Brijesh J. Patel, D.D.S., M.D

Diplomate, American Board of Oral & Maxillofacial Surgery

Phone: 805.532.1331

Fax: 805.532.1371

Email: info@moorparkoms.com

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Procedures

Procedures

Introduction

Oral & Maxillofacial Surgery Procedures

Whether your oral or facial surgery was planned or unexpected, we want your experience with the Moorpark OMS to be a good one. We make every effort provide you with information you may and let you know what you can expect with any procedure you have with us. You questions are encouraged, and we promise to answer any all of them as we take your pre and post-operative comfort seriously.

Wisdom Teeth

By the age of eighteen, the average adult has 32 teeth; 16 teeth on the top and 16 teeth on the bottom. Each tooth in the mouth has a specific name and function. The teeth in the front of the mouth (incisors, canine and bicuspid teeth) are ideal for grasping and biting food into smaller pieces. The back teeth or molar teeth are used to grind food up into a consistency suitable for swallowing.
The average mouth is made to hold only 28 teeth. It can be painful when 32 teeth try to fit in a mouth that holds only 28 teeth. These four other teeth are your Third Molars, also known as “wisdom teeth.”
Removal of wisdom teeth and non-restorable teeth:

Taking great pride in how we treat our patients who require wisdom teeth extractions, Moorpark Oral & Maxillofacial Surgery, P.C agrees with AAOMS (the American “association” of Oral & Maxillofacial Surgeons) that the best time for the removal of impacted or un-erupted wisdom teeth is between the ages of fifteen and twenty-five; however, timely wisdom teeth removal is integral part of preventative dentistry at any age. Waiting for impacted and un-erupted teeth to cause pain or complex clinical complications can result in more extensive or costly treatment later. Our patients report outstanding recovery rates follow wisdom teeth removal.

Facial Trauma

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 and 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.

  • Facial lacerations
  • Intra oral lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose, or eye socket)
  • Fractured jaws (upper and lower jaw)

The Nature of Maxillofacial Trauma

There are a number of possible causes of facial trauma. Motor vehicle accidents, accidental 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 either soft tissue injuries (skin and gums), bony injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Soft Tissue Injuries of the Maxillofacial Region

When soft tissue injuries such as lacerations occur on the face, they are repaired by “suturing”. In addition to the obvious concern of providing a repair which yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands and salivary ducts (or outflow channels). Dr. Patel is a thoroughly trained oral and maxillofacial surgeon who is proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors which include the location of the fracture, the severity of the fracture, and the age and general health of the patient. When an arm or a leg is fractured, a “cast” is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small “plates and screws” at the involved site. This technique of treatment can often allow for healing and obviates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of “rigid fixation” has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary are designed to be small and, whenever possible, are placed so that the resultant scar is “hidden”.
Injuries to the face, by the very nature, impart a high degree of emotional and 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.

  • Facial lacerations
  • Intra oral lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose, or eye socket)
  • Fractured jaws (upper and lower jaw)

Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth which look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that these teeth appear natural. Since there will be no distortion or facial contours, they can smile with confidence.
More and more patients are choosing dental implants for missing teeth over other dental procedures. Now considered the best standard of care, dental implants offer a more permanent and natural appearance.

What are Dental Implants?

The implants themselves are tiny titanium posts which are inserted into the jawbone where teeth are missing. These metal anchors act as tooth root substitutes. They are surgically placed into the jawbone. The bone bonds with the titanium, creating a strong foundation for artificial teeth. Small posts are then attached to the implant which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

Implants also help preserve facial structure, preventing the bone deterioration that occurs where ever teeth are missing.

Bone Grafting

Major and minor bone grafting

Over a period of time, the jawbone atrophies or is absorbed. This often leaves a condition in which there is insufficient bone for placement of dental implants. In these situations, most patients would not be candidates for placement of dental implants. However, we now have the ability to enhance bone in these areas. This enables us to place implants of the proper length and width and to better restore function and esthetic appearance.

The Procedures

The bone grafting procedures are referred to as either a sinus lift procedure, a ridge augmentation procedure, or a nerve repositioning procedure.

Sinus lift procedure: This procedure involves elevating the maxillary sinus membrane and placing a bone graft onto the sinus floor, adding depth to the bone in the back part of the upper jaw.
Ridge augmentation: A bone graft is placed to increase the ridge height and/or width in areas where it has been severely resorbed.
Nerve repositioning: The inferior alveolar nerve, which gives feeling to the lower lip and chin, may interfere with the ideal placement of dental implants in the lower jaw. In this case, the nerve is moved away from the intended implant site.

These procedures may be performed separately or together, depending upon each individual’s condition. There are several areas of the body which are suitable for attaining bone grafts. Sometimes bone grafts can be taken from inside the mouth. When a greater quantity of bone is required, it can be taken from the hip or the outer aspect of the lower leg.

These procedures can be performed in the out-patient surgical suite under IV sedation or general anesthesia. After discharge, bed rest is recommended for one day and physical activity is limited for one week.

Oral Pathology

Tumors or cysts sometimes develop in the bone or the soft tissue of the mouth. While often these tumors or cysts are harmless, others may threaten the health and function of the surrounding tissue and need to be surgically removed.

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. We would recommend performing an oral cancer self-examination monthly. Remember that your mouth is one of your body’s most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

Jaw Surgery

Orthognathic surgery is needed when jaws don’t meet correctly and/or teeth don’t seem to fit with jaws. Teeth are straightened with orthodontics and corrective jaw surgery repositions misaligned jaws. This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery?

People who can benefit from orthognathic surgery include those who have an improper bite because of 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. When this happens it affects chewing, speech, overall oral health, and appearance. Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved. Orthognathic surgery is required when the jaws need to be repositioned.

Difficulty in the following areas should be evaluated:

  • difficulty in chewing, biting or swallowing
  • speech problems
  • chronic jaw or TMJ pain
  • open bite
  • protruding jaw
  • breathing problems

Any of these can be present at birth or may develop after birth because of hereditary or environmental influences, or trauma to the face. Before any treatment begins, a consultation will be held to perform a complete examination with x-rays. During the pre-treatment consultation process, feel free to ask questions about any aspects of your proposed treatment. When you are fully informed about the details of your proposed treatment, you will make the final decision whether to proceed with treatment.

If you are a candidate for Corrective Jaw Surgery, the Moorpark OMSwill work closely with your dentist and orthodontist during your treatment. The actual surgery can move your teeth and jaws into a new position that results in a more attractive, functional and healthy dentol-facial relationship.

TMJ Disorders

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. Since some types of TMJ problems can lead to more serious conditions, early detection and treatment are important.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. The Maxillofacial Surgery Center can help you have a healthier and more comfortable jaw.

Trouble with Your Jaw?

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. Whatever the cause, the results may include a misaligned bite, pain, “clicking” or “grating” noise when you open your mouth, or inability to open your mouth widely.
No one treatment can resolve TMJ disorders completely and treatment takes time to become effective. The Moorpark OMS can help you have a healthier more comfortable jaw.

Trouble with Your Jaw?

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. Whatever the cause, the results may include a misaligned bite, pain, “clicking” or “grating” noise when you open your mouth, or inability to open your mouth widely.

Do You Have a TMJ Disorder?

  • Are you aware of grinding or clenching your teeth?
  • Do you wake up with sore, stiff muscles around your jaws?
  • Do you have frequent headaches or neck aches?
  • Does the pain get worse when you clench your teeth?
  • Does stress make your clenching and pain worse?
  • Does your jaw click, pop, grate, catch, or lock when you open your mouth?
  • Is it difficult or painful to open your mouth, eat or yawn?
  • Have you ever injured your neck, head or jaws?
  • Have you had problems (such as arthritis) with other joints?
  • Do you have teeth that no longer touch when you bite?
  • Do your teeth meet differently from time to time?
  • Is it hard to use your front teeth to bite or tear food?
  • Are your teeth sensitive, loose, broken or worn?

The more times you answered “yes,” the more likely it is that you have a TMJ disorder. Understanding TMJ disorders will also help you understand how they are treated.

Treatment

There are various treatment options that the Dr. Patel can utilize to improve the harmony and function of your jaw. Once an evaluation confirms a diagnosis of TMJ disorder, the Dr. Patel will determine the proper course of treatment. It is important to note that treatment always works best with a team approach of self-care joined with professional care.

Sleep Apnea

When obstructive sleep apnea occurs, the tongue is sucked against the back of the throat. This blocks the upper airway and air flow stops. When the oxygen level in the brain becomes low enough the sleeper partially awakens, the obstruction in the throat clears and the flow of air starts again, usually with a loud gasp.

People with obstructive sleep apnea (OSA) have disrupted sleep and low blood oxygen levels. OSA has been associated with cardiovascular problems and excessive daytime sleepiness.

The condition known as upper airway resistance syndrome (UARS) lies midway between benign snoring and true obstructive sleep apnea. People with UARS suffer many of the symptoms of OSA but normal sleep testing will be negative.

Moorpark Oral & Maxillofacial Surgery P.C.
145 Park Lane Ste#110 Moorpark, CA 93021

805.532.1331