Dental and Maxillofacial Surgery

Dental and Maxillofacial Surgery

Dentistry is a branch of science that aims to treat mouth, teeth and jaw-related disorders using surgical methods. It has many different titles. Surgical interventions can be performed under local anesthesia depending on the type and severity of the disease, or in some cases, under general anesthesia or sedation. In general operations involving the mouth, jaw and facial areas, general anesthesia or sedation is deemed appropriate if the patient has a severe nausea reflex or if there is a state of anxiety that may affect the general health condition.

What are the issues that maxillofacial surgery deals with?
-Empty wisdom tooth extraction
-Removal of broken root pieces stuck in the jaw bone
-Apical (root tip) resection
-Cleaning of jaw cysts
-Jaw fractures
-Implant surgery
-Orthognathic surgery / Surgeries performed on the jaw bone to complete orthodontic treatments at older ages
Impacted wisdom tooth extraction
-Sinus Lifting

Especially the extraction of wisdom teeth is a very common operation. The jawbone has shrunk over time with the change in human lifestyle and eating habits, leaving no space for wisdom teeth to erupt. For this reason, in many cases, these teeth either remain half-buried or cannot come out at all and are stuck in the jawbone. This causes inflammation in the mouth, cysts, wear on the tooth roots as they put pressure on the front teeth, and crooked alignment of the teeth. In order to prevent such deformations and disorders, impacted wisdom teeth are surgically removed from the jawbone and jaw alignment is restored.

Removal of broken root pieces stuck in the jaw bone
In some cases, tooth roots may break and remain in the jawbone during tooth extraction. These half-tooth roots may cause abscesses or cystic formations in the jawbone over time. For this reason, the broken tooth root must be surgically removed from the jawbone and that area must be cleaned. Thus, further damage to the jawbone is prevented.

Apical (root tip) resection
If the inflammation occurring at the root tip of the tooth is delayed in treatment, it will grow larger and the tooth will come to a halt that cannot be saved with root canal treatment. This surgical procedure aims to clean the growing lesion and restore the health of the tooth. The jawbone is opened at the level of the root tip, the inflammation is carefully curetted and the root tip is cut. The resulting gap is filled with bone graft and the area is closed.This procedure is of serious importance for the future of the tooth. If the tooth root, which is already too late to be treated, is neglected further, the inflammation in that area grows and turns into cysts, and a much more difficult and painful process begins to treat it.

Cleaning of jaw cysts
Jaw cysts are cavities that settle in the soft tissue or jawbone for various reasons, contain puree-like fluid, and are surrounded by tissue. They grow slowly on their own wherever they are. Considering all localizations in the body, the chin area is the place where cysts occur most frequently. These cysts do not cause any symptoms at first and grow secretly. They usually do not cause pain. Jaw cysts, whose existence is not noticed or whose treatment is neglected, grow larger over time and put pressure on the nerves. As a result, loss of sensation and burning occur. In advanced cases, it weakens the jawbone and makes it susceptible to fracture even with very light impacts. Jaw cysts are treated surgically in two ways. The first is enucleation, that is, the complete removal of the cyst and curettage, and the second is marsupialization, that is, not removing the cyst completely, but opening a window. The second treatment method is applied for large cysts. If there is no tooth loss in dental cysts, root canal treatment should be performed. If there is a suspicion of infection, antibiotic treatment should be administered before the surgical procedure.

jaw fractures
In cases of jaw fractures, which usually occur as a result of a severe physical impact, it is necessary to consult an oral surgeon or a plastic and reconstructive surgeon without delay. The broken pieces are fixed in place using wires, plates, screws and special splints. The aim of the treatment of jaw fractures is to reestablish the relationship between the teeth (occlusion) and to enable the patient to regain chewing and speaking functions as soon as possible.The average healing process is between 6-8 weeks. During this period, the patient cannot chew and must be fed with liquids. Oral hygiene is very important. The wires should be cleaned with soft brushes and antiseptic mouthwashes should be used.

Dental implant surgery
Dental implant surgery aims to provide the person with fixed teeth by placing artificial tooth roots into the jawbone in case of missing teeth. Implants placed in the empty jawbone under anesthesia are the closest alternatives to natural tooth roots in cases of single, multiple or total edentulism. The palate in the edentulous area is incised and opened, the bone is reached and implants of suitable diameter and length are placed into the bone. In some cases, the implant can be placed without opening the palate, but it is always more advantageous to work by seeing the bone. Except for some special cases, it is applied under local anesthesia. If the patient follows the doctor's recommendations after the operation (*applying ice after the procedure, *sleeping with the head in a high position for 2 nights, *using antibiotics when necessary), no pain or swelling will occur.

Orthognathic surgery
In cases where orthodontic treatment alone is not sufficient to correct the anomaly in the jawbone, it is a combined procedure in which the jaws are brought into proper position by surgery in addition to orthodontic treatment.Lower-upper jaw surgery planned by the orthodontist can only be performed by plastic and reconstructive surgeons or maxillofacial surgeons. It is a surgery performed under general anesthesia and aims to move the lower jaw back/forward or expand the upper jaw.

Sinüs lifting
If the upper jaw posterior (back) region remains toothless for a long time, melting of the jaw bone occurs. For this reason, the floor of the maxillary sinus sags downward and the bone loses its volume for implant placement. In such cases, the process of elevating the sinus floor and filling the resulting gap with bone graft is called sinus lifting.
It is applied in two different methods: open and closed.

Kapalı sinüs lifting:
When a 2-3 mm bone increase is needed for implant surgery, bone level is increased by loading bone from the socket where the implant will be placed, and healing is easier and faster.

Open sinus lifting:
It is applied in cases where more than 2-3 mm of bone is needed. A window is opened in the vestibule wall of the jaw bone, the sinus membrane is lifted up and a bone graft is placed in the resulting space. Bone formation in the desired volume is expected in that area.
The recovery process is a little more difficult.