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Oral & Maxillofacial Surgery

Oral and maxillofacial surgeons are specialists with advanced training and expertise in the diagnosis and treatment of various head and neck conditions and injuries.  After four years of dental school, an oral and maxillofacial surgeon completes four to six years of additional formal training in treating the craniomaxillofacial complex.  This specialty is one of 9 dental specialties recognized internationally and by the American Dental Association (ADA).

An oral and maxillofacial surgeon can diagnose and treat a wide variety conditions.  The following are just some of the many conditions, treatments and procedures oral and maxillofacial surgeon deal with on a daily basis:

  • TMJ, Facial Pain, & Facial Reconstruction

  • Dental Implants

  • Tooth Extractions & Impacted Teeth

  • Wisdom Teeth

  • Misaligned Jaws

  • Cleft Lip & Palate

  • Apicoectomy

  • Oral Cancers , Tumors, Cysts, & Biopsies

  • Sleep Apnea

  • Facial Cosmetic Surgery

Whether your dentist refers you to our office, you have pain or symptoms causing you concern, or you simply have questions you would like answered, please contact our office today to schedule an appointment. We are here to answer your questions and provide the treatment you deserve!

Dental Implants

Dental Implants

Dental implants are a great way to replace missing teeth and also provide a fixed solution to having removable partial or complete dentures. Implants provide excellent support and stability for these dental appliances.

Dental implants are artificial roots and teeth (usually titanium) that are surgically placed into the upper or lower jaw bone by a dentist or Periodontist – a specialist of the gums and supporting bone.  The teeth attached to implants are very natural looking and often enhance or restore a patient’s smile!

Dental implants are strong and durable and will last many years.  On occasion, they will have to be re-tightened or replaced due to normal wear.

Reasons for dental implants:

  • Replace one or more missing teeth without affecting adjacent teeth.

  • Resolve joint pain or bite problems caused by teeth shifting into missing tooth space.

  • Restore a patient’s confident smile.

  • Restore chewing, speech, and digestion.

  • Restore or enhance facial tissues.

  • Support a bridge or denture, making it more secure and comfortable.

What does getting dental implants involve?

The process of getting implants requires a number of visits over several months.

X-rays and impressions (molds) are taken of the jaw and teeth to determine bone, gum tissue, and spacing available for an implant.  While the area is numb, the implant will be surgically placed into the bone and allowed to heal and integrate itself for up to six months.   Depending on the type of implant, a second surgery may be required in order to place the “post” that will hold the artificial tooth in place.  With other implants the post and anchor are already attached and placed at the same time.

After several weeks of healing the artificial teeth are made and fitted to the post portion of the anchor.  Because several fittings may be required, this step may take one to two months to complete.  After a healing period, the artificial teeth are securely attached to the implant, providing excellent stability and comfort to the patient.

You will receive care instructions when your treatment is completed.  Good oral hygiene and eating habits, alongside regular dental visits, will aid in the life of your new implant.

If you have questions about dental implants or would like to schedule a consultation, please contact our office.

Dental Implants

3i Dental Implants

 

3i Dental Implants

Dental implants offer a natural looking replacement for adult teeth.  In addition, implants restore functionality to the jaw, making speaking, eating and chewing easier.  Most implants are comprised of a screw that is embedded into the bone, and a post, to which the prosthesis is attached.

Biomet 3i implants are unique because the microsurface of the cone-shaped screw contains an innovative bone-bonding component.  This means that implants can be placed in areas with low bone density, sparing the patient the mess and misery of wearing poorly fitting dentures.  Additionally, the bone-bonding component means quicker recovery time after the implant is placed.

Why should I choose 3i dental implants?

There are a wide variety of dental implants in the marketplace, but 3i have an almost unparalleled success rate.  Almost 98% of 3i implants are fitted successfully and last for a lifetime. 3i implants contain a unique feature, which is embedded in the surface of the screw.  Implant screws made by other companies are sprayed with calcium phosphate to enhance the bone integration process.  However, 3i screws actually contain calcium phosphate, which means that delamination is less likely to occur.

Additionally, the cone-shaped 3i screw adds precision to the placement of implants and ensures that the final prosthesis is comfortable and can withstand pressure.

Here are some of the other benefits associated with 3i implants:

  • Better oral health.

  • Higher success rate.

  • Improved self-esteem.

  • Long-lasting results.

  • Multiple 3i implants can be placed during a visit.

  • Natural-looking implants.

  • No adhesives or mess.

  • Prevention of bone loss and gum recession.

  • Sturdy, functional prosthetic teeth.

How are 3i dental implants placed?

The procedure for placing 3i dental implants is similar to many other implant procedures.  It is usually performed in two short visits, the first visit being typically an hour in length and the second taking around thirty minutes.

After the dentist has analyzed the X-rays and diagnostic results, the implant root can be inserted.  This procedure will be performed under local anesthetic, unless another type of sedation is preferred.

Here is a step-by-step process for the first stage of a 3i dental implant placement:

  1. An incision will be made in the gum tissue to expose the jawbone.

  2. A tiny hole will be drilled into the jawbone to insert the implant into.

  3. The implant will be screwed or tapped into the designated position.

  4. A small temporary stop-cap is placed to cover the implant, and the surgical site is sutured closed.

  5. After approximately 10 days, the sutures will be removed and the dentist will assess the healing process.

Generally, 3i dental implants enhance the healing process, which means that the second treatment phase can be completed around 10-12 weeks after the first.

Here is a brief overview of can be expected at the second appointment:

A local anesthetic will be administered, and a tiny incision will be made to expose the prosthetic root.  The temporary stop-cap will be removed and a small post or abutment will be attached to the implant.

When the healing process is complete, the new dental prosthesis (usually a crown) will be created from bite impressions.  A tiny screw will be used to secure the prosthesis onto the abutment.  Any necessary adjustments will be made to ensure the prosthesis is comfortable, and the 3i dental implant will be secure for a lifetime.

If you have any questions about 3i dental implants, please ask your dentist.

3i Dental Implants

Mini Dental Implants

Mini Dental Implants

Mini Dental Implants (MDIs) have changed the face of implant placement.  Unlike full implant placement where multiple dental visits are required, MDIs eliminate the need for surgery.  The development of long term MDIs now allows the dentist to place anchors in the jaw during one non-invasive treatment.  The most common use for MDIs is the stabilization of dentures and overdentures.  MDIs firmly anchor the dental prosthesis, which means there is no longer any need to suffer with ill-fitting, loose dentures.

MDIs are designed to eliminate bone grafting and expedite treatment.  Full implants require significant bone grafting and a recovery period.  The latent period allowed the anchor of the implant to properly embed itself into the jawbone.  The smaller size of MDIs means that no recovery period is necessary, and the denture can be fitted the same day.

What is the configuration of mini dental implants?

An MDI is a tiny dental implant (similar to a screw) that is designed to act in place of a natural tooth root.  MDIs are generally constructed from titanium and are either sprayed with calcium phosphate, or contain it along the length of the screw portion.  The design and structure of MDIs promotes quick healing and long lasting results.  The head portion of the implant looks very much like a ball.  This ball fits firmly into the retaining mechanism and together these structures hold the dentures at a designated level.  The dentures sit comfortably on the gum tissue and are able to withstand significant amounts of pressure and natural force.

What are the advantages of MDI placement?

MDIs are a true innovation for people who are reluctant to have invasive dental surgery and for denture wearers.  One significant advantage MDIs have over full implants is that they offer a viable treatment choice for patients who have experienced extensive bone loss.  Depending on the quality and density of jawbone available at the implant site, four of these mini implants may be implanted at one time.  Unlike full implants, MDIs don’t require invasive surgery, which makes MDIs a gentler option.  MDIs also minimize cost. Full-sized implants can be expensive to place, especially if many visits are required.  The most common use for MDIs is to stabilize a lower denture, however they can be placed anywhere in the mouth.

Here are some of the other advantages associated with MDIs:

  • Better smelling breath.

  • Clearer speech.

  • Easier chewing and biting.

  • Easier cleaning.

  • Firmer denture fit.

  • High success rate. Less discomfort.

  • No cutting or sutures.

  • No need for adhesives or messy bonding agents.

  • No rotting food beneath the denture.

  • No slipping, wobbling or discomfort.

  • Permanent results.

  • Quick treatment time.

  • Reduced costs.

How are mini dental implants placed?

The whole mini dental implant placement procedure takes approximately one hour.  Generally, in the case of lower jaw implants, four MDIs will be placed about 5mm apart.  Prior to inserting MDIs, the dentist will use many diagnostic and planning tools to find the optimal place to implant them.

Here is a brief overview of the MDI placement procedure:

  1. A mild anesthetic is administered.

  2. A small hole is drilled in the jawbone to situate each MDI.

  3. Each implant is screwed into place and tightened with a winged wrench.

  4. Finally, a ratchet wrench is used to fully stabilize the MDIs.

  5. The denture is measured against the mini implants and marks are made to indicate where the MDIs will fit.

  6. The denture is sent to the laboratory to have holes drilled to accommodate the MDIs.

Once the denture has been fully modified, it can be affixed to the MDIs.  The rubber O-ring on each MDI snaps into the designated spot on the denture, and the denture then rests snugly on the gum tissue.  MDIs hold the denture comfortably in a tight-fitting way for a lifetime.

In almost all cases, no stitching is required and no real discomfort is felt after the procedure.  After the denture placement procedure is complete, light eating can be resumed.  The denture can be removed and cleaned at will. MDIs enhance the natural beauty of the smile and restore full functionality to the teeth.

If you have any questions or concerns about mini dental implants, please ask your dentist.

Mini Dental Implants

Oral Pathology

Oral Pathology

 

 

An oral exam is routinely performed by the dentist during the course of an initial comprehensive exam and regular check-ups. An oral cancer exam refers to the identification and management of diseases pertaining to the maxillofacial and oral regions.

The soft tissue of the mouth is normally lined with mucosa, which is special type of skin that should appear smooth in texture and pink in color. Any alteration of the color or texture of the mucosa may signal the beginning of a pathologic process. These changes may occur on the face, neck, and areas of the mouth (e.g., gums, tongue, lips, etc.). The most serious of these pathologic changes (which may or may not be painful) is oral cancer, but there are also many other common pathologic problems.

Geographic Tongue – Also known as Benign Migratory Glossitis or Erythema Migrans, is a condition where the tongue is missing papillae (small bumps) in different areas, and a map-like appearance can develop. This condition is usually seen as red well defined areas on or around the sides of the tongue. The red patches (which can look like an unsightly rash) may come and go from hours to months at a time and cause increased sensitivity to certain substances.

Median Palatal Cyst – This cyst is of developmental origin and is essentially a fluid filled skin sac. It usually appears in the middle of the palate and may cause substantial discomfort.

Hairy Tongue – An overgrowth of bacteria or a yeast infection in the mouth which can cause the tongue to appear hairy and black. This condition is usually a result of poor oral hygiene, chronic or extensive use of antibiotics, or radiation treatments to the head or neck. It is often also seen in HIV positive patients and those who are intravenous drug users. Hairy Tongue may or may not require treatment.

Treatment of Pathological Diseases

In the majority of cases, the pathological changes experienced in the oral region are uncomfortable and disfiguring, but not life threatening. However, oral cancer is on the rise (especially among men) and the chances of survival are around 80% if an immediate diagnosis is made.

Oral cancer is a general term used when referring to any type of cancer affecting the tongue, jaw, and lower cheek area. Since it is impossible for the dentist to decisively diagnose a pathological disease without taking a biopsy sample of the affected area, seeking immediate treatment when changes are first noticed might be a life and death decision. For less serious problems, there are several options available, such as:

  • Antibiotics – In the case of a bacterial infection or persistent soreness, the dentist may prescribe a dose of antibiotics to return the mucosa to its natural state. This will alleviate soreness and discomfort.

  • Diluted Hydrogen Peroxide – When poor oral hygiene is causing changes to the soft tissue, the dentist may prescribe a diluted hydrogen peroxide mouthwash. This will kill more bacteria than regular mouthwash and improve halitosis (bad breath).

  • Oral Surgery – If the patient has cysts or abnormal non-cancerous growths, the dentist may decide to completely remove them. This can improve comfort levels, alleviate breathing problems, and make speech substantially easier depending on the location of the cyst.

Oral Examinations

During the course of a regular check up, the dentist will thoroughly inspect the soft tissue of the mouth and take serious note of any changes. If there are cell changes present, the dentist will take a biopsy of the affected area and send it away to be analyzed by laboratory specialists. When definitive results are obtained, the dentist can decide on the best course of treatment.

 

Oral Cancer Screenings

An oral cancer screening is usually performed during a comprehensive or recall (check-up) exam. Screening is painless and only takes a few minutes. The dentist or hygienist will use a laser light to assess the soft tissue for cell changes that might be indicative of oral cancer. If such cell changes are present, a small biopsy will be taken and sent to a laboratory for review. If the biopsy indicates that oral cancer is present, an excision (removal) will generally be performed.

If you are experiencing any pain or symptoms that cause you concern, we encourage you to contact us today to schedule an appointment.

Oral Pathology

Sleep Apnea

Sleep Apnea

Sleep apnea is a potentially life-threatening sleep disorder characterized by repeated pauses in breathing during sleep.  The term sleep apnea is derived from the Greek etymology meaning “without breath”.  Breathing pauses can last anywhere from several seconds to minutes, and happen as often as 30 times or more per hour.  Ongoing disrupted breathing causes an imbalance between the carbon dioxide and oxygen levels in the bloodstream, as not enough carbon dioxide is exiting and not enough oxygen is entering the body.

Sensing this imbalance, the brain sends a message to the body, telling it to wake up to restart the breathing process.  People with sleep apnea will partially awake as they struggle to breathe, and this is often accompanied by loud snoring or choking sensations.  Because people with sleep apnea don’t always completely awake during the episodes, they are often unaware they have a sleeping disorder and it can remain undiagnosed.

There are two main types of this disorder; central sleep apnea which occurs when the brain fails to send important signals to the breathing muscles, and obstructive sleep apnea which occurs when air cannot flow through the nose or mouth even though the body is still trying to breathe.  Obstructive sleep apnea is far more prevalent and easily treatable by the dentist.

Common signs of obstructive sleep apnea can include severe early morning headaches, sleepiness in the daytime, and insomnia. Fortunately, the dentist is equipped with the necessary technology and expertise to treat sleep apnea in several different ways.

Reason for treating sleep apnea

It is very important to seek medical attention if sleep apnea is suspected. A sufferer can completely stop breathing numerous times per hour, and this can quickly turn into a deadly situation. Obstructive sleep apnea occurs when the soft tissue lying at the back of the patient’s throat collapses into the airway. The tongue then falls towards the back of the throat which tightens the blockage and prevents oxygen from entering the lungs.

The problem worsens when the chest region, diaphragm, and abdomen fight for air. The efforts they make to obtain vital oxygen only cause a further tightening of the blockage. The patient must arouse from deep sleep to tense the tongue and remove the soft tissue from the airway.

Because sleep apnea causes carbon dioxide levels to skyrocket in the blood and oxygen levels to decrease, the heart has to pump harder and faster to compensate for the lack of oxygen. Sleep apnea patients can technically “die” many times each night. Sleep apnea has been linked to a series of serious heart-related conditions, and should be investigated by the dentist at the earliest opportunity.

What does sleep apnea treatment involve?

Initially, the dentist will want to conduct tests in order to investigate, diagnose, and pinpoint a suitable treatment. The dentist can offer many different treatment options which depend largely on the exact diagnosis and the health of the patient. The dentist may advise the patient to halt some habits that aggravate sleep apnea such as smoking, alcohol consumption, and tranquilizer use.

Sleeping masks were traditionally used to keep the patient’s airways open while they slept, but nowadays there are some less intrusive options. Dental devices that gently tease the lower jaw forward are very effective in preventing the tongue from blocking the main air passage. These dental devices are gentle, easy to wear, and often help patients avoid unwanted surgeries.

A more permanent solution is to have surgery that sections the lower jaw and helps pull the bone holding the tongue forward slightly. This surgery has an impressive success rate and is simple for the dentist or oral surgeon to perform. The dentist needs to formally make a diagnosis of each individual case before recommending the best course of action.

If you feel you may benefit from sleep apnea treatment, contact our practice today.

Sleep Apnea
Sleep Apnea Appliances

Sleep Apnea Appliances

 

Sleep Apnea Appliances

Sleep apnea is a serious, sometimes fatal medical disorder that affects around 10% of American men over the age of 40, and 6% of American women of the same age.  Sleep apnea sufferers completely stop breathing during sleep, sometimes hundreds of times in a single night.  Normal breathing ceases because the airway becomes obstructed, causing a serious reduction of airflow to the lungs.

There are a number of dental devices that can be used to alleviate this condition. The goal of most of these devices is to separate the jaws and push them forward slightly.  This slight repositioning opens up the airway, and allows oxygen to flow freely again.  Wearers of sleep apnea dental devices report that they stop loud snoring, feel more rested in the daytime, and are much more comfortable going to sleep.  Sleep apnea appliances work best on patients who are not significantly overweight. They offer a viable alternative to Continuous Positive Airway Pressure (CPAP).

Sleep apnea appliances fall into two categories: fixed and adjustable.  Here are brief descriptions of some commonly used sleep apnea dental appliances:

TAP® 3 (Thornton Adjustable Positioner)

The TAP® 3 is the smallest, most comfortable member of the TAP family.  It is a two-part custom-created sleep apnea appliance that fits over the teeth in much the same way as a sports mouthguard.  The TAP® 3 projects the jaw forward to prevent the tongue and soft tissues from impeding the airway.  The lower jaw positioner is adjustable, which means that it can be altered to suit the comfort level of the wearer.  The TAP® 3 appliance can accommodate the three main types of malocclusion, and allows the lips to fully close.

OASYS Appliance

The OASYS appliance is designed to move the base of the tongue toward the front of the mouth by gently repositioning the jawbone (mandible).  This shift opens the oropharynx and strengthens the upper airway.  An extension of the upper shield projects toward the nose, creating a larger nasal opening and less resistance to normal airflow.  This adjustable appliance is comfortable to wear and extremely patient friendly.

KlearwayTM Appliance

The KlearwayTM Appliance is generally used to alleviate obstructive sleep disorder and eliminate snoring.  The patient or dentist can project the jaw forwards in increments of .25mm at a time.  This ensures maximum comfort for the sleeper.  The KlearwayTM appliance is made from VariflexTM heat softening acrylic, which makes it easier to insert.  Running warm water over the appliance makes it pliable, but once placed in the desired position, the acrylic hardens again.

Herbst Telescopic Appliance

The Herbst appliance is held in the mouth by clasps and friction grips.  It is made of acrylic, and contains adjustable metal wiring.  The advantage of this appliance is that the wearer is able to move vertically and laterally without dislodging the appliance.  The Herbst appliance is usually used in mild and moderate cases of sleep apnea, and can also alleviate loud snoring effectively.

If you have questions or concerns about sleep apnea appliances, please ask your dentist.

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