Dental implants are changing the way people live and helping you smile with confidence. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. With dental implants, you can regain the ability to eat virtually anything while knowing that your teeth appear natural.
Dental implants are tiny titanium posts that are surgically placed into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts that protrude through the gums are then attached to the implant. These posts provide stable anchors for artificial replacement teeth. Implants also help preserve facial structure, preventing bone deterioration that occurs when teeth are missing.
Over a period of time, if you are missing teeth, your jawbone can start to atrophy or reabsorb. This loss of jawbone can develop into additional problems, both with your appearance and your overall health. You may experience pain, problems with your remaining teeth, and altered facial appearance, and eventually even the inability to speak and eat normally.
This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and aesthetic appearance.
Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank, or your own bone is taken from the jaw, hip or tibia (below the knee). Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.
Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.
By the age of 18, the average adult has 32 teeth: 16 teeth on the top and 16 teeth on the bottom. The problem is that the average mouth is made to hold only 28 teeth, so it can be painful when 32 teeth try to fit. These four extra teeth are your third molars, also known as "wisdom teeth."
Wisdom teeth are the last teeth to erupt within the mouth. When they align properly and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen. The extraction of wisdom teeth is 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. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to successfully erupt.
These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the teeth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain, and illness. The pressure from the erupting wisdom teeth may move other teeth and disrupt the orthodontic or natural alignment of teeth. The most serious problem occurs when tumors or cysts form around the impacted wisdom teeth, resulting in the destruction of the jawbone and healthy teeth. Removal of the 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.
There are a number of possible causes of facial trauma such as motor vehicle accidents, falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).
Proper treatment of facial injuries requires doctors and surgeons that are well versed in emergency care, acute treatment and long-term reconstruction and rehabilitation—not just for physical reasons but emotional as well. Oral and maxillofacial surgeons are trained, skilled, and uniquely qualified to manage and treat facial trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands-on” experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.
At Midwest Oral & Maxillofacial Surgery our surgeons are trained, skilled, and uniquely qualified to manage and treat facial trauma. They are on staff at local hospitals and deliver emergency room coverage for facial injuries, which include the following conditions:
Intra oral lacerations
Avulsed (knocked out) teeth
Fractured facial bones (cheek, nose or eye socket)
Fractured jaws (upper and lower jaw)
Orthognathic surgery is needed when jaws don't meet correctly and/or teeth don't seem to fit the jaw. Teeth are straightened with orthodontics, and corrective jaw surgery repositions a misaligned jaw. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.
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 jaws may grow at different rates. The result can be a 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.
Typical reasons for jaw surgery include:
Difficulty in chewing, biting or swallowing
Chronic jaw or TMJ pain
Some patients require minor oral surgical procedures before receiving a partial or complete denture in order to ensure the maximum level of comfort. A denture sits on the bone ridge, so it is very important that the bone is the proper shape and size. If a tooth needs to be extracted, the underlying bone might be left sharp and uneven. For the best fit of a denture, the bone might need to be smoothed out or reshaped. Occasionally, excess bone would need to be removed prior to denture insertion.
One or more of the following procedures might need to be performed in order to prepare your mouth for a denture:
Bone smoothing and reshaping
Removal of excess bone
Bone ridge reduction
Removal of excess gum tissue
Exposure of impacted teeth
The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer.
The following can be signs at the beginning of a pathologic process or cancerous growth:
Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth.
A sore that fails to heal and bleeds easily.
A lump or thickening on the skin lining the inside of the mouth.
Chronic sore throat or hoarseness. Difficulty in chewing or swallowing.
These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face and/or neck. Pain does not always occur with pathology, and curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer.
TMJ (temporomandibular joint) disorders are a family of problems related to your complex jaw joint. If you have had symptoms like pain or a "clicking" sound, you'll be glad to know that these problems are more easily diagnosed and treated than they were in the past. These symptoms occur when the joints of the jaw and the chewing muscles (muscles of mastication) do not work together correctly. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important. However, no one treatment can resolve TMJ disorders completely and treatment takes time to become effective.
TMJ disorders develop for many reasons. You might clench or grind your teeth, tightening your jaw muscles and stressing your TM joint. You may have a damaged jaw joint due to injury or disease. Injuries and arthritis can damage the joint directly or stretch or tear the muscle ligaments. As a result, the disk, which is made of cartilage and functions as the “cushion” of the jaw joint, can slip out of position. Whatever the cause, the results may include a misaligned bite, pain, clicking, or grating noise when you open your mouth or trouble opening your mouth wide.
Bone Morphogenetic Protein
Bone morphogenic protein is an isolated protein that induces specific cells in our body to form new cartilage and bone. During surgery, the BMP is soaked onto and binds with a collagen sponge. The sponge is then designed to reabsorb, or disappear, over time. As the sponge dissolves, the bone morphogenic protein stimulates the cells to produce new bone. The BMP also goes away once it has completed its task of jump-starting the normal bone healing process.
Since there is no need to harvest bone from the patients’ hip for BMP, recipients are spared donor site pain. Complications from the graft harvest site are also eliminated with the use of bone morphogenetic protein.
An impacted tooth simply means that it is “stuck” and cannot erupt into function. Patients frequently develop problems with impacted third molar (wisdom) teeth. These teeth get “stuck” in the back of the jaw and can develop painful infections and a host of other problems. Since there is rarely a functional need for wisdom teeth, they are usually extracted if they develop problems.
The maxillary cuspid (upper eyetooth) is the second most common tooth to become impacted. The cuspid tooth is a critical tooth in the dental arch and plays an important role in your “bite”. The cuspid teeth are very strong biting teeth and have the longest roots of any human teeth. They are designed to be the first teeth that touch when your jaws close together so they guide the rest of the teeth into the proper bite. If a cuspid tooth gets impacted, every effort is made to get it to erupt into its proper position in the dental arch.
The techniques involved to aid eruption can be applied to any impacted tooth in the upper or lower jaw, but most commonly they are applied to the maxillary cuspid (upper eye) teeth. Sixty percent of these impacted eyeteeth are located on the palatal (roof of the mouth) side of the dental arch. The remaining impacted eye teeth are found in the middle of the supporting bone but stuck in an elevated position above the roots of the adjacent teeth or out to the facial side of the dental arch.
In cases where the eyeteeth will not erupt spontaneously, the orthodontist and oral surgeon work together to get these unerupted eyeteeth to erupt. Each case must be evaluated on an individual basis but treatment will usually involve a combined effort between the orthodontist and the oral surgeon. The most common scenario will call for the orthodontist to place braces on the teeth (at least the upper arch). A space will be opened to provide room for the impacted tooth to be moved into its proper position in the dental arch. If the baby eyetooth has not fallen out already, it is usually left in place until the space for the adult eyetooth is ready. Once the space is ready, the orthodontist will refer the patient to the oral surgeon to have the impacted eyetooth exposed and bracketed.