Oral & Maxillofacial Surgery |Dynamic Family Dentistry

Oral & Maxillofacial Surgery

Oral & Maxillofacial Surgeons are dental specialists with advanced training in diagnosing and treating a wide range of conditions and injuries involving the head, neck, face, and jaws. After completing four years of dental school, these specialists undergo an additional four to six years of formal surgical training focused on the craniomaxillofacial complex. Recognized internationally and by the American Dental Association (ADA), Oral & Maxillofacial Surgery is one of the nine official dental specialties.

Oral & Maxillofacial Surgeons are highly skilled in handling various complex conditions, treatments, and procedures, including:

TMJ Disorders, Facial Pain, and Facial Reconstruction
Dental Implants
Tooth Extractions and Impacted Teeth
Wisdom Teeth Removal
Misaligned Jaws (Orthognathic Surgery)
Cleft Lip and Palate Repair
Apicoectomy (Root-End Surgery)
Oral Cancers, Tumors, Cysts, and Biopsies
Sleep Apnea Treatment
Facial Cosmetic Surgery

Why Choose an Oral & Maxillofacial Surgeon?

Whether your dentist refers you for specialized care or you are experiencing pain or symptoms that require expert evaluation, an Oral & Maxillofacial Surgeon can provide advanced diagnosis and treatment tailored to your needs.

Bone Grafting

Bone grafting is a procedure commonly performed to support dental restorations like bridges and implants. The height, depth, and width of the jawbone at the implant site play a crucial role in the success of these restorations. When the jawbone has deteriorated or sustained damage, bone grafting may be necessary to provide a stable foundation for implants or other restorative procedures.

Factors Affecting Jawbone Volume

Periodontal Disease: This condition can damage the jawbone that supports the teeth, progressively worsening until teeth become unstable.

Tooth Extraction: Studies show that after a tooth extraction, patients can lose 40-60% of the bone surrounding the extraction site within three years, resulting in a “bone defect.”
Injuries and Infections: Trauma to the jaw or infections can cause significant bone loss.

Reasons for Bone Grafting

Bone grafting is a highly successful procedure that can improve the health, stability, and structure of the jawbone.

Jaw Stabilization: Restores the jawbone’s foundation for implants or other restorative procedures, while correcting deformities.
Preservation: Prevents bone loss following extractions, periodontal disease, or injuries, ensuring better long-term oral health.

Oral Examination

Before the procedure, your dentist will conduct a thorough examination of your teeth, gums, and bone structure. This may include:
- Panoramic X-rays to measure the depth and width of the bone.
- CAT Scans for detailed bone condition analysis, if needed.
- Exploratory Examination under local anesthesia to determine the type and amount of bone required.

Types of Bone Grafts

Your dentist will recommend the most suitable grafting method for your condition:
- Autogenous Bone Graft: Bone is harvested from your own body (e.g., jaw or chin) for the most predictable results.
- Allograft Bone Graft: Uses bone from a donor or synthetic material.
- Xenograft: Utilizes bone from a cow.

What Does Bone Grafting Involve?

The procedure typically takes several months and includes the following steps:

Preparation: The dentist will numb the area with local anesthesia and make a small incision to prepare the site for the graft.
Bone Placement: Bone material is anchored into place, and in some cases, a synthetic membrane is used to protect the site and encourage bone growth.
Healing: Over time, the grafted bone fuses with the existing bone, increasing its volume and strength to support implants or restorations.

Post-Operative Care

The surgery is outpatient, and you’ll receive detailed post-operative instructions. Medications may be prescribed to manage infection, discomfort, and swelling. Proper care will ensure a successful recovery and long-term benefits from the procedure.

Dental Implants

Dental implants are a highly effective solution for replacing missing teeth, offering a fixed alternative to removable partial or complete dentures. They provide excellent support and stability for dental restorations, enhancing both functionality and aesthetics.

What Are Dental Implants?

Dental implants are artificial roots, typically made of titanium, surgically placed into the upper or lower jawbone by a dentist or periodontist (a specialist in gums and supporting bone). The teeth attached to these implants are natural-looking and can restore or enhance a patient’s smile.
Implants are strong, stable, and durable, often lasting many years. However, occasional maintenance, such as re-tightening or replacement, may be necessary due to normal wear.

Reasons for Dental Implants

Dental implants address a variety of oral health and aesthetic needs, including:

Replacing one or more missing teeth without affecting adjacent teeth.
Resolving joint pain or bite problems caused by teeth shifting into empty spaces.
Restoring a patient’s confident smile.
Improving chewing, speech, and digestion.
Enhancing or preserving facial structure and tissues.
Providing secure support for bridges or dentures, increasing comfort and stability.

What Does Getting Dental Implants Involve?

The dental implant process involves multiple steps over several months:

Initial Assessment
- X-rays and impressions (molds) are taken to evaluate bone, gum tissue, and available spacing for the implant.
Implant Placement
- Under local anesthesia, the implant is surgically placed into the jawbone.
- The implant integrates with the bone over a healing period of up to six months.
Post Placement (if needed)
- For some implants, a second surgery is required to place the “post” that holds the artificial tooth. Other types include the post and anchor in a single procedure.
Artificial Tooth Placement
- After the healing period, artificial teeth are custom-made and fitted to the implant post.
- This process may require multiple fittings over one to two months to ensure a perfect fit.
Final Attachment
- The artificial teeth are securely attached to the implant, offering excellent stability, comfort, and functionality.

Post-Treatment Care

Once the procedure is complete, your dentist will provide care instructions. Maintaining good oral hygiene, adopting healthy eating habits, and attending regular dental check-ups will help ensure the longevity and success of your dental implants.

Humans have two upper (maxillary) and two lower (mandibular) canine teeth, also known as cuspids, fangs, or "eye teeth" due to their position beneath the eyes. Canines are unique in their conical shape, thicker roots, and their role as the longest-rooted teeth in the human mouth. They are the last of the front teeth to fully erupt, typically around age 13.

An impacted tooth refers to one that is blocked, stuck, or unable to fully erupt and function properly. While wisdom teeth are the most commonly impacted, upper canines are the second most likely. Unlike wisdom teeth, which often serve no critical function, impacted canines are essential for proper bite and alignment, making treatment necessary for several reasons:

Why Are Canines Important?

Closing Gaps: Canines help close gaps between the upper front teeth as they erupt into place.
Biting Mechanism: Canines play a crucial role in the "biting" process, guiding other teeth into position when the jaw closes.
Alignment & Function: They are essential for the proper alignment and functionality of the dental arch, impacting both aesthetics and bite efficiency.

Causes of Impacted Canines

Several factors can lead to impacted canine teeth:

Extra Teeth
- Extra teeth may block the natural eruption path of the canines or cause overcrowding, leaving no space on the dental arch.
Overcrowding
- Poor alignment or crowded front teeth can prevent canines from erupting properly.
Unusual Growths
- Rarely, unusual growths in the gum tissue may restrict the progress of canines, leading to impaction.

Early detection is key. By age 7, a dentist should evaluate the presence and positioning of canine teeth. The older the patient, the less likely impacted canines will erupt naturally, making timely treatment essential.

Oral Examination

The dentist will perform a thorough examination, often including:
- Visual Inspection: To assess teeth alignment and any signs of impaction.
- Panoramic or Individual X-rays: To identify the location and cause of the impacted canines.
Based on the findings, the dentist, oral surgeon, or orthodontist will recommend appropriate treatment to aid the eruption of the canines.

Treatment Options for Impacted Canines

Tooth Extraction and Space Creation
- If overcrowding is the issue, the dentist may recommend removing adjacent teeth under local anesthesia.
Exposure and Guidance
- The impacted canine is surgically exposed by lifting the gum tissue, and a special bracket is placed to guide the tooth into position.
Orthodontic Treatment
- For younger patients, braces may be used to create space on the dental arch, allowing the impacted canine to erupt naturally.

Post-Treatment Care

Surgery for impacted canines is typically outpatient, with no overnight stay required. The dentist will prescribe pain medication as needed and provide post-treatment instructions to aid recovery.
Early intervention, proper treatment, and follow-up care can ensure the successful eruption and alignment of impacted canines, preserving both function and aesthetics.

Impacted Canines

Oral Pathology

Oral pathology involves the diagnosis and management of diseases affecting the maxillofacial and oral regions. During routine dental exams, dentists perform oral screenings to detect abnormalities in the mouth, face, and neck. Early identification of pathological changes is critical for effective treatment, particularly for conditions like oral cancer.

What Is Oral Pathology?

The mouth is lined with mucosa, a specialized type of skin that is typically smooth and pink. Changes in the texture or color of the mucosa may indicate the onset of a pathological process. These changes can occur in areas such as the gums, tongue, lips, face, and neck.

Common Pathological Conditions:

Geographic Tongue: Characterized by red, well-defined areas on the tongue where papillae are missing, giving it a map-like appearance. This condition is usually harmless but may cause sensitivity.
Median Palatal Cyst: A fluid-filled sac in the middle of the palate, often causing discomfort.
Hairy Tongue: An overgrowth of bacteria or yeast that causes the tongue to appear black and hairy. Poor oral hygiene, extensive antibiotic use, or radiation treatments can contribute to this condition.

Oral Cancer and Its Risks

Oral cancer, which can affect the tongue, jaw, or cheeks, is a serious concern in oral pathology. It is on the rise, especially among men, but early detection significantly improves survival rates (around 80% with prompt diagnosis).
Since oral cancer cannot be diagnosed without a biopsy, seeking immediate evaluation for unusual changes in the mouth is crucial.

Treatment of Pathological Diseases

Treatment options depend on the severity and type of condition:
- Antibiotics: For bacterial infections or persistent soreness, antibiotics can restore the mucosa to its natural state and alleviate discomfort.
- Diluted Hydrogen Peroxide: Prescribed for poor oral hygiene, this mouthwash helps kill bacteria and improve bad breath.
- Oral Surgery: Non-cancerous growths or cysts may require removal to improve comfort, breathing, or speech.

Oral Examinations

Regular dental check-ups include a thorough inspection of the soft tissue. If abnormalities are detected, the dentist may take a biopsy for laboratory analysis. This ensures accurate diagnosis and appropriate treatment.

Oral Cancer Screenings

Oral cancer screenings are quick, painless procedures often performed during comprehensive exams. A laser light is used to detect changes in the soft tissue. If suspicious cells are found, a biopsy is taken for further evaluation.
If cancer is confirmed, the affected area may be surgically removed.

When to Seek Help

If you notice any pain, unusual changes, or symptoms in your mouth, face, or neck, contact your dentist promptly. Early diagnosis and treatment can make a significant difference in managing oral health conditions.

Sleep Apnea Devices

Sleep apnea is a serious sleep disorder that causes breathing to repeatedly stop and start during sleep. This disruption occurs when the airway becomes blocked, reducing airflow and leading to oxygen deprivation. Untreated sleep apnea can strain the cardiovascular system, causing conditions like high blood pressure, heart disease, and stroke. Dental devices offer an effective, non-invasive treatment option to manage sleep apnea and improve overall health.

How Sleep Apnea Devices Work

Sleep apnea appliances are designed to reposition the lower jaw and tongue, keeping the airway open and preventing interruptions in breathing. These devices are particularly effective for mild to moderate obstructive sleep apnea (OSA) and can serve as an alternative to CPAP (Continuous Positive Airway Pressure) machines. Patients often report better sleep, reduced snoring, and improved daytime alertness when using these appliances.

Types of Sleep Apnea Devices

TAP® 3 (Thornton Adjustable Positioner)
- Fits over the teeth like a sports mouthguard.
- Moves the jaw forward to prevent airway obstruction.
- Features an adjustable lower jaw positioner for comfort and customization.
- Accommodates various malocclusions and allows lips to close fully.
OASYS Appliance
- Gently moves the jaw forward to open the oropharynx and strengthen the upper airway.
- Includes an upper shield that improves nasal airflow.
- Adjustable and comfortable for easy wear.
Klearway™ Appliance
- Alleviates obstructive sleep apnea and snoring.
- Allows small, incremental adjustments (0.25mm) to the jaw’s position.
- Made from Variflex™ heat-softening acrylic for easy insertion and a snug fit.
Herbst Telescopic Appliance
- Held in place with clasps and friction grips, featuring adjustable metal wiring.
- Effective for mild to moderate sleep apnea and reduces snoring.
- Allows vertical and lateral movement for added comfort and stability.

Benefits of Sleep Apnea Devices

Non-invasive and comfortable.
Easy to use and adjustable for individual needs.
Improve airflow, reduce snoring, and enhance sleep quality.

If you suspect you have sleep apnea or are considering a dental device for treatment, consult your dentist for a personalized recommendation. Early intervention can significantly improve your quality of life and prevent serious health complications.

Mini Dental Implants (MDIs) have revolutionized the field of implant dentistry. Unlike traditional dental implants that often require multiple visits and invasive surgery, MDIs offer a noninvasive, same-day solution. They are most commonly used to stabilize dentures and overdentures, eliminating issues with loose or ill-fitting prosthetics.

MDIs are designed to bypass the need for bone grafting, significantly reducing treatment time and recovery. Their smaller size allows for immediate denture placement, providing a fast, efficient alternative to traditional implants.

What Are Mini Dental Implants?

MDIs are small, screw-like implants made from titanium. They often include calcium phosphate along the screw portion to promote healing and durability.

Key features of MDIs include:

Structure: The implant head resembles a ball that fits securely into a retaining mechanism, stabilizing the denture.
Placement: MDIs rest comfortably on the gum tissue and can withstand natural pressure and biting forces.

Advantages of MDIs

MDIs are an excellent option for individuals seeking a less invasive, cost-effective solution for tooth replacement.
Benefits include:
- Permanent, stable results.
- No need for adhesives or bonding agents.
- Minimal discomfort and no cutting or sutures.
- Quick procedure (about one hour).
- Cost-effective compared to traditional implants.
- Suitable for patients with significant bone loss.
- Enhanced oral functionality, including improved chewing, clearer speech, and easier cleaning.
- Better smelling breath and reduced risk of food trapping under dentures.

How Are Mini Dental Implants Placed?

The MDI placement process is simple and efficient, typically completed in about an hour.
Steps include:

Preparation:
- Diagnostic tools are used to determine the optimal implant locations.
- A mild anesthetic is administered.
Placement:
- Small holes are drilled into the jawbone.
- Each MDI is screwed into place using specialized tools for stability.
Denture Modification:
- The denture is adjusted to fit the MDIs.
- Rubber O-rings on the implants snap securely into the designated spots on the denture, ensuring a snug fit.
Final Placement:
- The denture is affixed to the MDIs, resting comfortably on the gum tissue.

No stitches are required, and most patients experience little to no discomfort after the procedure. Light eating can typically resume immediately, and the denture can be removed and cleaned as needed.

Why Choose Mini Dental Implants?

MDIs offer a convenient and minimally invasive solution for denture stabilization and tooth replacement. With high success rates and permanent results, they restore both the aesthetics and functionality of your smile.
If you have questions about MDIs, consult your dentist to determine if they are the right option for you.

Mini Dental Implants (MDIs)

Wisdom Teeth Extractions

Wisdom teeth, or third molars, are the last teeth to emerge in the mouth, typically between the ages of 17 and 25. They are located at the back of the mouth, near the entrance to the throat. The term "wisdom" refers to the idea that these teeth surface at a time associated with increased maturity.

However, in most cases, there isn’t enough space in the mouth for wisdom teeth to emerge properly, leading to impaction. When wisdom teeth become impacted, they can be stuck in a harmful position, leading to various complications like infections, tooth damage, and cysts.

Types of Wisdom Teeth Impaction

Soft Tissue Impaction
- The crown of the tooth has emerged through the bone but is still covered by gum tissue.
- Food can get trapped under the gum, causing infections and decay, leading to pain and swelling.
Partial Bony Impaction
- The tooth has partially erupted, but part of the crown remains under the gum and jawbone.
- The area is difficult to clean, increasing the risk of infection.
Complete Bony Impaction
- The tooth is fully encased in the jawbone and cannot erupt naturally.
- This requires more complex surgical techniques to remove.

Reasons for Wisdom Teeth Removal

Not all wisdom teeth need to be removed, but extraction is often recommended for the following reasons:

Pain, Swelling, or Infection: Impacted wisdom teeth can cause significant discomfort, swelling, and infection.
Damage to Nearby Teeth: Impacted wisdom teeth can harm adjacent second molars, leading to cavities, gum disease, and bone loss.
Disease: Though rare, cysts or tumors can form around impacted wisdom teeth.
Tooth Crowding: There is a belief that impacted wisdom teeth can push on other teeth, causing misalignment. While not universally accepted, this theory persists in some dental circles.

Wisdom Teeth Examination

To determine if wisdom teeth need to be removed, your dentist will conduct a thorough examination. This often includes panoramic or digital x-rays to assess the position of the wisdom teeth, detect any current issues, and predict potential problems. Early evaluation, typically in the mid-teen years, is ideal for better outcomes when removal is necessary.

What Does the Removal Procedure Involve?

Wisdom teeth extraction is a common procedure typically performed under local anesthesia, intravenous (IV) sedation, or general anesthesia. The procedure is done in a specially equipped dental office, and patients generally don’t require an overnight stay. After the procedure, you’ll receive post-operative care instructions and medications to manage swelling and discomfort.
If you are concerned about your wisdom teeth or are experiencing any symptoms, consult with your dentist for an evaluation and treatment options.

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