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Oral and maxillofacial surgery lecture

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  • 1. Oral & Maxillofacial Surgery Please turn off cell phones.
  • 2. Oral & Maxillofacial Surgery
    • Education requirements
    • After completing 4 years of dental school, students must then complete a 4 or 6 year surgical hospital residency.
    • OMS programs may accept only 2 or 3 residents each year.
    • Students who complete the 6 year residency are eligible for a Medical Doctor degree upon completion of a medical internship.
  • 3. Oral & Maxillofacial Surgery
    • Common surgical procedures include:
      • Wisdom Teeth Removal
      • Orthognathic Surgery
      • Facial Trauma Reconstruction
      • Implants
      • Bone Grafting
      • Oral Pathology
      • TMJ Disorders
      • Cosmetic Surgery
  • 4. Oral & Maxillofacial Surgery
    • Wisdom Teeth Removal
      • The average adult has 32 teeth by age 18. However, the average adult only has enough room for 28 teeth. This often results in impaction of teeth.
  • 5. Oral & Maxillofacial Surgery
    • Wisdom Teeth – impactions
    • Soft Tissue Impaction: The tooth has erupted through the bone but not completely through the gum tissue. Result: Inadequate cleaning of the tooth.
  • 6. Oral & Maxillofacial Surgery
    • Wisdom teeth – impactions cont.
      • Partial Bony Impaction: The tooth erupted partially through the bone, but part still remains embedded in the jaw. Results: Difficulty cleaning, damage to surrounding teeth, possible crowding.
  • 7. Oral & Maxillofacial Surgery
    • Wisdom teeth impaction, cont.
      • Complete Bony Impaction: The tooth is completely buried in the jaw, there is NO room for even a partial eruption. Results: Damage to surrounding teeth, possible crowding, cyst formation.
  • 8. Oral & Maxillofacial Surgery
    • Wisdom Teeth Removal:
      • Wisdom teeth are ideally removed as soon as possible, preferably by the age of 18. Why so early?
      • 1. Younger patients heal faster than older patients.
      • 2. At a young age, the roots of the wisdom teeth are not fully formed, making them easier to remove.
      • 3. Wisdom teeth should be removed BEFORE they have the chance to become infected or damage surrounding teeth, etc.
  • 9. Surgical Removal of Impacted Wisdom Tooth
  • 10. Oral & Maxillofacial Surgery
    • Orthognathic Surgery:
    Orthognathic surgery may be needed when upper and lower jaws do not meet correctly. The jaws, also referred to as the mid and lower face, may not be of the same size, parallel, symmetric or a combination of these problems.
  • 11. Oral & Maxillofacial Surgery
    • Orthognathic Surgery, cont.
    Reconstructive facial surgery is combined with orthodontics to reposition the misaligned jaws. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.
  • 12. Oral & Maxillofacial Surgery
    • Orthognathic Surgery, cont.
      • Problems that may occur when jaws are not parallel, symmetrical, and/or of the same size:
        • Difficulty chewing, swallowing, and speaking
        • TMJ pain
        • Open bite
        • Breathing problems
        • Poor esthetics
  • 13. Oral & Maxillofacial Surgery
    • Facial Trauma
      • Reconstruction of the facial structures due to injuries including:
        • Facial lacerations
        • Intra-oral lacerations
        • Avulsed (knocked out) teeth
        • Fractured facial bones (cheek, nose, eye sockets)
        • Fractured jaws
  • 14. Oral & Maxillofacial Surgery
    • There are a number of possible causes of facial trauma: Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries account for many.
  • 15. Oral & Maxillofacial Surgery
    • Typically, facial injuries are classified as:
      • soft tissue injuries (skin and gums)
      • bony injuries (fractures),
      • injuries to special regions (such as the eyes, facial nerves or the salivary glands).
  • 16. Oral & Maxillofacial Surgery
    • Implants- what are they?
    • Dental implants are titanium posts which are surgically inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth.
  • 17. Oral & Maxillofacial Surgery
    • Implants – What are they?
      • Implant posts, called abutments, are then attached to
      • the implant and protrude through the gums. Abutments
      • provide stable anchors for prosthetic replacement teeth.
  • 18. Oral & Maxillofacial Surgery
    • Implants - How are they placed?
    • An incision is made to reveal the bone.
    • A socket for the implant is created in the bone.
    • The titanium post “root” is placed, the gums are sutured shut.
  • 19. Oral & Maxillofacial Surgery
    • Implants – How are they placed?
    • The implant is allowed to heal for six months.
    • During an “uncovering surgery”, a healing cap is placed over the implant.
    • 2 to 4 weeks later, the healing cap is removed and the abutment is placed. Finally, a crown can be fitted to the abutment.
  • 20. Placement of a Dental Implant
  • 21. Oral & Maxillofacial Surgery
    • Bone Grafting
    • Over time, the jawbone around missing teeth atrophies or is resorbed. This results in poor quality and quantity of bone suitable for placement of dental implants.
  • 22. Oral & Maxillofacial Surgery
    • Bone Graft
    • We now have the ability to grow bone where needed, allowing for placement of implants and restoring functionality and esthetic appearance.
  • 23. Oral & Maxillofacial Surgery
    • Oral Pathology
    • The inside of the mouth is normally lined with skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. Oral Surgeons perform biopsies for suspicious lesions as well as the surgical removal of cancerous and non-cancerous lesions.
  • 24. Removal of a Mucocele (a benign fluid-filled sack stemming from salivary glands)
  • 25. Oral & Maxillofacial Surgery
    • Oral Pathology
    • The following can be signs at the beginning of a pathologic process or cancerous growth:
    • *Reddish patches (erythroplakia) or whitish
    • patches (leukoplakia) in the mouth
    • *A sore that fails to heal and bleeds easily
    • *A lump or thickening on the skin lining the inside of the mouth
    • *Chronic sore throat or hoarseness
    • *Difficulty in chewing or swallowing
  • 26. Oral & Maxillofacial Surgery
    • TMJ Disorders
    • TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint.
    • TMJ disorders develop for many reasons including: clenching your teeth, tightening your jaw muscles and stressing your TMJ joint, misaligned bite or missing teeth. TMJ disorders can also be due to injury or disease.
    • Symptoms may include a misaligned bite, pain, clicking or grating noises when you open your mouth, or trouble opening your mouth wide.
  • 27. Oral & Maxillofacial Surgery
    • The Complex Temporomandibular Joint
    Displaced disc Arthritic Jaw Joint
  • 28. Oral & Maxillofacial Surgery
    • Cosmetic Surgery
    • Some Oral and Maxillofacial Surgery centers also offer procedures such as:
    • Brow Lift
    • Botox
    • Rhinoplasty
    • Lip Augmentation
    • Scar Revisitation
    • Laser Skin Resurfacing
    • Eye Lid Surgery