Surgery

Impacted Tooth

An impacted tooth is one that fails to erupt into the dental arch within the expected developmental window. Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Teeth may become impacted because of adjacent teeth, dense overlying bone, excessive soft tissue or a genetic abnormality. Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The wisdom teeth (third molars) are frequently impacted because they are the last teeth to erupt in the oral cavity. Mandibular third molars are more commonly impacted than their maxillary counterparts. Some dentists believe that impacted teeth should be removed except, in certain cases, canine teeth: canines may just remain buried and give no further problems, thus not requiring surgical intervention. However, removal of asymptomatic, pathology-free, impacted teeth isn't a medical consensus:   Most commonly the individual complains of food getting lodged beneath the gums and a soreness that is usually confused with throat infections. In slightly milder forms a swelling is visible and mouth opening becomes difficult in severe cases. Pain is invariably present.

      

Management: Impacted teeth might be extracted or left alone, depending on the dentist (and the health authority's guidelines in that country) and the situation. Extraction might be contraindicated and might be simple or surgical, often depending on the location of the teeth.                                                                             

In some cases, for aesthetic purposes, a surgeon may wish to expose the canine. This may be achieved through open or closed exposure. Studies show no advantage of one method over another.

Oral Cyst and Tumors

Oral cysts and tumors are relatively rare lesions (sores) that develop in the jawbone or the soft tissues in the mouth and face. These typically include:

  • Cysts (sacs possibly filled with fluid)

  • Benign (non-cancerous) tumors (lumps of skin that do not resemble the skin around them) that may be slow or fast growing.

  • Malignant (cancerous) tumors

Our Oral and Maxillofacial surgeons evaluate, diagnose and treat cysts and tumors in and around the head and neck. This includes lesions in the jaw bones, salivary glands, lips, cheeks, and teeth. A cyst is an abnormal sac or pocket in bone or soft tissues which may contain fluid. There are many different kinds of cysts. The most important reason for removing a cyst is that over time they increase in size and may become harmful. Very large cysts may weaken the lower jaw bone to the point where it can break more easily. Teeth beside a large cyst may become loose and move around. In some cases, cysts may destroy the tooth structure – this is called root resorption. 

A tumor is a solid or semi-solid mass within bone or soft tissue that is made of cells that are different than cells usually found in that location. There are several types of soft-tissue tumors which may be found on the lips, cheeks, tongue, mouth floor (under the tongue), and gums.

Before starting treatment for a tumor, you will have a biopsy. A biopsy is a surgery that removes part of the tumor and helps the doctor to determine if the tumor is benign or malignant and what would be the best treatment for it. Different tumors require different types of treatment ranging from minimally invasive procedures to more extensive surgery. It is very important to diagnose the tumor correctly with a biopsy prior to Facial and jaw cysts and tumors often do not have any symptoms. Your doctor or dentist may discover them during regular check-ups or x-rays. When they do cause symptoms, they usually look like a non-painful bump or lump. These cysts and tumors are often benign (not cancer), but all tumors in the head and neck must be examined by our surgeons as soon as possible.

After a surgeon examines the cyst or tumor, we will often recommend an x-ray ( x-ray of your mouth and jaw), CT scans (three dimensional X-ray showing the inside of a body part) to determine what kind of treatment you need.

 

Osteotomy

An osteotomy is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment. Combining this surgical technique with teeth alignment is orthognathic surgery.

Orthognathic surgery is mostly performed to correct developmental or acquired oral and maxillofacial skeletal deformities (OMSDs). During the past three decades, significant advances in surgical osteotomy techniques and instrumentation have been developed and carried out in orthognathic surgery.

Cleft Corrections

Cleft lip and cleft palate are among the most common birth anomalies affecting children. The incomplete formation of the upper lip (cleft lip) or roof of the mouth (cleft palate) can occur individually, or both defects may occur together. The conditions can vary in severity and may involve one or both sides of the mouth. Surgery is required to repair cleft lip and/or cleft palate.

Early intervention by a team of specialists is needed to evaluate and manage your child's treatment and development in cases of cleft lip and/or cleft palate. The team will work together to define a course of treatment, including feeding recommendations, surgical repair of the cleft, speech rehabilitation and dental restoration.