Bone Grafting

Dental implants can provide a safe, predictable way for the surgeon to restore patients to proper health and appearance. Areas that do not have enough bone to facilitate implant placement (a prerequisite for this type of therapy), however, must be augmented through a surgical procedure called "guided bone regeneration." This term describes a technique whereby bone grafts are used to increase the volume of a deficient bone structure or ridge.

Autogenous bone grafts (autografts) are tissues that are transplanted from a donor site to the graft site within the same individual. Autografts improve the success of the grafting procedure by reducing the risk of inflammation and infection because living bone is transplanted from within the same patient. Synthetic bone grafts (alloplasts) are also available and provide the advantage of reducing the number of surgical sites.

Common bone graft procedures utilized in attaining suitable bone structure include the sinus-lift procedure, in which the surgeon elevates the sinus membrane and the bone graft is placed onto the sinus floor, and ridge augmentation, where a bone graft is placed to increase the ridge height and/or width. Your surgeon will make a decision based on the graft material available and your personal situation.

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Dental Implants

Dental implants are permanent solutions for replacing missing teeth. Implants are tiny titanium posts that are surgically placed into the jawbone. They act as anchors and are designed to provide foundations for your replacement teeth.

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Facial Trauma

Oral and maxillofacial surgeons are trained to manage and treat facial trauma to the teeth, the facial bones, and the jaws. Injuries to teeth can involve partial to total dislocation of a single tooth or multiple teeth. Repositioning of the dislocation utilizing a splint or orthodontic appliance may be necessary. Following injury, immediate treatment is recommended to ensure proper healing of the patient's facial and oral structures.

Treatments for trauma to facial bones are the same as those for broken arms or legs. Your bones must be lined up and held in position long enough to allow healing (6 weeks or more). Simple fractures are stabilized utilizing splints or other devices. Fractures to the jaws may impair the patient's ability to chew. These fractures are treated using arch bars, which are fixed to the patient's teeth.

More complicated facial fractures often require surgery to align and stabilize the bone segments. The fracture is further stabilized using wires or bone plates and screws. Wound care instructions should be followed to reduce complications from swelling and infections. While some injuries require hospital treatment, less serious injuries can be treated in the office. Facial surgery can effectively restore the patient's facial aesthetics and jaw function.

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Wisdom Teeth Removal

The extraction of wisdom teeth is necessary when your wisdom teeth are prevented from properly erupting. For many patients, this simply means that they do not have enough room in their jaws for four additional teeth. It's sensible to have the wisdom teeth removed before they become impacted, which can cause pain, cavities, infection, or gum disease. They may grow sideways, partially emerge from the gum, or even remain trapped beneath the gum and bone. When wisdom teeth partially erupt, the opening around the tooth allows bacteria to grow and cause infection. The result is swelling, jaw stiffness, and pain. Pressure from the erupting wisdom tooth can move adjacent teeth and disrupt the alignment of surrounding teeth.

More serious conditions occur when tumors or cysts form around the impacted wisdom tooth, causing the destruction of jawbone and healthy teeth. Removal of the impacted tooth or teeth usually resolves these conditions. Early removal is recommended to avoid future problems and to decrease the surgical risk involved with the procedure.

Periodic checkups and x-rays will allow the dentist to determine if your wisdom teeth have enough room to erupt. Early removal may be advised to avoid an impaction that may compromise the health of your mouth.

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Orthognathic Surgery

Orthognathic surgery is a corrective jaw surgery used to treat abnormalities in facial bones and teeth. This type of surgery is generally performed in conjunction with orthodontics so that the teeth are in proper position thereafter. Using sophisticated surgical techniques, the facial bones can be repositioned in order to restore function and an aesthetic appearance.

In repositioning the upper and lower jaws, the rear portion of the jawbone behind the patient's teeth is separated, and the tooth-bearing portion can be repositioned forward or backward; the jaw can also be raised or lowered. Surgery may require the jaws to be separated into several parts, adding or removing bone to achieve proper alignment. Other facial bones that contribute to the imbalance may also be repositioned, augmented, or reduced in size. Miniature titanium plates and screws are used to fix the facial bones in their new positions.

Depending on the extent of surgery being performed, orthognathic surgery is performed in the hospital or outpatient surgical center. Procedures last anywhere from one to several hours. Some patients consider having cosmetic procedures along with orthognathic surgery to enhance their new appearance, such as surgery on the eyes, nose, chin, or neck.

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Sleep Apnea

Snoring can be a warning sign of a medical condition known as obstructive sleep apnea. Heavy snoring is most common in males and overweight persons, and generally worsens with age. Snoring is caused by a partial obstruction of the airway in the back of the patient's throat and nose. The characteristic rattling sound is the vibration of the soft palate and uvula or other structures in the upper airway.

Sleep apnea can be aggravated by blocked nasal air passages from a cold, allergies, or weak muscle tone in the soft palate. The condition may be further irritated by a large uvula; hypothyroidism; nasal polyps, cysts, or a deviated septum; excessive body weight; enlarged tonsils and adenoids; or consumption of alcohol, drugs, or by smoking.

Surgeons experienced in the diagnosis and treatment of snoring and obstructive sleep apnea can help you assess the severity of your condition. The solution may be found in managing a nasal allergy or infection, wearing a facial device or mouthguard, or reshaping the soft palate with laser treatment. Surgery is performed in the doctor's office using laser technology to reshape the soft palate and open the airway so you can breathe better during sleep.

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Oral Pathology

The inside of your mouth is lined with a thin layer of skin called mucosa. The mucosa is smooth and coral pink in color. Alterations in this appearance could be a warning sign for a pathological process, and if you notice its appearance in your mouth, you should schedule a visit with your dentist. The most serious of these conditions is oral cancer.

The following can be indications at the beginning of a pathological process or cancerous growth: reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth; a sore that bleeds easily or doesn't heal; a lump on the inside of the mouth; chronic sore throat or hoarseness; or difficulty in chewing or swallowing. These changes can be detected on the lips, cheeks, palate, gums, tongue, face, and/or neck.

Do not ignore suspicious lumps or sores. Pain does not always indicate a pathology and is not often associated with oral cancer. Patients with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. A monthly self- examination of the oral tissues and an examination by your dentist can help detect early stages of an oral pathology.

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