Surgical Services

Impacted Teeth Teeth may fail to erupt into the mouth. When this happens it is said that the tooth is impacted. Any tooth in the mouth can be impacted, however as the third molars (also called wisdom teeth) are the last teeth to develop in the mouth, these are the most commonly impacted teeth. Often this is because the jaw is a few sizes too small for the teeth (sort of like trying to fit 32 teeth into a size 28 mouth!)

When the teeth are impacted and they do not erupt completely, problems can develop such as infection, damage or decay of the adjacent teeth, crowding of teeth or formation of a cyst surrounding the unerupted tooth. Often these troubles occur during late teens and early twenties. These problems subside when the teeth are removed. To have these teeth removed, you will need to be seen at a consultation, where we will discuss your history, you will be examined and your xrays will be analysed.

Impacted teeth, including third molars, will most likely need to be surgically removed. This procedure can be carried out when you are awake, under twilight sedation or when you are asleep in hospital (general anaesthetic). The decision as to which method suits you, will be made at your consultation.

Dental Implants Teeth may be lost due to injury, decay or gum disease, and although nothing is as good as your own natural teeth, dental implants are the best way to replace them. By replacing missing teeth you will restore a balanced, more harmonious function of your bite, and help to prevent resorption of the jawbone.

A dental implant is a metal fixture that is made from pure, surgical grade titanium. The fixture is surgically placed into the jawbone where the teeth are missing. During a healing period (between 2 - 6 months), the bone actually attaches itself to the implant by a process known as "osteointegration". This anchors the fixture, allowing it to be used to connect a replacement tooth or teeth.

Treatment planning for dental implants is a team effort, involving a surgeon, your general dentist, possibly a prosthodontist (restorative specialist) and a periodontist (gum specialist), and of course, you. You may require a CT scan to evaluate the exact dimensions, shape, and quality of your bone. Dental casts or moulds of your teeth will be taken to analyse your bite. Depending on your situation you may need one; a few or many implants to be placed to give the best overall result. In some people, bone loss has occurred and there may not be enough to place the fixture. In these cases, bone grafting or other additional procedures, may be required to improve the chances of success. After all the required information is gathered, treatment plan options will be presented to you.

Dental implants have been studied for over 2 decades. According to the literature, there appears to be a success rate of greater than 90% with dental implants. Thousands of people in many, many countries have had fantastic results with dental implants. Why not let that be you too?

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Bone & Tissue Grafting Sometimes when you decide that you want to replace missing teeth with implants, you may find out there is an inadequate volume of tissue or bone necessary to successfully place the implant. This can occur when teeth have been missing from an area for a long time. The bone is lost by a process known as resorption. Sometimes there is not enough bone available due to anatomical reasons, for example an enlarged air sinus. In most case when this occurs, it is possible to rebuild the jaws so that dental implants can be placed. This is achieved by placing grafts of bone or other tissues into the area where they are needed.

Small amounts of bone may be taken from the jawbone from within the mouth. If larger amounts of bone are required, it may be taken from else where on the body (eg hip) and placed where it is needed. There are other types of man-made substances that may also be used to substitute bone.

Sometimes, once a bone graft is placed, there is not adequate amount of soft tissue to close the wound without compromising healing. In these cases, a soft tissue graft may be used to cover part of the bone graft to facilitate its healing. Tissue can be obtained from other parts of the mouth or from a skin graft. At your consultation, your particular situation will be analysed and all the options of treatment will be discussed with you.

Oral Pathology Oral pathology is the specialty of dentistry and pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes and effects of these diseases. The practice of oral pathology includes research, diagnosis of diseases using clinical, radiographic, microscopic, biochemical or other examinations, and management of patients.

Oral pathology in the Oral & Maxillofacial region deals with lesions and problems associated with the teeth, jawbones and soft tissues.

Orthognathic Surgery Orthognathic surgery is also known as corrective jaw surgery. It is used to treat a variety of facial and jaw abnormalities in which the facial bones and teeth are not correctly aligned. This can result in difficulties with chewing, speaking, and other jaw functions. In many cases, the facial appearance is affected by this problem, meaning the face may not look quite right. Abnormal jaw and facial development can be genetic or acquired due to disease or injury

Orthognathic means 'straight jaws'; orthognathic surgery is surgery to 'straighten jaws', ie surgery that corrects jaw and facial deformities. Using sophisticated surgical techniques, the facial bones can be repositioned in order to restore proper function and facial appearance. This type of surgery can be complicated and is best done as a s team approach with an orthodontist (a dentist who is specialised in straightening teeth), so that after the jaws are corrected, the teeth will come together properly.

In addition, some patients may decide to have other cosmetic procedures done in conjunction with orthognathic surgery to further enhance their facial appearance. These include procedures to the chin, cheeks, eyes, nose, neck and facial skin.

Most patients state that the post-operative discomfort is much less than they were expecting. Almost all patients agree that they are happy with the results and would go through the surgery again, without hesitation. The improvement in jaw function and facial appearance is remarkable. Most patients experience a great improvement in their self-confidence and quality of life after orthognathic surgery.

Facial Trauma Oral and maxillofacial surgeons are trained to manage and treat facial trauma to the teeth, the facial bones, and the jaws. Injuries of the teeth can involve fractures of the teeth, or partial to total dislocation of a single tooth or multiple teeth. Your dentist will manage chipped or fractured teeth, where repositioning of the dislocation utilizing a splint or orthodontic appliance may be necessary and can be carried out by and oral and maxillofacial surgeon. Following injury, immediate treatment is recommended to ensure proper healing of the patient's facial and oral structures.

Treatments for trauma to facial bones are the same as those for broken arms or legs. Your bones must be lined up and held in position long enough to allow healing (6 weeks or more). Most facial fractures require surgery to align and stabilize the bone fragments, a process known as reduction and fixation. Stabilization is achieved using bone plates and screws.

Temporomandibular Joint Disorders Temporomandibular Joint DisordersThe temporomandibular joint (TMJ) is the joint that connects the lower jaw (mandible) to the skull. Problems with the TMJ may result in pain, clicking, reduced opening and movement of the jaw and difficulty chewing. TMJ disorders can be relatively minor, or they can be extremely painful and debilitating.

The cause of most TMJ problems is related to trauma, systemic disease, or developmental jaw problems. Diseases of the joint can cause damage of the cartilage, bone, or disc inside the joint. The muscles used for chewing can spasm and this can cause facial pain, limited opening, headaches, and neck pain, even though the joints are normal. Myofascial pain is results from spasms of the muscles associated with this joint. This can take the form of facial pain, headaches, neck aches and limited opening of the mouth.

There are many forms of treatment that vary from rest and soft diet to surgery of the joint. Your treatment will be tailored for your specific needs.

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