is the default recommendation whenever an implant is planned, and the implant follows after healing.
How long is recovery?
Two to three days of soreness for most extractions and grafts, with most patients back to normal routine the next day or two. Larger procedures, sinus lifts, and grafts carry more swelling and a few more days of reduced activity. You'll get a specific timeline for your procedure before it's scheduled.
What's the first step?
A dental exam, with a CBCT scan for anything beyond a simple case, which shows exactly what your case involves, whether surgery is needed, and what it would take. Book online or call (818) 900-2800. If you've been referred by your dentist, bring or have them send your records.
