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Oral Surgery
Oral
and maxillofacial surgery is the specialty of dental practice that deals with the diagnosis and surgical treatment of diseases,
injuries and defects of the mouth, jaws, face and related structures. This includes the removal of impacted and decayed teeth,
pre-prosthetic surgery, biopsy, removal of cysts and tumors of the mouth and jaws, treatment of facial trauma. An Oral Surgeon is
a dentist who has had additional years of specialized training in oral surgery at a post-doctoral educational program
in a hospital training center and is certified as such.
Impacted teeth removal
(e.g. wisdom teeth)
This is a surgical removal of totally or partially embeded wisdom teeth
or any other teeth that have not erupted normally into the oral cavity. This is done either under local anesthesia, conscious
sedation or general anesthesia. Its just like a feeling of having a simple extraction but it's longer or more complicated.
For more information about impacted wisdom teeth, check our FAQ.
Incision and drainage of oral abscess
When an large carious
tooth becomes infected and abscess is present together with large swelling, incision and drainage is usually done to
drain out all the pus and to release pressure. This is done under local anesthesia either intra-orally or extra-orally.
The patient is then place under antibiotic therapy.
Management of cyst and tumors
A cyst is a cavity
that contains fluid, a semisolid material or air that is surrounded by a lining wall. A tumor is an abnormal mass of tissue
either soft or hard and present either within or outside the bone or soft tissue. A very common signs and symptoms of
cysts or tumors is bone expansion that might be misdiagnosed as swelling. Management for these lesions are marsupialization
( decompression ) or complete removal of the lesion by enucleation. This is done either local anesthesia or general
anesthesia, depending how complicated is the case.
Management of oral-sinus communication
Caldwell-luc
operation is a surgical procedure designed to treat dislodge tooth or foreign materials located in the maxillary
sinuses. This operation involves making an incision above the gum of the upper jaw and removing a small amount of bone which
forms the front wall of the maxillary sinus. Through the opening in the bone, the surgeon can then remove the dislodge tooth
or foreign material from within the maxillary sinus.
Berger's technique is a surgical procedure done
whenever a sinus membrane is perforated upon retrieving a root tip in the molar area of the upper jaw or just
plain simple extraction due to its anatomical position of the root tip. A surgical flap is created to cover up
the perforated sinus membrane.
Both procedures can be done either local anesthesia or general anesthesia.
Labial ang lingual frenectomy
Labial frenum
is a thin band of fibrous attachment seen extending from the lip of both upper and lower up to the gums. Lingual frenum
are the same with labial frenum extending from the tongue up to the floor of the mouth. Sometimes these attachments
are so wide that may interfere with denture construction and orthodontic teeth movement and even esthetically not acceptable.
A surgical reconstruction of the attachment will be the remedy.
Soft and hard tissue biopsy
When there's
a suspicion of any pathological lesions, a biopsy is done to know what type of lesion, how will the treatment be carried out
and how bad is the the condition is. It's a surgical removal of part or the whole lesion and submit it to a laboratory for
pathological analysis. The word biopsy is a misnomer, because it is usually related to malignancy, but it is not,
there are two types of results: it could be benign or malignant. Most oral pathology are benign lesions.
Alveoloplasty (bone recontouring)
Irregularities
of the ridge of the jaw found either at the time of tooth extraction or after a period of initial healing require recontouring
before final prosthesis construction. A surgical bone trimming will be done to make your ridge ready for prosthesis
placement.
Apicoectomy
When a root
canal treatment failed, an apicoectomy is done. This is surgical cutting of the root apex of the tooth and curretage of infected
tissue debris at the apical region in order to save the tooth from extraction.
Gingivectomy (gum trimming)
Gingivectomy
is a form of gum surgery. It is best described as the surgical removal of gingiva. Healthy gums are an important part of a
person's general oral hygiene and appearance. Sometimes in certain people the gums can grow and build up over the front surface
of a tooth. This formation of extra gum can change the balance between the length of the teeth and the height of the gum line,
leading in some cases to a person having a bad smile.
A gingivectomy is a type of minor surgery that involves
the removal of a small amount of gum tissue around a tooth or teeth. A gingivectomy can be performed to correct a poor smile
or maybe needed to be done to remove a diseased tooth, or allow a filling to be placed.
Performing a gingivectomy is quick and relatively painless. Firstly a local anesthetic is applied to completely
numb the area of the gums. A small incision is made and the excess gum tissue is removed using a dental tool. A periodontal
dressing covers the teeth and gums post-surgery to protect them while fully healing. This takes a few weeks, but after that
the gum is completely free of pain.
Torus removal (bony exostosis)
Torus is a bony growth on either palate or lower jaw. Torus
are usually a clinical finding with no treatment necessary.[2] It is possible for ulcers to form on the area of the tori due to repeated trauma. Also, the tori may complicate
the fabrication of dentures. If removal of the tori is needed, surgery can be done to reduce the amount of bone present.
Interdental wiring of fractured jaws
Fractures are break in the continuity of bone brought about by inadvertent
amount of force. Fracture of the upper or lower jaw are cause by vehicular accidents like car accidents and most
prone to is motorcycle accidents. It is also cause by sudden blows on the face, fall off from the stairs or tree and
pathologic lesion in the jaws. To stabilize fractured area, an interdental wiring and maxillomandibular fixation is needed
with the use of an arch bar and orthopedic wires to fixate the fracture site by ligating the teeth and the upper and lower
jaw. This will take 6-8 weeks of fixation.
Exposure of impacted tooth for orthodontic
considerations
During orthodontic treatment(braces treatment) whenever there's
an impacted tooth that can be pull out to the main arch, the orthodontist may ask for the help of an oral surgeon to expose
the impacted tooth surgically, place a bracket, bond to the tooth and ligate an orthodontic wire so that the orthodontist
can facilitate for its movement towards the main arch.
Obturators / acrylic splints
A
palatal obturator is a prosthesis that totally occludes an opening such as an oronasal fistula (in the roof of the mouth). They are similar to dental retainers, but without the front wire. Palatal obturators are typically short-term prosthetics used in order to
close defects of the hard/soft palate that may effect speech production or cause nasal regurgitation during feeding. Following surgery, there may remain a residual oronasal opening on the palate, alveolar ridge,
or labial vestibule. A palatal obturator
may be used in order to compensate for hypernasality and to aid in speech therapy targeting correction of compensatory articulation
caused by the cleft palate. In simpler terms, a palatal obturator covers any fistulas (or "holes") in the roof of the mouth
that lead to the nasal cavity, providing the wearer with a plastic/acrylic, removable roof of the mouth, which aids in speech,
eating, and proper air flow.
Palatal obturators are needed by individuals
with cleft palate, those who have had tumors removed or have had traumatic injuries to their
palate.
Conscious sedation for surgical procedures
This is an anesthetic technique wherein
the patient is under an I.V. fluid, then drugs for sedation are administer through an I.V. line. The patient may feel
groogy and sleepy but still conscious enough to respond on anything. In other words, reflexes are still intact. This
should be considered for anxious patients, patients who are not responsive or cooperative, patients in whom the risk of general
anesthesia are too great and medically compromised patients needing stress reduction.
Remember only a qualified,
well trained, and certified oral and maxillofacial surgeon can perform these procedures. Don't take chances with your dental
health....
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