Oral & Maxillofacial Surgery

What is Oral and Maxillofacial Surgery?

Oral and Maxillofacial Surgery is one of the most important clinical branches of dentistry. This branch covers medical and surgical treatments of esthetic and functional problems of soft and hard tissues of the oral cavity, upper and lower jaws, and the face, caused by congenital or acquired disorders, trauma or any other pathological reason.

Oral and maxillofacial surgeons are graduates of Oral and Maxillofacial Surgery Department at dental schools. Graduates of this department offer treatment not only for teeth but also for soft tissues such as cheeks, lips, tongue and salivary glands. They identify the problems and determine the surgical procedures that will be applied to hard tissues such as jaw bones and joints.

Oral and maxillofacial surgery deals with;

  • Extraction of impacted teeth, with complicated circumstances
  • All surgical treatments of infection around the oral cavity and face
  • Surgical treatments of cysts and tumors occurring in the jaws
  • Surgical treatments of soft tissue diseases of the oral cavity
  • Treatment of intraosseous lesions caused by roots of the teeth (Apical Resection)
  • Treatments of fractures the took place in the face and jaws
  • Surgical correction of soft and hard tissues before prosthetic treatments
  • Medical and surgical treatments of the pains occurring in jaws and face
  • Medical and surgical treatments of temporomandibular joint disorders
  • Treatments of cleft palate
  • Medical and surgical treatments of salivary gland disorders
  • Surgical correction of deformities causing esthetic and functional problems in the oral cavity, jaws, and face (orthognathic surgery)
  • Treatment of bone necrosis caused by medication and radiation therapy for cancer treatment
  • Implant operations

 

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    How it is Applied?

    As in a lot of treatments, oral and maxillofacial surgery treatments are planned carefully by the professionals. The plan differs according to the type of treatment that will be chosen for the condition. An x-ray of the area where the patient has a problem, an examination is carried out by the professionals. After the problem is identified, the treatment method is decided and the surgical procedure, if needed, is done by multiple doctors.

    Surgical procedures are executed under anesthesia. Local anesthesia is enough for most of the cases. But for more comprehensive operations general anesthesia is needed. This is decided by the doctor after a thorough examination.

    Oral and maxillofacial treatments provide many advantages for patients. A good jaw and face structure can be restored with proper treatment, for people with deformities caused by fractures or trauma on the face and jaw area.  Treatment of defects in soft tissues makes it possible for people to have a healthier and comfortable life.

    Thanks to the oral surgery procedures executed by professionals, diseases are cured and the bad prognosis is avoided. Esthetic works on teeth and jawbones help people have better appearances.

     

    Wisdom teeth

    Wisdom teeth are the 3. Molar teeth that are placed most posteriorly in the oral cavity. They are the last ones to be completed.

    The reason for wisdom tooth extraction

    Wisdom teeth fail to erupt fully in most cases and end up partially or completely impacted in the bone. This situation disrupts the form of remaining teeth by abnormal localization of root growth hence pushing on other teeth. Wisdom teeth can be found covered by either soft tissue or hard tissue, horizontally positioned and applying the adjacent tooth pressure. A wisdom tooth trying to erupt can disrupt ideally positioned or orthodontically treated teeth, causing crowding. One of the most serious problems a wisdom tooth can cause is cysts and tumors connected to the wisdom tooth and its sac, called the follicle, resulting in the destruction of healthy bone and teeth.

    The most common complaints of wisdom teeth are the pain, swelling, redness and enlarged lymph nodes below the lower jaw. It is important to treat these teeth in a timely manner. Wisdom teeth operations fall into the oral and maxillofacial field.

     

    What is pericoronitis?

    Pericoronitis is an infection caused mostly by partially impacted wisdom teeth. Bacteria clusters occur around partially impacted wisdom teeth and infection is developed. This infection, taking place in the soft and hard tissue surrounding the wisdom teeth, is called pericoronitis. The symptoms include swelling, localized pain and struggle to put pressure on that area while closing the mouth or eating. In some cases, infectious fluid flow can be observed. It is possible to keep pericoronitis under control for a while with antibiotics, but the only way to make sure pericoronitis does not come back is the extraction of the related tooth.

    Impacted Wisdom tooth Extraction

    Wisdom teeth can be found covered with soft and hard tissue in several positions. In this case, oral surgeons extract to the tooth by cutting it into pieces with proper material, causing minimal trauma to the surrounding soft and hard tissue. This operation takes place comfortably under local anesthesia. After the operation, the soft tissue is brought back together with sutures and the procedure is completed. Postoperative caretaking guidelines of the oral surgeon must be followed.

     

    What is Corrective Oral Surgery?

    The aim of corrective oral surgery or orthognathic surgery is to restore comfortable chewing, speaking and breathing functions by means of correcting the minor and major teeth and skeletal disorders such as misplaced teeth. It is conducted by oral surgeons.  Tooth misplacements can be corrected by orthodontic treatment. But when the jaw placements need to be adjusted, orthognathic surgery is indicated. The people that have one jaw over or under-developed than the other, people with open-bite can benefit from corrective surgery.

    Corrective surgery deals with,

    • Chewing problems
    • Speaking problems
    • Chronic pain of the jaws and the jaw joints
    • Open-bite
    • Protrusive lower jaw
    • Protrusive upper jaw
    • Gummy smile
    • Increased over-jet
    • Uneven frontal or side profile of the face

     

    How Is It Applied?

    Pretreatment photos, x rays, and CBCT data are evaluated by the oral surgeon. Nowadays one of the most important developments in orthognathic surgery is that computer-supported treatment planning is possible. Computer-supported treatment planning gives us the opportunity to have more predictable and faster-acquired results.

     

    Advantages of Corrective Surgery

    Recently the most important focal points of oral surgery are to restore lost bone structure and make up for tooth loss using dental implants. Teeth are located inside the bone and functions such as biting or chewing constantly stimulates the osseous tissue, keeping it active. Missing one or more teeth the bone in that area is left without stimuli and resorption begins. In such cases oral surgery takes charge.

     

    Minor Bone Grafting and Guided Tissue Regeneration

    Depending on the bone loss quantity, bone tissue can be restored with a variety of solutions. In cases of small and medium size bone defects, bone grafts and barrier membranes acquired from tissue banks can be enough. With this method, called the guided bone regeneration, bone regeneration can be achieved at the same time the dental implant is applied, completing the treatment in one appointment.

     

    Extraction Socket Grafting

    Extraction socket grafting is done immediately after the extraction of the tooth and consists of filling the extraction socket with bone graft material. It is a preventative treatment eliminating the bone resorption that would be caused by tooth extraction. This way ideally sized dental implant can be applied to the site ensuring optimal esthetic results.

    Major Bone Grafting

    In cases with bigger bone defects, the patient’s own bone is used. Lower jaw bone and specific sites of the hip bone act as donor. Today, the main principle in oral surgery, donor site is considered to be the lower jaw bone, since it has optimal bone quality and enough amount of tissue can be acquired.   This way bone regeneration is achieved 3 dimensionally, meaning that the vertical bone augmentation can be achieved as well as horizontal. The most important part of having the lower jaw as the donor site is that the procedure limited to the oral cavity and making general anesthesia and hospital conditions is obsolete.

     

    Post Op Care

    It is important to keep good oral hygiene after having oral surgery. The instructions given by the doctors must be followed. Necessary medical materials must be used in order to avoid bacteria reproduction on the soft tissue of the oral cavity. Otherwise, serious health problems can be encountered after oral surgery.