Maxillomandibular and Dental Surgery

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Question

Question
How long does implant treatment take?
Answer

Implant treatment lasts one day to three months. This period depends on many factors including but not limited to type of implant and bone reserve etc. 

Surgical process of implant treatment (construction of implants) lasts half an hour to four hours depending on number and bone reserve. Three months should elapse to ensure a strong bonding and union to the bone. Temporal denture may be placed on the implant within two days depending on course of the case. After union of implant to the bone is completed, superior dentures are constructed within two to three weeks.

 

Question
Is implant treatment a painful procedure?
Answer

Patient feels no pain, since implant procedure is carried out under local anesthesia. Following implant procedure, pain generally disappears in response to painkillers within 1 to 2 days.

Implant procedures are routine treatments in daily practice of dentistry. Patient feels no pain under local or general anesthesia during the procedure. Maximal comfort is assured with post-procedural resting and appropriate medications.

Question
Which materials are used for implant production? Does implant treatment harm the body?
Answer

Dental implants are produced using titanium and titanium compounds. Titanium is preferred as implant material, since titanium does not interact with body tissues. Implant generally does no harm for body. Rejection is not a probability, but not all patients are eligible for implant treatment.

Titanium is a biocompatible material. All implants are manufactured from titanium. Success rate of implant procedure is 95%. This rate is high in general medicine. Underlying causes of failure are usually related with incompliance with post-procedural recommendations and systemic conditions of patient.

Question
Who are eligible for implant therapy?
Answer

High success rates are achieved with implant therapy for persons who are aged >18 years, have good general health status, performs a good oral care and have healthy gingiva and bone structure that allows and supports implant in the jaw bone. In some cases, amount of bones may not be sufficient for placement of an implant. If loss of bone is high, appropriate infrastructure can constructed using advanced techniques in order to place implants.

Question
Who are not eligible for implant therapy?
Answer

Persons who received radiotherapy for head and neck region, young persons with incomplete bone growth and development and heavy smokers are not appropriate candidates, since smoking suppresses intra-oral wound healing and success of implant. Implants can be placed if correct conditions can be achieved after health status of persons with diabetes, hypertension, hemophilia and systemic diseases, such as autoimmune diseases, and, who use Bisphosphonate, corticosteroid or immunosuppressive agents, is consulted with primary or relevant physicians.

An implant is not preferred for patients with uncontrolled diabetes and/or other advanced stage systemic diseases (kidney, liver and heart failure, cancer, mental diseases, etc.).

Question
What can be done when jawbones are insufficient for an implant?
Answer

Quality, width and height of jawbones may reduce due to several reasons. Those losses can be restored to a particular limit depending on general health status of the patient or using bone chips that are artificially prepared or obtained from the patient.

Question
What is the use of bone dust in implant treatment?
Answer

With the advancing technology and successful outcomes of implant treatment, sufficient bone volume is no longer a prerequisite, as many different types of devices and materials are developed and novel surgical procedures are explored to offer implant treatment to every possible patient. Insufficient volume of bone can be supplemented by synthetic bone materials or bone grafts that are obtained from other creatures or any other body region of the patient. Decrease in the amount and quality of the bones depends on many factors such as gum problems, infection or trauma.But with current techniques dentists can increase the width and height of the bone. Bone destruction zones and anatomical cavities (such as the sinus) are filled with some special techniques,So that implant's position is prepared. Clinical examination, x-ray and tomography are evaluated before operation to tell whether you will need bone grafts.

 

Question
Is it required to extract wisdom teeth?
Answer

If wisdom teeth are inflamed, cause pain or if caries is noted, if they compress the nearby teeth or cannot erupt properly, they need to be extracted. Extraction is not needed for teeth that erupt at normal position and do not cause any compression.

Question
Can an implant be placed right after teeth extraction?
Answer

There are 2 different approaches. If there is no inflammation or defect at the extraction site, an implant can be placed immediately after tooth is extracted. However, if there is any defect at the extraction site, artificial bone chips must be applied to this locus and approximately 2 months should elapse to allow wound healing at the extraction site.

Question
How long should be waited for prosthesis after placement of implants?
Answer

4 to 6 months should elapse in order to ensure that implant bonds to and integrates with the jaw bone after the implant surgery. Nutritional and aesthetic deficiencies can be eliminated with temporary dentures at this period.

Question
How should implants be cared and cleaned?
Answer

In total implant treatment, success and sustainability of outcomes depend on health of 2-mm thick gingiva that surrounds the implant. You need to brush your dentures and gingiva properly at least twice a day. You can consult to your dentist about effective brushing techniques. It is useful to use interdental brush or dental floss for flossing and removing food residues around your implant. Mouth wash can be used to ensure oral hygiene. Mouth shower can be used to ensure oral hygiene.

Question
What needs to be taken into consideration after tooth extraction?
Answer

One needs to apply pressure on cotton packs placed in the cavity after tooth extraction for 30 minutes. This pressure will stop initial bleeding at the extraction wound. It is not recommended to change the cotton frequently, since it delays blood clotting. First 30 minutes are extremely important since bone and soft tissue healing is organized over healthy blood clot at the wound site. Mild pain may be felt after effects of anesthesia wear off. A painkiller can help this complaint. No hot bath should be taken. You should avoid hot weather and sun exposure. You should not smoke or drink alcohol. Food that seems unhygienic should not be eaten. Wounds of tooth extraction heal in 1 to 2 weeks. It is recommended that more attention is paid to the oral hygiene.

Question
What is a cyst in jaw bone?
Answer

Cysts may originate from teeth at any location of intraoral cavity. It is noticed by the patient when it causes pain or swelling or it can enlarge to a giant size without being noticed. Although treatment methods vary depending on location and size of the cyst, they should be removed by Oral, Dental and Maxillofacial Surgeons.

Question
Which problems arise out of cysts of jaw bone?
Answer

Odontogenic cysts are generally slow-growing benign formations; however, they can reach large sizes and damage normal anatomical spaces, such as nasal cavity, sinus or nerves or cause bone loss or show malignant symptoms (transformation into malignant tumors can be seen), if they are not intervened timely. Formed cysts can become an infection focus. Any microorganism originating from this site can migrate to and settle in the heart, joints and kidneys through the blood circulation. Those bacterial plaques may result with very serious conditions. Therefore, it is required to remove odontogenic cysts.

Question
Is surgical management of odontogenic cysts a painful procedure?
Answer

It is a pain-free procedure if anesthesia is induced efficiently and sufficiently. Antibiotics, painkillers and antiseptic mouth washes are used afterwards. Regular follow-up examinations will ensure a comfortable healing process.

Question
Can wisdom teeth cause disorders of jaw joint (temporomandibular joint – TMJ)?
Answer

Malocclusions and eruption of wisdom teeth posterior to normal location are most important factors that result with TMJ disorders.

 

Question
How are TMJ disorders diagnosed?
Answer

Clinical examination and some adjunct tests help diagnosing disorders of temporomandibular joint. Computed tomography and magnetic resonance images are imaging modalities that are commonly used. Scintigraphy or PET scan can be required, albeit rare. Pain radiating to anterior side of the external auditory canal, temples and both sides of the head is an important symptom of TMJ disorders. Spasms and fatigue of muscles of mastication point out presence of bruxism, which is an important trauma to the temporomandibular joint. Crackles heard in temporomandibular joint -while mouth is opened and closed- and pain are important signs of joint problems.

Question
What is the typical course of an implant treatment?
Answer

Similar to tooth extractions, local anesthetic agent is administered and surgical procedure is performed. However, dental implants can be placed using open or closed methods.

Question
How long does healing of implant insertion sites take?
Answer

Healing or complete binding to the bone takes 2 to 6 months for dental implants that are inserted into bone, very similar to healing of bone fractures. Next phase is the prosthesis. They do not only provide better speech and chewing functions in comparison to conventional crowns and bridge restorations, but they also give face a natural look in terms of esthetics. Moreover, since bone loss is not observed at insertion site, these implants protect supportive tissues in the long-term.

Question
Does the commercial brand of implant make a difference?
Answer

Since replacement of an implant that had already fused with the bone results with bone loss, it is not preferred unless it is compulsory. Therefore, it is substantial for the implant and parts of prosthesis to be in the market for decades. Implants can also be classified in terms of quality, just like other products. Considering a necessity to replace prosthesis, commercial brand is important factor for continuity of implant and availability of relevant parts in the future.

Question
What is apical resection?
Answer

Infections, caused by decays or traumas, may subsequently lead to formation of cysts at root ends. In such cases, canal treatment alone is not sufficient to eliminate the infection that spreads to the bone. For teeth with dental conditions, canal treatment should be followed by drainage of cyst and debridement of infected bone tissue with a surgical intervention. This approach will prolong viability of especially anterior teeth. After treatment is completed, the patient can use that tooth for years without experiencing any problem.

Question
Do implants have a disadvantage?
Answer

Cost of dental implants is higher than conventional prostheses, since their materials are produced using high technology and all materials are imported. Dental prosthesis requires formation of a strong bond between the implant and the bone; and therefore, treatment takes longer time in comparison with other treatment options. After the implant is placed, oral care and hygiene must be given far more importance than ever.

Question
Will I be toothless until I get an implant?
Answer

Again, your dentist will make final decision on type of temporary prosthesis, according to number of your missing teeth. If you have more than one missing tooth, you can spend this time with a removable denture.

Question
What is sinus lifting?
Answer

Maxillary sinus is the name of the anatomic cavities that are located above the upper jaw near molar teeth. Their main function is to create sound and to decrease weight of the head. When sinus cavities droop inferiorly, bone loss occurs.

   These bone losses can be considered as a natural physiological process; however, if an implant treatment is planned, some problems can be faced when sufficient bone height cannot be achieved.
Sinus grafting is used to perform implant treatment for edentulate regions by filling cavities of sinus that droop downward.

If implant treatment is planned for patient, who experiences loss in volume of bone due to prolapsed sinus, sinus lift surgery is initially performed in the treatment. Sinus Lift Surgery is performed using PRF support in our center. PRF is preferred since it not only increases the success rate substantially, but it also shortens the waiting period.

    Sinus lift surgery is carried out under local or general anesthesia.  After the surgery that takes about half an hour is completed, minimal postoperative pain may occur that can be managed with pain killers.  After all procedures are completed, it takes approximately 4 to 5 months to have bone tissue grow to desired volume.

Question
How long does implant treatment take?
Answer

Implant treatment lasts one day to three months. This period depends on many factors including but not limited to type of implant and bone reserve etc.

Surgical process of implant treatment (construction of implants) lasts half an hour to four hours depending on number and bone reserve. Three months should elapse to ensure a strong bonding and union to the bone. Temporal denture may be placed on the implant within two days depending on course of the case. After union of implant to the bone is completed, superior dentures are constructed within two to three weeks.