Oral and Maxillofacial Surgery serves as a modern, multidisciplinary surgical branch dealing with diseases of the hard and soft tissues of the mouth, teeth and jaw regions of individuals of all ages, congenital (congenital), tumoral (cancer), traumatic (accident), infectious diseases.
ORAL, DENTAL AND JAW SURGERY TREATMENT SCOPE OF WORK
- Normal and surgical tooth extractions of teeth,
- Impacted tooth extractions,
- Diagnosis and treatment of jaw cysts and tumors,
- Surgical and non-surgical treatment of temporomandibular joint diseases,
- Treatments of cystic or tumoral formations that develop in both soft (cheek, palate, tongue, lips, muscles, etc.) and hard tissues (teeth, bones) in the mouth,
- Dental implant applications and sinus lifting (sinus elevation) and/or graft (bone powder-autogenous block grafts) applications when deemed necessary,
- Implant surgery,
- Treatment of infections in the maxillofacial area.
WHAT DOES AN IMPACTED TOOTH MEAN?
There is bone and gum tissue around our teeth. When the teeth begin to come out, they first pass the bone tissue and then the gum tissue. However, since some teeth cannot find a place to drive in the direction or in the mouth, they cannot pass either both tissues or only the gum tissue and remain under these tissues or tissues. The teeth in such cases are called impacted teeth.
DO ALL WISDOM TEETH NEED TO BE EXTRACTED?
If there is no problem with its position and it does not cause infection, caries formations, bad breath, it may not be withdrawn. But it should not be forgotten that; These problems don’t come up all of a sudden. Depending on the dynamics that change in the mouth with the passing of time, pain may be heard gradually or bad breath may occur. You may want your tooth to be extracted to avoid these and similar situations.
WHEN DO WISDOM TEETH COME OUT?
It is a subject that varies a lot according to the person. In some people, wisdom teeth may not come out at all, and in some people, they may last at an early age. It usually occurs between the ages of 17-25.
HOW IS AN IMPACTED WISDOM TOOTH EXTRACTION PERFORMED?
The position is determined after the intraoral examination of the tooth. Treatment is planned by looking at the position of the tooth in the mouth and according to the situation on the x-ray. Embedded wisdom shots are performed in sterile environments under local anesthesia. The impacted wisdom tooth is more comfortably pulled out of the gum with the help of an incision. The extracted area is cleaned with the help of surgical instruments and sutures are placed on the gum. Stitches are removed after an average of 7-10 days.
IS IMPACTED WISDOM TOOTH EXTRACTION PAINFUL?
Thanks to the local anesthesia performed before the procedure, it does not cause pain during the procedure.
HEALING PROCESS AND CARE
The healing time can take several days, or in some cases a week, depending on how buried the wisdom teeth are and how they come out. In the first 24 hours after the operation, it is recommended to avoid very hot and cold foods, alcohol, cigarettes, acidic drinks, hard foods. It is recommended not to use the injured area for 24 hours. After tooth extraction, it is recommended not to shake or spit so that the clot covers the bone socket and can guide healing. If the person has systemic diseases (diabetes, chemotherapy / radiotherapy history, bisphosphonate use, bone metabolism diseases, etc.), the recovery time may vary, it is important for the patient to inform the physician before the procedure. Brushing and gargling should not be done for 24 hours after shooting. From the second day, attention should be paid to the hygiene of the area. If there is a medicine prescribed by the physician, it is used regularly.
SINUS LIFTING OPERATION
After the extraction of the upper small molars and large molars, a number of losses in bone volume occur as a result of the downward sagging of the sinus cavities, especially after waiting for a long time. Although these losses are seen as a natural process, they pose a problem when it comes to implant treatment. Sinus grafting is used to apply implant treatment to toothless areas as a result of filling the sinus cavities that are sagging down. Thanks to this process, it ensures that sufficient volume is created for the length and width of the implant, which must be fully placed in the bone.
How is sinus lifting surgery performed?
Sinus lifting (sinus lifting, lifting) operation; It is a surgical intervention performed in the standard dentist’s chair, usually under local anesthesia. The sinus area is lifted at the desired level and made accessible through a small window opened through the mouth in that area. After the desired rate of elevation in the sinus membrane covering the inside of the sinus, bone powder and grafting are performed in the cavity and the region is closed by suturing.
What should be considered after sinus lifting operation?
After the sinus lifting operation, care should be taken to eat with the other side for 24 hours to protect the wound area. After the procedure, nothing should be eaten or drunk until the effect of anesthesia passes (until the numbness passes). After the sinus removal process, pressure should not be applied while cleaning the nose and the mouth should be kept open when sneezing.
TEMPORAMANDIBULAR JOINT DISORDERS
This problem, which is a constantly recurring pain in the jaw joint or chewing muscles and dysfunction that occurs in the joint; It develops for different reasons and the main reason is; is the loss of disc harmony in the joint with the jaw joint surface.
What are the causes of tempromandibular joint disorders?
- Grinding teeth,
- Posture disorders,
- One-sided chewing habit,
- Closing disorder in the jaw
- Psychological causes (stress, etc.)
What are the main symptoms of temporomandibular joint disorders?
- Severe headaches similar to migraines
- Ringing sensation in the ears
- Only limited opening, locking or dislocation of the jaw
- Dizziness
- Pain or stiffness in the neck area
- Pain and fatigue during chewing
- Pain and asymmetry in the face
- Pain when closing teeth on top of each other
- Strain and pain when yawning or chewing gum
What should patients with jaw joint complaints pay attention to?
- The habit of chewing gum should be abandoned.
- Foods that are difficult to eat and hard to eat, such as snacks, should be avoided.
- Unilateral chewing should be avoided.
- Problems of clenching and grinding teeth should be solved.
- Excessive yawning should be avoided.
- When you wake up in the morning, a compress should be applied to the joint area with a hot towel.
- A stress-free life should be lived as much as possible.
WHAT IS IMPLANT APPLICATION?
Implant; It is placed in the jaw bone for functional and aesthetic purposes in place of the missing teeth in the mouth with a small surgical operation in a sterile environment. Implants are screws made of titanium. The jawbone provides osseointegration with the implant surface and completes the healing as a whole.
HOW IS SUCCESSFUL IMPLANT TREATMENT PLANNED?
Successful implant treatment requires surgical planning and evaluation of treatment options based on a very clear prosthetic evaluation prior to the procedure.
The thickness of the jawbone or its distance from the surrounding tissues is evaluated. Then, panoramic radiography or three-dimensional image (tomography) of the teeth is taken and modeling procedures are performed. The type and brand to be applied are decided.
After implant placement, oral hygiene should be ensured as after every procedure. The area and even the entire oral environment need to be kept clean.
If there is not enough bone in the place where the implant will be applied, what kind of method is applied?
Density, height and thickness values of the bone in the area where the implant will be placed are important. This situation affects the success rate of the treatment. In cases where bone is not sufficient, it is necessary to create bone with different techniques (using bone grafts) to bring bone density to the desired level. For this procedure, procedures such as bone formation in the jaw in horizontal and vertical directions, block grafting, sinus lift operations in the upper back region can be performed.
İWHAT ARE THE ADVANTAGES OF IMPLANT APPLICATION?
- High-quality implants can be used for many years with good care.
- It eliminates the necessity of moving the prostheses.
- It gives a feeling of self-confidence and gives an aesthetic smile.
- During the procedures, the neighboring teeth are not interfered with and only the relevant tooth is operated.
- With dental implants, no other material or materials are needed to hold the dentures in place.
- Basically, the implant gives a much more natural, healthy chewing feeling, speech and appearance as it takes on the burden of dental prostheses like a real tooth root. For this reason, implant dental treatment is the most accurate treatment method applied instead of non-existent teeth.
- As with your main teeth, it’s easy to brush and floss your implanted teeth.
FACTORS AFFECTING IMPLANT TREATMENT
- Hypertension
- Diabetes
- Cardiovascular diseases
- Osteoporosis (osteoporosis)
- Age
- Gender
- Cigarette
- Oral hygiene
- Bruxism (gnashing of teeth)
- Quality of the implant material
- Adequate bone level
In conclusion, implant treatment is a very preferred and comfortable treatment option today, and systemic and local evaluation of the patient is of great importance for the success of the treatment.
What is Bone Grafting Application?
With time, bone loss may occur in areas where tooth deficiency occurs. With this condition, the bones are adversely affected. Implant construction may be difficult for patients with this condition. However, with the grafting process, the amount of bone is obtained and a successful result is obtained.
What should be considered after grafting application?
Graft applications are very sensitive applications. It may be necessary to wait about 3-6 months for a healthy response, depending on the person and the case. A positive response will be obtained in terms of fusion of the bone tissue with the applied area. The waiting time for its recovery should not be ignored. During this time, you should avoid a force or blow to the treated area. This period will be determined by the physician at the time of the procedure. Being careful about the advice given after the procedure or the use of the prescribed drugs will be the solution for complicated problems that may occur.
Is the Grafting Procedure Painful?
Thanks to the local anesthesia performed before the procedure, there will be no pain.Depending on your pain threshold after the procedure and if the physician deems it necessary, painkillers can be used.
COMPLICATIONS AFTER SURGICAL PROCEDURES
The responses given during the recovery period after each surgical procedure may vary from person to person.Although the name of the procedure is the same, each operation proceeds and results in its own unique way. Because of these differences, symptoms or complications of varying severity may occur. After each procedure, the patient will take the recommendations and information carefully and increase your comfort after the procedure.
Some of the complications that may occur are;
- Swelling and/or redness, discomfort in the surgical area,
- Redness and cracking in the corners of the mouth due to stretching,
- Infection and delayed wound healing
- Dry socket (alveolit) ; jaw pain, which usually begins a few days after surgery due to inadequate care; It is more common in lower jaw extractions, especially wisdom teeth,
- Damage to the neighboring tooth, especially in the presence of large fillings and crowns,
- Loss or reduction of sensation in the gums, lips, tongue, teeth and jaw tip. It can be seen especially in teeth whose roots are close to the nerves, such as wisdom teeth. Almost always the numbness returns to normal, but very rarely it can be permanent,
- Trismus; is a limitation in opening the mouth due to inflammation or swelling,
- Bleeding in the form of leakage can continue for 1-2 days.