Oral and Maxillofacial Surgery
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What is Oral and Maxillofacial Surgery ?
Oral and maxillofacial surgery is a branch of surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. Maxillofacial refers to the region of the facial skeleton and includes bones of the forehead, cheekbone, face, and jaws and regional soft tissues.
Oral surgery includes all conditions affecting the teeth, gums and their supporting (alveolar) bone, which is outside the scope of 'usual' dental surgery (i.e., the restoration of teeth, crowns, bridges and other prostheses). Oral surgery therefore includes the treatment of:
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Dear GOD, if today I lose my hope please remind me that your plans are better than my Dream.....
Oral Maxillofacial Surgery Procedures
Sinus Lift - the maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.
There is a solution and it's called a sinus graft or sinus lift graft. The dental implant surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After several months of healing, the bone becomes part of the patient's jaw and dental implants can be inserted and stabilized in this new sinus bone.
The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.
If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the Sinus Augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed.
Facial Trauma - Maxillofacial injuries or facial trauma encompass any injury to the mouth, face and jaw. The facial trauma injuries caused by impersonal violence, accident falls, hit from a heavy object or sports injuries are treated by the expert surgeons. One of the most common types of serious injury to the face occurs when bones are broken. Fractures can involve the lower jaw, upper jaw, palate, cheekbones, eye sockets or combinations of these bones. These injuries can affect sight and the ability to breathe, speak and swallow. Because of this, the expertise of the oral and maxillofacial surgeon is indispensable. Avoiding injury is always best, so it is extremely important to use seat belts, protective mouth guards and appropriate masks and helmets for everyone who participates in athletic pursuits at any level.
Bone Grafting - Both minor and major bone grafting surgeries are performed. The procedure of bone grafting can restore the implant sites having poor bone structure which could be a result of the previous gum disease, injuries or extractions. The bone could be either the patient’s bone taken from the hip or jaw or could also be taken from a tissue bank. To change the bone in the posterior upper jaw, sinus bone graft technique is used. The process of guided tissue generation or guided bone generation is done to persuade more bone generation by dissolving the special membranes under the gum and thereby protecting the bone graft.
Dental Implants - Dental implants are long-term replacements for missing teeth that your oral and maxillofacial surgeon surgically places in the jawbone. Composed of titanium metal that fuses with the jawbone through a process called osseointegration, dental implants never slip and never decay. Because dental implants fuse with the jawbone, bone loss is generally not a problem.
Jaw Surgery (Orthognathic Surgery) - Corrective jaw or orthognathic surgery is performed in which the upper jaw, lower jaw and chin may be repositioned to correct minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth which can improve chewing, speaking and breathing. Difficulty chewing or biting food, excessive wear of teeth, a receding chin, a protruding jaw or sleep apnea may indicate the need for corrective jaw surgery. The different problems should be evaluated-
Wisdom Teeth Removal - Wisdom teeth are the last set of teeth to develop. Sometimes they emerge from the gum line, and the jaw is large enough to allow room for them, but more often than not, they fail to emerge and become impacted. When a wisdom tooth is impacted, it may need to be removed. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections and even gum disease.
TMJ Disorders (Temporomandibular Joint Disorder) - The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet and allows the lower jaw to move and function. If you experience jaw pain, earaches, headaches, a limited ability to open or close your mouth, clicking or grating sounds, you may have Temporomandibular Disorder (TMD). TMJ treatment may range from conservative dental and medical care to complex surgery. If non-surgical treatment is unsuccessful or if there is clear joint damage, surgery may be indicated which can involve either arthroscopy or repair of damaged tissue by a direct surgical approach.
Cleft Lip and Palate - During early pregnancy, separate areas of the face develop individually and then join together, including the left and right sides of the roof of the mouth and lips. However, if some parts do not join properly, sections don’t meet and the result is a cleft. If the separation occurs in the upper lip, the child is said to have a cleft lip.
A completely formed lip is important not only for a normal facial appearance but also for sucking and to form certain sounds made during speech. A cleft lip is a condition that creates an opening in the upper lip between the mouth and nose. It looks as though there is a split in the lip. It can range from a slight notch in the colored portion of the lip to complete separation in one or both sides of the lip extending up and into the nose. A cleft on one side is called a unilateral cleft. If a cleft occurs on both sides, it is called a bilateral cleft.
A cleft in the gum may occur in association with a cleft lip. This may range from a small notch in the gum to a complete division of the gum into separate parts. A similar defect in the roof of the mouth is called a cleft palate.
The palate is the roof of your mouth. It is made of bone and muscle and is covered by a thin, wet skin that forms the red covering inside the mouth. You can feel your own palate by running your tongue over the top of your mouth. Its purpose is to separate your nose from your mouth. The palate has an extremely important role during speech because when you talk, it prevents air from blowing out of your nose instead of your mouth. The palate is also very important when eating. It prevents food and liquids from going up into the nose.
As in cleft lip, a cleft palate occurs in early pregnancy when separate areas of the face have developed individually do not join together properly. A cleft palate occurs when there is an opening in the roof of the mouth. The back of the palate is called the soft palate and the front is known as the hard palate. A cleft palate can range from just an opening at the back of the soft palate to a nearly complete separation of the roof of the mouth (soft and hard palate).
Sometimes a baby with a cleft palate may have a small chin and a few babies with this combination may have difficulties with breathing easily. This condition may be called Pierre Robin sequence.
Oral Pathology - The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:
These changes can be detected on the lips, cheeks, palate and gum tissue around the teeth, tongue, face and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.
Cosmetic Jawline Surgery - Facial cosmetic surgery is considered as the choice solution for the correction of physical deformities resulting from aging, injury, disease and birth defects. The cosmetic jaw surgery procedures include treatment of upper jaw (Maxillary Osteotomy) and lower jaw (Mandibular Osteotomy). It also includes Apertognathia, also known as jaw joint surgery, wherein the oval shaped gap between the upper and lower front teeth is filled.
Cyst and Tumors - An unwarranted growth in any part of the body is biopsied if it is present more than 10 to 14 days. A biopsy is a surgical procedure wherein an entire section of the growth is removed. Such lesions can lead to oral cancer in the later stage and therefore all apprehensive lesions should be biopsied.
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