Oral and Maxillofacial Surgery
What Is Oral And Maxillofacial Surgery?
It is the department that performs the diagnosis and treatment of all disorders related to the soft tissues in the oral cavity (cheek, palate, tongue, lips, etc.) and hard tissues (teeth, bones) under local anesthesia, general anesthesia, or sedation.
Oral and maxillofacial surgery is the department that performs surgical operations in the hard and soft tissues of the mouth and jaw to assist the construction of prosthesis. It performs treatments such as the removal of traumatised teeth, construction of dental implants, sinus lifting operations, surgical removal of cysts and tumors associated with the teeth and soft tissue. Also following procedures can be performed : apical resection, oral implant operations, small biopsies, removal operations of impacted teeth and normal teeth under sedation, jaw fractures, large cysts, biopsies, operations that require maxillofacial surgery under anesthesia.
Oral surgery is performed under operating room conditions and in a sterile environment and by accomplished faculty and staff members who are experts in their respective fields.
Wisdom Teeth And The Treatment Process
Wisdom teeth are the third molars that erupt between the ages of 17 and 26. Because they are located in the most posterior region of the jaw, their maintenance and brushing can be difficult compared to other teeth. Therefore, the incidence of caries is high. It can cause pain and bad breath.
Due to the lack of space in the jaw, the wisdom teeth cannot take their place on the dental arch from time to time in a regular way, so their eruption is delayed, or they may not erupt at all. In this case, the gums and jawbone may be affected. They can cause food to be stuck between teeth and infection as a result of trauma. This condition, which causes swelling and redness on the gums around wisdom teeth, severe pain in the neck and ears, difficulty in opening the mouth, pain when opening the mouth and swallowing, is called pericoronitis.
Fully affected wisdom teeth can cause malocclusion by pushing the teeth in front of them. They can put pressure on the neighboring tooth, causing tooth decay. Wisdom teeth that have not been noticed for many years cause cysts that reach large sizes in the jaw, which can lead to serious problems.
Even if it does not cause any problems, it may be necessary to remove wisdom teeth for orthodontic treatment. A healthy wisdom tooth placed in the correct position does not need to be removed. Removal of wisdom teeth should be performed by maxillofacial surgeons.
In addition to wisdom teeth, canines and small molars can also be affected. If they cannot be corrected orthodontically, they may need to be removed with an operation.
What Is Dental Implant?
Dental implants are screws that mimic the root of teeth and are made of titanium, which is known as a tissue-friendly material that best mimics the natural tooth in the empty space. They provide proper function and aesthetics and eliminate tooth deficiency in patients who have lost their teeth for a number of reasons. It can be applied to any suitable individual, from single tooth deficiencies to patients with total tooth loss. Implants, made out of titanium, which is a material compatible with the tissue, are the most preferred treatment method today because they are the best alternative to natural teeth.
Clinical and radiographic examinations are performed by dentists and maxillofacial surgeons to evaluate the general health and to conduct the dental examination of a patient who will undergo implant treatment. The patient's expectations from the treatment and, if necessary, the suitability of the existing bone for the implant are evaluated with 3-D radiographic images. It is risky to administer this treatment to people who have a significant systemic disease that is not under control, and who have recently received radiation therapy or chemotherapy. Therefore, it is extremely important that the surgeon knows the health history of each patient who will have an implant. Dental implant can be administered at any age. However,earlier implant placement before the age of 18. It is should be evaluated by a dentist.
Dental implants can be easily applied under local anesthesia. It can also be applied under sedation or general anesthesia if necessary. The dental implant treatment process may vary depending on the number of missing teeth and the condition of the bone. In some cases, the prostodontic stage can be started on the same day, while in other cases, the construction stage of implant prostheses is usually started 3 months after the implant is inserted. If additional surgical procedures have been performed in cases where bone volume is insufficient, the duration of the application of implant prostheses may be extended as a result of methods such as sinus lifting, graft and membrane applications.
After the implant operation, the patient is given appropriate medications and informed about what needs to be done after the operation. Patients who have dental implants are asked to come for a check-up every 6 months.
What Is The Purpose Of Implant Application?
Bone resorption, which occurs due to tooth loss, leads to a decrease in the level and volume of the alveolar bone. The placement of dental implants prevents and stabilizes bone loss. Implants have a function close to natural teeth in the functioning of chewing, smiling, and speaking. This functionality provides patients with social, psychological, and physical comfort.
What Are The Advantages Of Implant Treatment?
- Eliminating The use of removable prostheses
- It opens up the possibility of using a fixed implant denture even for people who do not have teeth in their mouth.
- Since there is not enough bone support, life quality of the patient is improved by switching from removable prostheses to fixed prostheses.
- It helps to eliminate nausea in patients using total and removable prostheses.
- Thanks to the implant, a better chewing function and, accordingly, a healthier and balanced diet are accomplished.
- Patients regain self-confidence.
Question-Answer
A tampon is placed on the tooth extraction area to control bleeding. It is required to bite the tampon for 20-30 min. In addition, patient should pay attention not to consume hot foods and drinks, alcohol, acidic drinks and not to use tobacco products for 24 hours. The night after the extraction of the tooth, patient should lay on a high pillow, and take the medications prescribed by the doctor appropriately. After surgical removal, eudema may form on the cheek. In order to minimize eudema, it is necessary to apply cold for the first 24 hours after the procedure. After surgeries that are, performed quickly and adequately, there is not much pain, and the pain can be easily controlled with mild painkillers.
Platelet-rich fibrin (PRF), one of the most frequently used applications in dentistry in recent years, is a biomaterial obtained by centrifuging the blood taken from the patient. When PRF is applied to the operation area, it increases the release of healing cells and growth factors that activate these cells during the healing period of the wound. Thus, the wound healing process accelerates and increases the success of the treatment by increasing new tissue formation.
In patients undergoing dental implant treatment, if the vertical distance required for the implant around the molar and premolar teeth in the upper jaw is not enough, a sinus lift operation is performed to increase bone height. Thanks to this process, it is ensured that a sufficient volume is created for the length and width of the implant,. Sinus lift (sinus graft, sinus augmentation) is a surgical intervention performed in a standard dentist's chair, usually under local anesthesia. The sinus region is lifted to the desired level and the doctor cuts a window to the sinus from the inside of the mouth which makes it accessible in this region. After achieving the desired rate of elevation in the sinus membrane covering the inside of the sinus, bone powder and grafting are performed into the resulting window, then the area is sutured close. Depending on the condition of the existing bone, implants can be placed during the sinus lift operation or sinus lift can be performed first and implants can be placed 4-6 months later.
If the patient has a systemic disease that will slow down the recovery after the procedure, if the defect in the bone or soft tissues is large and the tissues will take time to repair themselves, PRF application may be recommended. It is applied for faster healing of the extraction cavity and wound area after tooth extraction. It is applied to create sufficient bone level in implant surgery, sinus lift operation and bone graft applications. The acceptability of the bone graft and membrane mixed with PRF by the body increases and the success of the treatment increases. It is used to protect open wound surfaces and accelerate healing in cyst operations. It is used in the treatment of periodontal defects to eliminate bone loss around the teeth due to gingivitis. It is used to cover the root surfaces exposed in gingival recessions with gingiva.
It is the surgical removal of the inflammatory tissue located at apex area of the teeth that do not respond to root canal treatment. With this method, many anterior teeth can be preserved in the mouth for many years without extraction. Apicoectomy is performed after administering local anesthesia to the area and making a small incision in the gums. By cleaning the infected tissues, the area is sutured closed.
In the PRF method, blood is taken from the patient during the treatment and the blood is centrifuged. With this process, the healing cells are separated and become a strong membrane. Meanwhile, the PRF obtained during the ongoing treatment can be used alone or mixed with bone grafts.
• In cases of cysts and infections, which form at the root of the tooth, are not cured with canal treatment, • In cases where canal treatment has not been successful, • In cases where the broken part can be removed and the tooth can be saved in fractures that occur at the root of the tooth because of trauma, • In cases where a biopsy is required from a lesion in the root of the tooth, • For temporary teeth that have not formed a permanent tooth under it, but have formed a lesion at the root, • In cases where canal treatment cannot be fully performed due to the problems related to the formation and development of the tooth root,
Since it is completely from the patient's own tissue, it has no side effects and is extremely reliable. Since the patient's own blood is used, there is no risk of infection, infectious disease or allergy.
Odontogenic (tooth-related) or non-odontogenic (not tooth-related) cysts can form anywhere in the mouth. It can be noticed by the patient due to the pain or swelling, or it can reach quite large sizes without being noticed at all. Cysts are usually benign slow-growing formations, but if they are not treated in a timely manner, they can reach to greater sizes and damage anatomical structures such as sinuses, nasal cavity, nerves, or show signs of malignancy. Cyst operation is not different from operations such as tooth extraction and implant. It can be easily performed under local anesthesia, and sedation or general anesthesia may be preferred for cysts that reach large sizes. Before the procedure, the examination of the teeth associated with the cyst and the necessary treatments are completed. As with other surgical procedures, antibiotics, painkillers, and antiseptic mouthwashes that are deemed appropriate by the maxillofacial surgeon may be used.
It provides natural and easier healing of the treated area. Since it contains healing and immune-boosting blood cells; It makes a great contribution especially to bone healing. Since it is obtained from the patient's own blood, no side effects occur.
