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Oral And Facial Defects With Oral And Maxillofacial Surgical Treatments 

Oral and facial defects can be acquired or congenital and fortunately, they can be corrected with the help of oral and maxillofacial surgeries. At MEDSTAR, our well-known surgeons are highly efficient in treating orofacial defects and disorders safely, improving the quality of life of the patient.

At MEDSTAR, all oral maxillofacial diagnosis and treatment procedures are performed under the Advanced Digital Dentistry programme for the best long-lasting results under one roof in Dubai. All treatments are safe and performed by our highly experienced surgeons. Our surgeons are efficient in performing cleft lip and palate surgeries, temporomandibular joint/jaw joint disorders and bone grafting, with excellent results and the least complications.

CLEFT PALATE SURGERY

  • A Cleft lip and palate is an abnormal gap due to incomplete fusion of orofacial tissues in a developing foetus inside the mother. This gap can be present in the lips or the palate(roof of the mouth) or it may involve both lip and palate.
  • This defect is present in babies since birth and can be successfully treated during the first 18 months after the birth of the baby.
  • Cleft lip repair (cheiloplasty)
    • This surgery is used to repair the lip defect. It involves reconstruction of the lip, correction of the nasal defect, reconstruction of nose floor and alignment of the upper gum line.
    • This surgery is performed in both the cases of the cleft lip and cleft lip & palate defect.
  • Cleft palate repair (palatoplasty)
    • This surgery is used to repair the palate defect. In this surgery palatal defect is closed and the function of normal speech production and feeding is achieved. 
    • Cleft palate surgery is scheduled after cleft lip surgery in cases of cleft lip and palate patients.

JAW JOINT DISORDERS/ TEMPOROMANDIBULAR JOINT DISORDER

  • The jaw joint is the joint where the temple bone of the skull and lower jaw i.e. mandible forms a gliding joint. This joint is known as the temporomandibular joint or TMJ.
  • TMJ allows the smooth functioning of the lower jaw during eating, speaking, opening and closing the mouth. The disorders of the jaw joint are the medical conditions that affect the normal function of the jaw joint.
  • At MEDSTAR, our surgeons are highly experienced in diagnosing TMJ disorders and providing the best treatment.

BONE GRAFTS

  • Bone grafts can be defined as the transplant of bone tissue or synthetic biocompatible material, for the healing and reconstruction of bones.
  • Bone grafts are used for:
    • Treating injury or trauma of the bones of the oral and facial region 
    • Filling the defects in the bones or oral and facial region
    • To prepare jaw bone for dental implants
    • To change the shape of facial bones for cosmetic purposes

What is Oral and maxillofacial surgery?

  • Oral and maxillofacial surgery is the surgical branch of dentistry that deals with the diagnosis and treatment of problems in the oral and maxillofacial region like fractures of facial bones and jaws, cleft lip and palate, tumours in facial and jaw area, dental implants, jaw and jaw joints disorders and bone grafts. 
  • These surgical procedures also help in reconstructing the oral and facial structures.

Conditions requiring oral and maxillofacial surgery

Cleft lip and palate/ cleft lip/ cleft palate

  • Due to incomplete fusion of oral and facial tissues in the foetus a gap or cleft is formed in the lip and palate region of the face. When this cleft involves the lip it is called a cleft lip and when the palate is involved it is called a cleft palate. When both are involved then it is called cleft lip and palate. 
  • A cleft lip or palate looks like a gap or cut and can be present on both sides.
  • Causes
    • In most cases, the cause is unknown.
    • Smoking: Women who smoke during pregnancy have more chances of having a baby with cleft lip and palate.
    • Diabetes: The diabetic medical condition of the mother can also cause cleft lip and palate in the baby
    • Certain medications consumed by pregnant women like anti-seizure drugs, acne drugs containing Accutane, and immunosuppressive drugs like methotrexate can also cause cleft lip and palate defect in babies.
    • Family history of cleft lip and palate.
    • Medical conditions having cleft lip and palate as a symptom like Apert syndrome and Pierre robin sequence syndrome.
  • Complications of cleft lip and palate:
    • Difficulty in feeding: Opening in the palate results in the passing of food and liquids from the mouth into the nose. Especially designed nipples and bottles can help in feeding the babies. Also, an artificial palate is used for the nourishment of the baby till surgery.
    • Ear infections: Children with cleft palate are more prone to fluid build-up in the middle ear leading to ear infections. If left untreated, it results in loss of hearing. To prevent ear infections and hearing loss, special tubes are used for draining out the liquid from the ears.
    • Speech problems: This condition also causes speech with nasal tone or difficulty in speaking. 
    • Dental Problems. Children with clefts often have missing, extra, malformed, or displaced teeth requiring dental and orthodontic treatments. They also have an upper jaw bone defect and more cavities.

Temporomandibular joint disorder

  • The temporomandibular joint is the joint formed of the temporal bone and lower jaw( mandible) with an elastic disc in between these bones, present in front of the ears.
  • The smooth functioning of this joint is necessary for the movement of lower jaws like opening, closing mouth, eating and speaking. Any abnormality, disorder or trauma of TMJ can affect the normal functions resulting in TMJ disorders.
  • Causes:
    • Trauma or injury to TMJ 
    • Joints affecting medical conditions like arthritis, osteoporosis etc
    • Erosion of the bony surfaces or disc of the joint
    • Excessive grinding or clenching of teeth 
    • Jaw bone defects by birth
    • Infection of the joint
    • A faulty dental restoration or dental prosthesis
    • Fusion of bones of the joint i.e. ankylosis
  • Symptoms: 
    • Pain in the temporomandibular joints and around the ears
    • Difficulty in eating and speaking
    • Swelling in the TMJ area
    • Pain while chewing
    • Difficulty in opening or closing mouth
    • Stiffness and pain in the jaw muscles
    • Limited movement of jaw or mouth
    • The jaw can lock sometimes
    • Clicking or popping while opening or closing mouth
    • Misalignment of upper and lower jaws

Bone grafts

  • Bone grafts are transplants made up of bone tissue or biocompatible bone substitutes that help in the healing, formation or reconstruction of bone. 
  • They are widely used in dentistry for healing the injury of jaws due to trauma or in reconstructing the shape and size of jawbones.
  • Bone grafts can be :
    • Autograft: These grafts are obtained from the bones of the patient itself.
    • Allograft: These grafts are obtained from the bones of other humans.
    • Xenograft: These grafts are obtained from animals.
    • Synthetic bone substitutes: These bone substitutes are polymers and proteins which results in bone formation.
  • Most commonly, autografts or synthetic bone substitutes are used in dentistry. Autografts are obtained from the hip bone, tibia (lower leg bone), chin bone and retromolar area (bony area behind the third molar) of the patient. Autografts heal faster and there is no risk of rejection by the body.
  • Conditions requiring bone grafts:
    • Severe gum disease: Gum disease when left untreated progress to severe bone loss resulting in small bone ridges or ridges without bones under gums. 
    • Preparing for dental implants: In some cases of dental implants, the required thickness of jaw bones is constructed by adding bone grafts. After successful bone grafts, implants are placed. Bone grafting helps in the stability of dental implants.
    • Reconstruction of jaws: In some cases of injury or trauma like fractures of jaws when a bone fails to heal and repair itself, bone grafting is done to heal it. It is also performed for cosmetic purposes.
    • Bone loss due to medical conditions: Some conditions like osteoporosis, cleft lip and palate can result in bone loss in jaws. This bone loss can lead to dental problems and misalignment of jaws. In cancer treated jawbones, the removed part of the bone is reconstructed by bone grafts.

Are You Eligible for oral and maxillofacial surgery?

  • Oral and maxillofacial surgery patient requires careful monitoring before and after the surgery. 
  • For Cleft lip and palate surgery:
    • The preferred age of the child for surgery is the first 10 -12 months after birth. Early age cleft surgery helps in improving normal functions early.
    • The child must be healthy and gaining weight. Rule of three 10s is followed- weight 10 pounds, haemoglobin value 10 and age 10 months.
  • For Temporomandibular joint disorders:
    • Surgery for TMJ disorders is recommended in cases of severe pain during normal movements of jaws or restricted jaw movements due to joint immobility. 
    • Visiting the doctor will help in ruling out the causes of TMJ disorder symptoms and its treatment. 
  • For bone grafts:
    • Bone grafting is performed in cases of severe bone loss after chemotherapy, trauma or due to medical conditions like osteoporosis.
    • Also, in cases of shaping the jaws and chin for improved aesthetics.

Consult our highly experienced oral and maxillofacial surgeon at MEDSTAR, for accurate diagnosis and the best-suited treatment plan as per the requirements of the patient.

Why choose MEDSTAR for Oral And Maxillofacial Surgeries?  The MEDSTAR Advantage

The oral and maxillofacial surgery department at MEDSTAR is updated with modern technologies for accurate diagnosis and result-oriented treatment of the patient. Our dentistry department works under the Advanced Digital Dentistry programme and making our centre well known for satisfactory results in Dubai.

Our dental surgeons are skilled and highly experienced in using modern technologies like intraoral scans and CBCT for precise diagnosis. An accurate diagnosis helps in providing the exact treatment to the patient with minimum post-treatment complications.

Cleft lip aka Cheiloplasty

  • The surgery used to repair the lip cleft defect is called cheiloplasty. This procedure reconstructs the normal anatomy and function of the lip, correction of the nasal deformity, and construction of the floor of the nose and proper alignment of the maxillary segments. 
  • This surgery is performed under anaesthesia.
  • Surgery is performed at approximately 4-6 months of age.
  • Bilateral lip repair i.e cleft present on both sides of lips can be done in the same surgical procedure or in the second procedure at least 8 weeks after the first surgery. 
  • The child patient has to stay in the hospital for one night.

Cleft palate surgery aka Palatoplasty

  • This surgery repairs the cleft palate by closing the palatal defect and create an adequately functioning velopharyngeal mechanism for normal speech production.
  • Surgery of the palate generally performed between 9-15 months of age under anaesthesia.
  • Palatoplasty is scheduled after cleft lip surgery or cheiloplasty.
  • The child may need further surgeries up to the age of 18 years to:
    • Correct speech problems not resolved with speech therapy
    • Improve the aesthetics of the nose or lip area
    • Teeth and gum alignment

Temporomandibular joint disorder (jaw joint disorder)

  • Surgeries for TMJ disorders are decided by the surgeon according to the cause of the disorder and whether surgery will resolve it or not.
  • Types of surgeries are:
    • Arthrocentesis: in this procedure, medicated fluid is injected into the joint. This injected fluid wash out the chemical mediators of inflammation present in the joint resulting in relief from pain and stiffness. This is the first-line treatment of painful and stiff temporomandibular joints.
    • Arthroscopy: This surgery is performed by the use of an arthroscope. An arthroscope is inserted through the holes made on the skin above the joint. The arthroscope helps the surgeon to see inside the TMJ and operate accordingly.
    • Open-joint surgery: In this surgery, a few inches long incision is made over the joint for access. through this surgeon can remove the excess bone or can repair or remove the disc.

Bone grafts

  • Bone grafting is done to heal and reconstruct the bone that is unable to heal itself.
  • The procedure of bone grafting is done by obtaining the bone graft. In the case of oral bone grafts, bone grafts are obtained from the hip bone, tibia, chin and retromolar area of jaws. Synthetic bone grafts are also used.
  • This procedure is performed under the effect of anaesthesia. The recipient site is prepared to receive the graft. The obtained bone graft is implanted onto the recipient site.

What are the various oral and maxillofacial surgeries available at MEDSTAR?

Cleft lip and palate surgery

  • Under this section, MEDSTAR provides the complete treatment plan for cleft lip and palate surgery. All treatments required for normal functioning of the palate and lip are available under one roof in Dubai.
  • Cheiloplasty and Palatoplasty: Our surgeons are highly experienced in performing cheiloplasty and palatoplasty. With The help of intraoral scans, surgeons can accurately make the treatment plan.
  • We provide counselling for the parents and follow up procedures to regain the normal functioning of the palate, lips, ears, nose and teeth.

Temporomandibular joint disorder(jaw joint disorder)

  • Treating TMJ disorders requires the skill and expertise of the surgeon to diagnose and treat the underlying condition of the disorder.
  • TMJ disorder surgery options available at MEDSTAR are:
    • Arthrocentesis: This procedure is used for relieving the symptoms of pain and stiffness of the TMJ joint due to inflammation. 
    • Arthroscopy: This is the minimally invasive technique of treating the use of an arthroscope. 
    • Open joint surgery: This surgery is used to remove excess bony growths or repair or replace discs present in between the bones.

Bone grafts

Our surgeons specialise in performing bone grafting procedures for repairing and reconstruction of bone for both functional & cosmetic purposes. The use of autografts and synthetic bone substitutes results in quick healing of the bone without the risk of rejection of the grafts.

Successful oral and maxillofacial surgery helps our patients to relieve symptoms and improve their quality of life. Our highly experienced oral surgeons and modern technologies are helping us in achieving impossible goals for our patients. 

How is cleft lip and palate treated?

  • Cleft lip and palate is an abnormal condition due to incomplete fusion of facial tissues during foetal development inside the mother. It is a gap present in the lip or the palate or both lip and palate together.
  • Treatment of cleft lip and palate includes the repair and reconstruction of lip and palate resulting in the normal function of speech, hearing and eating.
  • This condition can be treated by surgery only. These surgeries are performed during the first 10-12 months of the baby. For the complete reconstruction and complete normal functioning of the lip and palate, the child may need more than one surgery.

What to expect after cleft palate surgery?

After cleft palate surgery the patient is able to feed properly, there is no passage of food or milk into the nose through the mouth. Ear infections are also reduced. This surgery helps in improving the quality of life of the baby. But for normal functions like speech and hearing, other surgeries or treatment might be required with the growth of the baby.

How long to recover from cleft palate surgery?

It takes 3 to 4 weeks for surgical wounds to heal post cleft palate surgery. Usually, after the 1st week, the baby is back to normal behaviour. To protect the surgical wound from touching or rubbing, the baby is made to wear padded arm splints to restrict hand movements. After 3-4 weeks follow up appointments are scheduled to track the progress of healing.

Who is an oral and maxillofacial surgeon?

The oral and maxillofacial surgeon is the dentist who specialises in the surgical treatment of disorders related to the mouth and facial region. The oral surgeon performs surgeries to treat, repair and reconstruct the hard and soft tissues of the oral and facial region. He/She also helps in reconstructing these regions for cosmetic purposes.

How much time a bone graft take to heal?

Healing of the bone graft depends upon the size of the graft and the location of the bone graft. In the case of oral bone grafts, it takes 2 weeks to 2 months to heal completely. Bone grafts will completely fuse with the recipient’s bone in 2 months. Healing might get delayed due to pre-existing medical conditions like diabetes, the habit of smoking or infection of the surgical wound. The surgeon will give you strict instructions to be followed post-surgery for quick and normal healing of the bone graft.

Where does dental bone graft come from?

  • Bone grafts can be obtained from the patient( autograft), other humans(allograft) and animals(xenografts). Synthetic bone grafts are also available for clinical use. These are made up of synthetic bone proteins and polymers.
  • In the case of oral surgeries, autografts and synthetic bone substitutes are preferred. Autograts are obtained from the hip bone, tibia, chin and bony area behind the wisdom tooth (retromolar area) of the patient.

What is a bone graft for a tooth implant?

A bone graft for a tooth implant is the procedure of transplanting the bone graft to increase the strength of the jawbone before the placement of the dental implant. Bone graft fuses with the jaw bone and increases the chances of stability of the dental implant. Mostly, autografts and synthetic bone grafts are used for bone grafting before dental implants.

What are temporomandibular joint disorders?

  • The temporomandibular joint is the joint that connects the lower jaw (mandible) to the temporal bone of the skull. This joint helps in the normal functioning of the lower jaw like eating, speech opening and closing of the mouth.
  • Conditions affecting the normal functioning of this joint movement are called temporomandibular joint disorders. These disorders can be localised like trauma or can be the symptom of a medical condition like arthritis.

Are temporomandibular joint disorders curable?

Treatment of TMJ disorders is entirely based upon the diagnosis to identify the cause of the disorder. Accurate diagnosis of the cause of the TMJ disorder and its treatment results in effective and long-lasting results. Diagnosing the disorder requires a skilled and experienced oral surgeon who specialises in TMJ treatment. At MEDSTAR, our patients get the advantage of treatment from our experienced oral surgeon who also specialises in TMJ disorders.




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