Craniofacial surgery is plastic surgery of the cephalic extremity, including the skull, the face, and, in particular, the orbit. It involves the cephalic skeleton as well as surrounding soft tissues.
Oral maxillofacial surgery is the dental specialty that manages the underlying conditions, diseases, defects and injuries causing and/or contributing to functional and esthetic problems in the mouth, teeth, jaws and face. Closely linked to oral maxillofacial surgery, oral maxillofacial pathology focuses on diagnosing and understanding the nature of diseases and abnormal conditions (pathology) in the oral and facial region.
Congenital anomalies, defects after tumor ablation, and posttraumatic deformities are the types of pathology that can be treated. Congenital conditions should be treated early in infancy to optimize final results. Reconstruction of resultant defects after tumor ablation and trauma often requires the input of the craniofacial surgeon for both pediatric and adult patients.
The goals of surgery include correction of the dysmorphogenesis and prevention of functional impairment.
Treatments and procedures performed by oral maxillofacial surgeons address a variety of conditions and diseases of the mouth, teeth, jaw and face. These include:
- Diagnosis/treatment of potentially life-threatening infections of the maxillofacial region
- Performing biopsies and other diagnostic tests
- Diagnosis/treatment of oral cancers
- Diagnosis/management of impacted teeth, wisdom teeth, tooth extraction and dentoalveolar surgery, which encompasses all procedures relating to the teeth, supporting tissue and bony structures in the mouth
- Surgical treatment of facial pain problems related to the temporomandibular joint (TMJ)
- Surgical correction of oral and facial deformities caused by differences in skeletal growth between upper and lower jaws, and congenital defects, including cleft lip and palate
- Reconstructive jaw surgery to correct hard and soft tissue injuries in the upper and/or lower jaws resulting from trauma or tumor surgery
- Treatment/repair of traumatic injuries to the face, jaws, mouth and teeth
- Dental implant placement (single tooth, several teeth, entire mouth)
- Cosmetic facial procedures
Maxillofacial trauma includes injury to the face and jaw resulting most commonly from sports, accidents or violence.
Treatment for maxillofacial trauma varies depending upon the type and severity of the injury. Treatment will include a careful and systematic evaluation of structure and systems, including a comprehensive physical exam and x-rays. In some cases, diagnosis and treatment must be deferred until swelling subsides or until more severe injuries are resolved.
At Royal Dental Clinics, our oral and maxillofacial surgeon collaborates with emergency personal in the evaluation and treatment of patients with maxillofacial trauma.
Treatment for facial trauma is complex and often involves airway control, bleeding control, reduction of swelling, prevention of infection, repair of bone fractures, repair of lacerations or soft tissue injury, and reconstruction. Our expert dental and maxillofacial surgeons at Royal Dental Clinics can help you in such cases. The combination of dental and surgical training makes oral and maxillofacial surgeons uniquely skilled at restoring the aesthetics of facial proportions, the functionality of jaw joints and bites, and damaged or missing teeth.
Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates 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.
In a bone graft procedure, the surgeon will take a section of bone from another area of your body, or – as is most often the case now – use a special bone grafting material, and graft it onto your jaw bone. It is possible if you only need a minor graft that the procedure might be able
to be done at the same time as the implant surgery, our dental experts and surgeons will help you make the final decision. A successful bone graft allows your jaw bone to be strong enough to support your dental implant.
Once the bone graft is complete, the rest of the implant surgery can proceed. As with any surgical procedure, it is important to discuss your personal medical history and all the risks and benefits of the surgery with our dental specialist. Once our expert doctors’ determine are a good fit for the procedure, you can look forward to a brand new smile.
Most cases of cleft lip and cleft palate are noticed right away at birth and don’t require special tests for diagnosis. Increasingly, cleft lip and cleft palate are seen on ultrasound before the baby is born.
The goals of treatment for cleft lip and cleft palate are to improve the child’s ability to eat, speak and hear normally and to achieve a normal facial appearance.
Surgery to correct cleft lip and palate is based on your child’s particular situation. Following the initial cleft repair, your doctor may recommend follow-up surgeries to improve speech or improve the appearance of the lip and nose.
Surgeries typically are performed in this order:
- Cleft lip repair — within the first 3 to 6 months of age
- Cleft palate repair — by the age of 12 months, or earlier if possible
- Follow-up surgeries — between age 2 and late teen years
In general, procedures may include:
- Cleft lip repair. To close the separation in the lip, the surgeon makes incisions on both sides of the cleft and creates flaps of tissue. The flaps are then stitched together, including the lip muscles. The repair should create a more normal lip appearance, structure and function. Initial nasal repair, if needed, is usually done at the same time.
- Cleft palate repair. Various procedures may be used to close the separation and rebuild the roof of the mouth (hard and soft palate), depending on your child’s situation. The surgeon makes incisions on both sides of the cleft and repositions the tissue and muscles. The repair is then stitched closed.
- Ear tube surgery. For children with cleft palate, ear tubes may be placed to reduce the risk of chronic ear fluid, which can lead to hearing loss. Ear tube surgery involves placing tiny bobbin-shaped tubes in the eardrum to create an opening to prevent fluid buildup.
- Surgery to reconstruct appearance. Additional surgeries may be needed to improve the appearance of the mouth, lip and nose.
Surgery can significantly improve your child’s appearance, quality of life, and ability to eat, breathe and talk.
Advanced Maxillofacial Paediatric Surgery
Paediatric maxillofacial surgery encompasses surgery of the entire facial structure, including both soft and hard tissue, in children and adolescents. The surgical team at Royal Dental Clinics are specialised in performing maxillofacial surgery for infants, children, and adolescents, and can treat both congenital malformations and acquired problems.
The most common interventions in paediatric oral and maxillofacial surgery are the following:
- Maxillofacial surgery of the lingual frenulum: children often experience problems with the lingual frenulum. A short frenulum is usually associated with difficulty in speaking properly and problems with phonation, the misalignment or movement of the teeth or their incorrect position in the dental arch. Sometimes the frenulum can be easily injured through an odd movement or by trauma, causing haemorrhage.
- Facial trauma: this type of trauma is more frequent in children under the age of two and between the ages of 8 and 10.
- ongenital malformations: harelip and cleft palate are the most common malformations in children and adolescents. Surgery is essential in order to restore the speech and swallowing functions, for a good facial appearance and the social adaptation of the child.
- Reparative and reconstructive maxillofacial surgery: This kind of surgery encompasses a wide range of aesthetic procedures to improve appearance, covering everything from otoplasty and rhinoplasty to scar correction.
- Paediatric oncology: tumours in the maxillofacial region of a child patient are usually benign but we always have to rule out the malignancy of the process and to ensure adequate treatment. If a malignant process is detected, a multidisciplinary approach is essential.
Whether it is emergency surgery or a planned procedure, children need surgeons devoted to caring for kids and families. Our pediatric maxillofacial surgeons know growing bodies and have advanced training in surgery to treat a wide range of conditions on children from newborns to teens. Whatever your child’s needs, we at Royal Dental Clinics will work together to provide safe, comprehensive surgical care.