Maxillofacial surgery is the medical-surgical specialty that focuses on the study, diagnosis, treatment and rehabilitation of congenital or acquired diseases of the oral cavity, facial skeleton and related cervical structures. The maxillofacial surgeon has extensive knowledge in oral and maxillofacial surgery that allow him to perform complicated extractions, bone grafts and dental implants, among many other treatments.
Most common problems
What pathologies are treated with surgery?
Maxillofacial surgery treats all those diseases that occur in the mouth, jaw, head and neck and require surgical intervention. They can be acquired pathologies of tumor, traumatic, degeneration or aging origin. Among the most common we highlight:
Lack of jaw or jaw bone: Bone loss is often difficult to identify in its initial stage and, if you do not go to the dentist on a regular basis, bone loss can be detected when you are already in an advanced state. The alveolar bone begins to be reabsorbed gradually losing height and thickness at a rate of 40-60% in the first 3 years. That makes it possible for a person to lose one or more teeth in a short time.
Problems in the salivary glands and the oral mucosa: Due to the large number of systemic diseases that have manifestations in the oral mucosa, sometimes a large number of clinical specialists are involved in their diagnosis and treatment, for example, rheumatologists, allergists, immunologists and, of course, maxillofacial surgeons. Lesions of the oral mucosa are of transcendental importance to avoid those with malignant potential. Tumor lesions of the oral mucosa are mainly associated with the consumption of tobacco and alcohol. Salivary gland tumors are found to a greater extent in the parotid glands and are often benign. Even so, its growth causes facial deformity, discomfort and pain, and may affect the facial nerve, responsible for facial expressiveness.
- Temporomandibular joint pathologies (ATM): They have a high prevalence: 20-40% of the population. These pathologies encompass a large number of disorders, not only of traumatic, neoplastic, autoimmune and infectious origin, but also those derived from dysfunctional alterations of their jaw structure that allow chewing and speaking.
- Facial trauma: When a tooth receives a blow or breaks, its structure weakens causing the stimulation transmitted to the bone to stop. This may result in the beginning of a dental bone resorption (bone loss).
- Head and neck tumors: Cancer in the maxillofacial region is one of the 10 most common types of cancer that manifest in the human body. This may have a tumor and usually appears on the face, neck and mouth.
- Osteoporosis: Bisphosphonates, one of the medications prescribed to fight osteoporosis, can cause osteochymionecrosis of the jaws in the long term. This side effect creates bone exposures in the oral cavity and delays in the healing of certain processes due to maxillary necrosis.
What surgical techniques can be performed?
Oral and maxillary surgery is a very complex anatomical territory. That is why this surgical specialty encompasses a wide variety of procedures of high level and complexity:
Dental extractions or exodontias:
Wisdom teeth: The removal of wisdom teeth (or strings) is a quick and painless intervention, in which minimally invasive techniques are used that expedite recovery and significantly reduce it. It is performed with local anesthesia and lasts between 10 and 30 minutes. Milk teeth that do not fall: The presence of some children’s dental pieces in adults is a fairly common occurrence (usually canines or upper premolars). The extraction process goes through a small surgical operation, which consists of an outpatient procedure, nothing traumatic, performed with local anesthesia.
Treatment to make space: When there is a great lack of space that cannot be corrected by other means, the extraction of one or two teeth can be considered as an intervention necessary to align the rest of the teeth of the mouth. This decision will be the result of a series of orthodontic analyzes. Extraction will always be the last resort, because in every decision, the conservation of the original pieces is above all else. Fractured or decayed teeth: An extraction of a broken, broken, fractured or affected tooth by an important tooth decay will be carried out as long as it cannot be reconstructed. Doing so can prevent a possible infection from spreading to other teeth, stop a bone loss or prevent the worsening of periodontal disease.
Corrective Jaw Surgery
- Temporomandibular joint syndrome (TMJ): This disorder is usually temporary and does not get worse, so it only requires a simple treatment to relieve discomfort. However, if the symptoms cannot be controlled, a minimally invasive maxillofacial surgery can be performed, which involves removing the inflamed tissue and manipulating the structures. In some cases, when the damage is very serious, the damaged madibular joint can even be replaced by a prosthesis.
- Maxillofacial fractures: Facial traumatology is a specific part of traumatology that requires a specialized approach by a maxillofacial surgeon to avoid both functional and aesthetic sequelae. An appropriate treatment allows a 100% reconstruction of the fracture, without any sequelae.
- Incorrect bite: In case of suffering a severe bad occlusion or presenting complexes that prevent the development of a normal life, the problem of incorrect bite can be treated with orthognathic surgery combined with an orthodontic treatment. This intervention is aimed at correcting the bite, as well as obtaining a more harmonious face that meets the patient’s expectations.
- Bruxism or grinding of teeth: There are techniques to improve the distribution of occlusal forces, such as occlusion adjustments, occlusal balance, selective wear or replacement of missing teeth. Surgery would be chosen in cases of dentofacial deformities or prosthetic and functional rehabilitation.
- Jaw reconstruction: It consists of the insertion of tissue and bones in patients suffering from tumors in the face, neck and mouth. Head and neck tumors represent approximately 5% of cancers in men and 2% in women. The surgical procedure involves the removal of said tumor and the reconstruction of the defect that has been generated in the extraction.
- Dental implants: Dental implant surgery is a procedure that replaces the roots of the teeth with metal bolts that look like screws to replace the missing, or damaged, tooth with an artificial tooth that looks the same and fulfills the same function as a real tooth Dental implant surgery can offer a well-accepted alternative to dentures or bridges that are not well fixed.