Oral and Maxillofacial Surgery

Oral and maxillofacial surgery is the field of dentistry that deals with the treatment of diseases, injuries, functional and aesthetic deformities of the soft and hard tissues of the mouth, jaw and face. Tooth extraction, surgical management of impacted wisdom teeth, implant treatment, resection of root apex, surgical correction of maxillofacial dislocations and fractures as well as surgical operations such cyst and tumor operations are carried out at the Oral and Maxillofacial Surgery branch.

The third molar tooth placed in the lower and upper jaws, one on each side of the jaws and totally 4 units, is called as wisdom tooth.

When Do Wisdom Teeth Erupt?

Depending on the suitability of jaw bone, they erupt from the age of 15. In some cases, they may erupt at later ages.

Why Do Lower Wisdom Teeth Erupt More Difficultly?

Lack of adequate space behind the 2nd molar

Tooth development can not catch up the speed of the development of lower jaw.

Why Should Wisdom Teeth Be Extracted?

Wisdom teeth may cause inflammation of the gums. Affected teeth may cause infection of or damage to the surrounding teeth.  They cause decay of neighbouring teeth and gum problems. Wisdom teeth can affect the positioning of other teeth, leading to crowding in the anterior teeth.

What may happen after extraction of wisdom teeth?




There may be difficulties in opening mouth.

Such complaints stop within a week.

Which Instructions Should Be Followed After Extraction of the Wisdom Teeth?

The tampon placed on the wound after tooth extraction  must be kept for 20 minutes.

Rinsing and spitting should be avoided after extraction.

Hot beverages and foods, acidic beverages and spicy foods should be avoided.

Avoid eating during drowsiness  and drinking any beverage for 2 hours

The extraction site should be protected until healing has taken place.

It should be fed with high-liquid-content foods.

Since smoking will delay healing of the wound, it should be stopped or minimized.

Should Impacted Wisdom Teeth Be Definitely Extracted?

There is no need to extract teeth that do not cause any distress and that do not harm neighboring teeth and surrounding tissues in radiological examination.

The impacted wisdow teeth should be checked periodically.

Canker sores are small lesions generally developing in the mouth. They are painful ulcer lesions that frequently develop on tongue, lips, cheek mucosa and gums and that are surrounded with yellow-red border. They may be single or multiple. They are more common in women than men. It is very painful and not epidemic.

What Are The Causes of Canker Sores?

The actual cause of canker sore is unknown, but some factors of daily life cause formation of the canker sore. These factors can be listed as follows:

High stress

Trauma, chronic lip and cheek biting can accelerate the formation of the canker sore.

Vinegar, pickles, extremely spicy and salty foods can increase the formation of canker sore.

Behçet’s syndrome

Excessive smoking

Nutrition disorders

Vitamin B12 deficiency

How to Treat Canker Sores?

There is no treatment for canker sores, only treatments that help relieve the discomfort.

Canker sores generally heal on its own in 7-10 days  even if nothing is done.

Hot and spicy foods should be avoided.

Pain relief sprays can be used before meals.

Anesthetic creams can be used.

B complex vitamin supplements can be used.

They can be treated with laser applications.

Oral cancer usually manifests as a growth in your mouth area, whether it be on your gums, lips, other parts of the inside of your mouth, including the posterior portion and throat. It can be life threatening if not diagnosed and treated early. Oral cancers are not very painful and progress very quickly. Regular dental check-up is the most effective method for prevention of oral cancers.

What are the causes of oral cancers?

According to the American Oral Cancer Foundation, oral cancer is more common in men than in women and it is more common over the age of 40.

Those smoking cigarettes, cigars or pipes have a higher risk of developing oral cancer than non-smokers.

Harmful habits such as chewing tobacco

Excessive alcohol consumption

Carcinogenic substances

Excessive sun exposure especially at young ages

Chronic traumas (continuous lip and cheek biting)

Genetic predisposition

Poor oral care

What are the signs of oral cancer?

Sores in the mouth that don’t heal and bleed easily

Red or white patches on the gums and tongue

Hoarseness in voice

Difficulty swallowing

Trouble moving your jaw or tongue

Loss of feeling and numbness in various parts of the mouth

Unexplained swellings and sores

Spontaneous bleeding

Chronic sore throat or voice change

Ear pain

Weight loss

What is Alveolar Osteitis?

It is a complication characterized by a pain that occurs within 2-3 days after tooth extraction. The reason is that the tooth socket remains empty due to insufficient blood supply in the extraction site.

It is more common after wisdom teeth extraction.

One of the most important reasons is smoking after extraction.

Cleaning the blood clot in the tooth socket by the patient causes the bone to come out in that area. This causes delay of healing and pain of the sore.

Treaatment of Alveolar Osteitis

The site where the tooth is extracted is cleaned by the dentist and the tooth socket is packed with a paste having pain relieving effect.

How to prevent alveolar osteitis?

Do not scrape extraction socked with toothpick or similar

Do not rinse your mouth with water after extraction

If you smoke, avoid smoking for a while

Apical resection is the surgical removal of the cyst that develops due to decay or trauma at the root of the tooth together with the affected root area.

In Which Cases Is Apical Resection Performed?

In the existence of a cyst that is formed at the tooth root and does not heal by root canal treatment

In cases where root canal treatment can not be performed depending on the structure of the root

In teeth where cleaning of root canal and filling procedure cannot be performed successfully

They are pathological formations that form especially in wisdom teeth and at the roots of decayed teeth that have not been treated for a long time. They can form in soft tissue or bone. Tumors may develop if the cysts formed in the bone are not treated for a long time and spread to very large areas. Although cysts can form anywhere on the body, they are most common in the jaws.

Treatment of Jaw Cysts

Jaw cysts are treated surgically. If they are not treated, they can cause serious problems such as swelling in the face, inflammation, deformation of the jawbone, formation of benign or malignant tumour.

After the surgery, it should not be spit out and the mouth should not be rinsed with water. Spitting and rinsing the mouth with water will dislodge the clot that will form in the wound and will cause bleeding to restart and delay of healing of the sore. Nothing should be eaten or drunk for 2 hours after the surgery. Beverages should be warm.

During the first 24 hours after the surgery, ice pack should be applied in regular intervals to the face in affected area.

Stop smoking for a while

Surgical site should be kept clean.

Heart patients should definitely inform the dentist about the drugs they use and the type of disease before the extraction. Patients using anticoagulants (blood thinners) should stop using the medicine for a while under the guidance of a specialist doctor.

Patients with blood disease should definitely take consultation and inform the dentist about the disease.

Patients taking nervous system drugs should report the drugs they use because these drugs may reduce the effect of the anesthetic agent.

The values ​​of diabetics should be under control.

In pregnancy, the first and last three months are safe, however, consultation with a gynecologist is necessary.

The patient with allergies should inform the dentist what they are allergic to him or her.

It should be tested whether the anesthetic agents to be used are allergens for the patient.

Blood pressure patients must have taken their medicines and must inform the dentist about the medicines they are using. If the blood pressure values ​​are normal, tooth can be extracted.

Which Instructions Should Be Followed After Tooth Extraction?

The tampon placed on the wound after tooth extraction must be kept for 20 minutes.

Rinsing and spitting should be avoided after extraction.

Hot beverages and foods, acidic beverages and spicy foods should be avoided.

Avoid eating during drowsiness and drinking any beverage for 2 hours.

The extraction site should be protected until healing has taken place.

It should be fed with high-liquid-content foods.

Since smoking will delay healing of the wound, it should be stopped or minimized.

What is bone grafting?

Bone graft (bone powder) is a material in the form of particles obtained from various sources. These particles can be of human origin (autogenous), animal origin or synthetic origin. Autogenous grafts have the highest success rate. During the surgery, since autogenous grafts are obtained from the jawbone or different parts of the body of the same individual receiving the graft, a much faster recovery is achieved.

Why is bone graft used?

Bone grafting is a method used when implant treatment cannot be performed due to bone deficiency. Bone grafting is performed when bone loss occurs due to the presence of infection in the extracted tooth and there is not sufficient quantity and density of bone for any reason. Bone grafts are used in sinus lift procedures, losses due to cyst formations and to create a good bone level during the placement of the implant. The cells in the bone grafts trigger bone formation and density. This is called bone augmentation.

What is sinus lift technique?

The sinus cavity is an anatomical structure that is adjacent to the area where molars are located in the upper jaw. These sinus cavities filled with air sometimes prolapse downward. Therefore, the amount of bone in the upper jaw decreases. When patients do not want to use removable prostheses or when dentals implants are to be placed due to tooth loss, the bone deficiency in the upper jaw near sinuses prevents dental implant procedures. In sinus lift procedure, the sinus floor is slightly raised with surgical applications. The necessary space for the placement of dental implants is provided using this procedure.

There are two main techniques for performing sinus lifts: the lateral window technique (LWT) and the osteotome (vertical) technique.

The lateral window technique (LWT):

This technique is performed when the patient has a bone height less than 4 millimetres. Gum tissue is cut into to expose the jawbone under local anaesthesia. Thereafter, a small window is created in the lateral upper jawbone to expose the membrane lining the sinus cavity. The membrane lining the sinus floor is carefully raised through this window. A bone graft is then placed into the now-empty space left behind by the gently raised membrane, and the area is stitched shut. It takes up to 6 months for the bone graft to mesh with the bone already there.

The osteotome (vertical) technique

The osteotome (vertical) technique is performed when the patient has a bone height more than 4-5 millimetres. The sinus floor is carefully raised by an instrument called osteotom. The space required for the place of dental implants is obtained. In this technique, generally, dental implants are placed during the same session.

What are the post operative instructions after sinus lift procedure?

Tampon placed by the surgeon should be kept in the mouth for 20 min.
Very hot and hard foods should be avoided, soft, warm and high-liquid-content foods should be preferred more.
Smoking should be avoided.
Oral hygiene should be maintained well.
Reactions like sneezing which creates pressure should be avoided. Mouth should be kept open while sneezing. Closing mouth which causes pressure should be avoided.
All medications should be taken as prescribed.

In addition to the visible part of the tooth in the mouth, the part of tooth inside the bone is also important in diagnosis and treatment and x-rays allow to see these areas. It is important in the treatment of an existing disease, as well as in the early diagnosis of a disease that does not cause discomfort.

Are X-Rays Harmful?
With the replacement of digital x-ray devices with film x-ray devices, the level of radiation used has decreased significantly. Especially with the help of digital panoramic devices, all teeth can be evaluated at once by using extremely low-level radiation.

What is Dental Abscess?

It is the form of abscess that occurs at the root of the teeth or in the gingiva around the tooth root due to decays or trauma. The infection spreads from the tooth to the bone and reaches the gums.

The tooth causing the abscess may have a pain that starts spontaneously or increases during chewing.

Before its formation, an abscess initiates mild swelling, pain and sensitivity in that site. The most important factor in the formation of abscess is the patient’s delay in treatment. Swelling may be seen on the face, neck and lymph nodes. In the treatment of abscess, the abscess should be drained first. After draining, root canal treatment or tooth extraction can be performed. It may be necessary to use antibiotics to prevent systemic disorders. However, medicine should not be taken without consulting a doctor.

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