Maxillofacial Surgery, which can either be Cosmetic or Reconstructive gives a new structure to the jaw bone, head, face and other such injuries. In other words, your body structure can be rectified to a great extent by this procedure. However, the treatment is only given after a proper study of the patient's condition.
Maxillofacial surgery can be used to treat wisdom teeth, misaligned jaws, tumors, cysts and the mouth area. So areas like the face, head, and neck can be rectified to a great extent by this surgical process.
Wisdom Teeth Extraction
By the age of eighteen, and average adult has 32 teeth in the mouth. Generally an average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are THIRD MOLARS also known as WISDOM TEETH two in the upper jaw and two in the lower jaw.
Why should Wisdom teeth be removed?
Wisdom teeth are the last teeth to erupt within the mouth. When they are properly aligned in the mouth and gum tissue surrounding them is healthy wisdom teeth are not to be removed. But this is highly unlikely as when the time for their eruption comes, the jaw growth is over and there isn’t sufficient space to accommodate them.
The extraction becomes necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum and even remain trapped beneath the gum and bone and remain impacted.
These impacted and poorly positioned teeth can cause following problems:
- When they are partially erupted, the opening around the tooth allows food to accumulate which further favors bacterial growth and leads to infection resulting in pain, swelling, diffliculty in mouth opening and generalised illness.
- The infection may cause a cavity in the adjacent tooth.
- The pressure from the erupting wisdom tooth may move to other teeth and disrupt the orthodontic or natural alignment of teeth.
- The most serious problems occur when tumors or cyst form around the impacted wisdom tooth, resulting in destruction of the jaw bone and healthy teeth.
- An impacted wisdom tooth also causes jaw to fracture easily in case of minor injuries to the jaw as jaw in the area of third molar is very thin and the presence of wisdom teeth in it further weakens it.
Removal of offending impacted teeth usually resolves these problems. Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure.
Jaw Fractures
Injuries to the face impart a high degree of emotional as well as physical trauma to patients. Oral and maxillofacial surgeons are trained, skilled and qualified to manage and treat facial trauma. The management of facial trauma requires specialized techniques because the management influences the patient’s long term function and appearance.
Facial trauma includes:
- Facial Lacerations
- Intra Oral Lacerations
- Avulsed Teeth
- Fractured facial bones, Cheek, Eye socket, Nose, Forehead
- Fractured jaws (upper and lower)
TMJ Disorders
TMJ (Temperomandibular Joint) disorders are a wide array of problems related to your complex jaw joint. TMJ Stands for Temperomandibular joint which is the name for each joint (right and left) that connects your jaw to the skull and is located in front of your ears on both right and left side. The problems in TMJ could be :
Clicking or popping sound : This is usually due to slippage of Articular disc in the joint which acts as a cushion and the joint head rubs against the disc on opening the jaw resulting in joints sound. This may be painful in few cases. Sometimes it causes restriction in mouth opening. This may require TMJ LAVAGE. TMJ LAVAGE is an office based procedure where two needles are inserted in the joints to wash the joint, under local anesthesia.
Pain in and around the joint : This is usually due to fatigue of the complex neuromuscular apparatus in and around the joint causing myofacial pain. It requires psychogenic counselling, medication and muscle exercises.
Deviation on opening : This is also due to uncoordination between the ligaments and muscles of the joint.
TMJ Ankylosis : It causes complete restriction of mouth opening and arrests the jaw development also. This may lead to cosmetic deformity. Treatment is done by surgically opening the joint and seperating the jaw bone from skull to achieve mouth opening. This is a very complex surgery and requires highly skilled team of anesthetists and Maxillofacial Surgeon. Hospitalization is for five to six days.
Subluxation/Dislocations of the jaw : In this condition the jaw feels loose in the joint and even dislocates out of the joint. May require reduction of the dislocated joint by the surgeon.
Orthognathic Surgery
Orthognathic surgery is needed when jaws don’t meet correctly and for teeth that don’t seem to fit with in the jaws. Teeth are straightened with Orthodontics, corrective jaw surgery repositions misaligned jaws. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.
The disparity in jaws could be of the following types:
- Deficient & excessive upper jaw
- Deficient & excessive lower jaw
- Combination of both.
Who Needs Orthognathic Surgery?
People who can benefit from Orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly, jaw growth is a gradual process and in some instances, the upper and lower may grow at different rates. The result can be host of problems that can affect chewing function, speech long term oral health and appearance, injury to the jaw and birth defects can also affect jaw alignment. Orthodonathics alone can correct bite problems when only the teeth are involved. Orthographic surgery may be required for the jaws when repositioning is necessary.
Cosmetic Maxillofacial Surgery
This includes various surgical procedures to improve your aesthetic appearance.
FACIAL AUGMENTATION
Augmentation of deficient areas of face like cheek bone, jaw line and chin by alloplastic material like porous polyethylene (MEDPOR). This is available in various shapes to suit individuals need. It is totally biocompatible and is well accepted by human body. It is fixed onto the deficient areas by a screw. The surgery is done through the mouth.
SCAR REVISION
Management of old unesthetic scar by various facial plastic surgical procedures.
GENIOPLASTY
It is a procedure where a small and deficient chin on patients face is surgically moved forward to a new position which is more aesthetically acceptable. The chin is fixed to its new position by wires or plates. The surgery is done under general anesthesia and is a day care procedure. It can also be done to reduce over sized chin where it is pushed back. In selective cases GENIOPLASTY yields very good results.
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