Jaw reconstruction surgery
Dental implants are made of titanium and, having been in clinical practice for three decades, are total an excellent substitute of natural teeth with an excellent long-term prognosis. Small metallic supports are attached to the implants forming the substrate for the artificial teeth. Working together with a dentist-dental implant specialist, the oral and maxillofacial surgeon assesses the patient and places the implants on the jaw bones.
Also, at a hospital setting, more difficult and lengthy surgical operations can be performed for the placement of dental implants. In order to minimise surgery-induced stress and ensure optimal conditions for the patient, IV (sedation) or general anaesthesia is used.
When the existing bone material in the jaws is not sufficient to adequately support the implantation procedure or the implants (e.g. due to periodontitis, trauma or surgical resection of tumors), the oral and maxillofacial surgeon may transplant to the defective areas bone grafts derived from within the oral cavity (chin, lower jaw region) or sites outside the buccal area (iliac crest, tibia, calvaria), so as to improve the quantity and quality of hard tissue. Firstly, reconstructive surgery (bone auto-transplantation) and then, once the bone graft has settled (5 to 6 months), dental implants are placed.
Facial imbalances – facial and jaw abnormalities
Developmental imbalances between the upper and the lower jaw can cause functional and psychological problems. Functional problems consist in disorders related to chewing, swallowing, vocalisation, breathing, as well dysfunction of the temporomandibular joints. Psychological problems arise from the aesthetic and social aspects of these asymmetries.
Dental distortions can be corrected using “braces” by an orthodontist. More severe disorders of skeletal development (such as prognathism, , or laterognathia) require corrective surgery in order to restore the upper and lower jaw to a natural, functionally and aesthetically, position. This is preceded by an appropriate pre-operative preparation by an orthodontist. If there is proper diagnosis and treatment planning, the outcome is fully predictable.
Congenital facial abnormalities (cleft lip and palate, cleft jaw, craniofacial dysostoses, etc) arise as a result of an abnormal embryonic and early post-embryonic development. As a member of a team of specialised hygienists, the oral and maxillofacial surgeon plays a very important role in the carefully-orchestrated and multi-stage restoration plan for these patients, always guided by the aim to accomplish normal function and appearance.
The oral and maxillofacial surgeon is the most specialised surgeon to diagnose, offer pre-operative evaluation and surgically treat benign and malignant tumors developing in the oral cavity, the jawbones and the face. Among other problems, this surgeon handles precancerous lesions in the oral mucosa (e.g. leukoplakia), oral cancer (e.g. squamous cell Ca), salivary gland tumors (e.g. in the parotid and the submandibular gland), as well as benign but aggressive neoplastic lesions of the jaws (e.g. adamantinoblastoma and keratin cysts).
Responsible surgical management of these conditions required further training (fellowship training) that is obtained after basic specialty training in oral and maxillofacial surgery in suitable medical institutions. The patients must be managed by a team of surgeons, radiotherapy specialists and oncologists.
The oral and maxillofacial surgeon should be broadly trained and experienced in handling injuries, such as fractures of the upper and lower jaw, eye socket, cheek bones, frontal bone and the nasopharynx, as well as contusions of the facial soft tissue.
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