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Oral & Maxillofacial Surgery
Oral & Maxillofacial Surgery is a surgical specialty which involves the diagnosis, surgery and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral cavity and maxillofacial region such as teeth, jaw bones, cheek bones, nose and chin area. More simply put, the Oral and Maxillofacial Surgeon is the orthopedic and plastic surgeon of the facial region.
We at Clove Dental have the best Maxillofacial surgeons from the Indian Armed Forces, trained in complex reconstructive procedures. They have the expertise and skils to do Advanced surgical procedures for the treatment of developmental deformities, malignancies and pathologies, impaction surgery, skin grafting, reconstructive surgery for the jaws and facial features, surgery for soft tissue lesions and cyst removal.
Carious teeth or fractured teeth that cannot be restored by the dentist must be removed because they will frequently give rise to severe infections and pain. The removal of teeth can vary from simple extractions to complicated surgical procedures. Loss of teeth can be a traumatic psychological experience that can lead to inability to chew food properly, deterioration of dental alignment, difficulty with speech, and changes that make the face look older. In most instances teeth can be replaced with Implants or bridges. Please discuss replacement options with your oral and maxillofacial surgeon.
Third molars (wisdom teeth) are the last teeth to develop and frequently become trapped under the bone because of lack of space in the jaw or blockage by other teeth. Other teeth can also occasionally become similarly trapped. These unerupted teeth are called “Impacted teeth”.
Impacted teeth should be removed because they can cause severe infections and pain. Impacted teeth may initiate development of cysts and tumours which may cause crowding and damage to other teeth. Infections from impacted teeth can spread to the cheeks, throat, neck and become severe enough to warrant hospitalization. The extent of surgery necessary to remove impacted teeth varies according to the position of the teeth.
Cysts and Tumours occasionally develop in the jawbones and the surrounding soft tissues such as the cheeks and lips. Cysts and Tumours should always be removed promptly.
Biopsies are performed to remove any abnormal tissue growths. A biopsy should be considered for any growth that is present for more than two weeks. The tissue will be submitted for analysis, and the patient will be notified about the results. Further treatment may be necessary, depending on the result of analysis.
The temporomandibular joints (TMJ) connect the lower jaw, or mandible, to the temporal bones at the sides of the head. TMJ dysfunction may cause any one or a number of following symptoms ;
- Pain in the facial region
- Difficulty or pain in chewing food
- Limited and painful opening and movements of the jaw
- Clicking sounds in the TM Joint
- Temporomandibular joint (TMJ) dysfunction can be the cause of secondary headache. The TMJ may become painful and dysfunctional as a result of incorrect alignment of teeth and jaws, trauma and pathological conditions. In severe cases, the TMJ may require surgical correction
Diagnosis and Treatment of TMJ Disorders
The TMJ disorders are treated either conservatively (non-surgical) or surgically. Most of the cases are normally managed without resorting to surgical intervention.
Conservative Non Surgical TMJ Disorders Treatments
Non-surgical treatment for TMJ disorders includes physical therapy, lasers, appliances, medicines and counselling. Stress is one of the major contributing factors in TM joint disorders and some of these patients may need psychological evaluation and counselling.
Surgical Treatments for TMJ Disorders
Surgical treatments includes osteotomy of the joint and replacement of the condylar head of the mandible.
A Dental Implant is an artificial tooth root that a Maxillo-Facial Surgeon places into your jaw to hold a replacement for a tooth. Dental Implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason. Being among the latest advancements in dentistry, Dental Implants are patient friendly since they save the patients teeth when compared to traditional bridgework, since Implants do not rely on neighbouring teeth for support.
Advantages Of Dental Implants
Dental Implants are changing the way people live. Many of them find it more comfortable, efficient and secure than dentures or bridgework. With Dental Implants, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life. Dental Implants are a better solution to the problem of missing teeth when compared to dentures or a bridge mainly because of the following reasons:
- Function and Aesthetics: Teeth supported by Dental Implants look natural and feel like your own teeth. Since Dental Implants integrate into the structure of your bone, they prevent bone loss and gum recession that often accompany bridge work and dentures
- Tooth-saving: They do not sacrifice the quality of your adjacent teeth unlike a bridge since neighbouring teeth are not reduced in size or altered to support the implant. Major portion of your teeth is left untouched, which in turn is a significant long-term benefit to your remaining natural teeth and Oral Health
Jaw Deformity Correction
If deformities of the teeth and jaws are too extreme for Orthodontics, Orthognathic (jaw) surgery becomes the procedure of choice. Malformations of the jaws and face can be traced to trauma, disease, or heredity. By repositioning the jaws, the surgeon can help you avoid future problems with your bite and provide a better cosmetic appearance. Besides growth differences between your upper and lower jaws, jaw deformities may be caused by genetic factors, trauma and certain birth defects, such as cleft lip and cleft palate.
Signs and Symptoms
Jaw deformities need to be corrected in case of the following problems:
- Under bite or overbite, caused by malocclusion (the improper alignment of the teeth)
- “Gummy smile,” in which your upper jaw has grown too far down
- “Long face syndrome,” in which you have an open bite with a long-looking face
- “Toothless smile,” in which your upper jaw is too small
- Prognathic Jaw (Lower jaw is bigger)
- Chin size – The chin may be over or under developed and would make the face look disproportionate
When making a diagnosis of your jaw deformity, your oral and maxillofacial surgeon will first start by asking about your medical history and conducting a thorough physical and dental evaluation. This will include evaluating:
- The proportions of your face
- Functional problems and abnormalities related to your jaws and teeth
- Problems with dental hygiene, periodontal problems such as gum pockets, gum infections and recession of gums
- Functional problems and abnormalities related to your air passage, which may cause problems such as sleep apnea(disorders such as mouth breathing and snoring)
In addition dental casts, photographs of your face, imaging tests such as X-rays and CT scans also may be recommended to assess potential treatment approaches.
Jaw deformities caused by unequal jaw growth can be surgically corrected. Treating your jaw deformity will eliminate or greatly reduce any problems related to your condition, such as chewing, breathing and speaking difficulties, as well as restore the aesthetic balance of your entire face.
Corrective jaw surgery involves moving all or part of the upper or lower jaw, or both, into a more balanced position. The majority of the surgery is performed inside the mouth without any external scarring. A hospital stay and recovery period may be necessary for some of the surgeries, while minor procedures can be performed on a same-day basis.
- Surgically Maxilla and Mandible are placed in a forward position so that the space behind the tongue and palate is enlarged, making obstruction less likely. Surgical removal of excess tissue from Nose and Throat
- It may cause snoring or blocking of the respiratory passages
- One may require to adapt certain lifestyle changes such as, loosing weight, avoid smoking/alcohol & other sedatives
- Sleep on your side or abdomen rather then on the back
The preparation of your mouth before the placement of a prosthesis is referred to as pre-prosthetic surgery.
Some patients require minor oral surgical procedures before receiving a partial or complete denture, in order to ensure the maximum level of comfort. A denture sits on the bone ridge, so it is very important that the bone is in proper shape and size. If a tooth needs to be extracted, the underlying bone might be left sharp and uneven. For the best fit of a denture, the bone might need to be smoothed out or reshaped. Occasionally, excess bone would need to be removed prior to denture insertion.
One or more of the following procedures might need to be performed in order to prepare your mouth for a denture:
- Bone smoothening and reshaping
- Removal of excess bone
- Bone ridge reduction
- Removal of excess gum tissue
- Vestibuloplasty- Deepening of the vestibules
- Exposure of Impacted teeth
There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face.
When soft tissue injuries such as lacerations occur on the face, they are repaired by suturing.
Fractures of the bones of the face are treated by Bone Plating and wiring the fractured jaws together.
Injuries to teeth are quite common and may require the expertise of various Dental Specialists.
Use of laser in dentistry was first approved by FDA in 1994. In dentistry both soft tissue and hard tissue lasers are used. Laser dentistry can be a precise and effective way to perform many dental procedures. The potential for laser dentistry to improve dental procedures rests in the dentist’s ability to control power output and the duration of exposure on the tissue (whether gum or tooth structure), allowing for treatment of a highly specific area of focus without damaging surrounding tissues.
Benefits of Laser Dentistry
Some of the major benefits associated with Laser Dentistry are:
- By Lasers one can do precise cutting of the hard or soft tissues
- There is minimal or no bleeding while cutting soft tissues
- Lasers sterilises the area operated upon thus reducing chances of infection. In cases where tissues are not infected there isn’t any need for antibiotics after laser surgery
- After Laser surgery normally there is minimal or no pain. Thus eliminating the need of pain killers
- Certain Laser Dentistry procedures may not require anaesthesia
- Bacterial infections are minimized because the high-energy beam sterilizes the area being worked on
- Damage to surrounding tissue is minimized
- Wounds heal faster and tissues can be regenerated
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