Oral Surgery - Namibian Dental Association

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Oral Surgery

Debtal Procedures

Oral Surgery can be divided into two main categories:

  • Maxillo, Facial and Oral Surgery and

  • Periodontal Surgery

Maxillo, Facial and Oral Surgery

There are 7 main divisions of Maxillo, Facial and Oral (MFO) Surgery:

1. Dento Alveolar Surgery includes surgical procedures such as the removal of impacted wisdom teeth and apicoectomies.

The surgical removal of impacted or partially erupted wisdom (or other) teeth, and sometimes supernumery (additional) teeth, is often needed to prevent or treat cystic changes or enlarged follicles around these impacted teeth. Often, trauma of the overlying gum tissue or even resorption of adjacent teeth may be the result if impacted teeth are not removed. Head, neck and referred pain may be the result of impacted or partially erupted teeth.

Please visit the Frequently Asked Questions Page (FAQ's) for much more information on impacted wisdom teeth.

An apicoectomy is a surgical procedure used to seal the root tip of a tooth an infected tooth. This procedure is normally only done if root canal treatment cannot be performed satisfactorily on a tooth that developed an infection or abscess at the root tip.

2. Surgery for Facial Trauma. This includes the surgical treatment of mid-facial and lower jaw fractures and treatment of facial trauma.

Trauma of the face (due to accidents, gunshot wounds, sports injuries and such) may involve bone injury only, or may be a combination of soft tissue and bone injury.

3. Surgery for Pathological Conditions and Oncology refers to the surgical treatment of diseases, abnormal growths and tumors of the face, oral cavity and jaws.

4. Treatment of Temporo-mandibular Joint (TMJ) and Facial Pains. This includes procedures such as meniscus operations and joint replacements.

Abnormalities or disease of the joint between the lower jaw and the skull (the TMJ) often lead to head, neck or referred pain and sometimes needs surgical treatment to correct the functioning of this joint.

5. Orthognathic and Cranio Facial Surgery includes the shortening or enlargement and repositioning of jaws to create and maintain a normal relationship between the upper and lower jaws.

An orthognathic deformity is any deformity, which negatively influences the masticatory (chewing) and facial functions. It includes: upper or lower jaws that are too large and prominent, upper and lower jaws that are to short, jaws that are malpositioned to one side, displaced chins and lip incompetence (the lips cannot be closed).

The surgical reconstruction of the mentioned conditions can involve only one jaw, or sometimes both jaws. Sometimes, especially when the upper jaw is moved, additional bone is needed to fill and close defects. This may necessitate surgery on the patient's hip in order
to harvest additional bone.

6. Pre-Prosthodontic Surgery refers to surgery done before the manufacturing and fitting of dental prosthesis (dentures, crowns and bridges).

Pre-Prosthodontic Surgery includes the placing of dental implants to support crowns and bridges or dentures for artificial dentures and the building up or shaping of the jaw bone to enable the placement of a dental prosthesis. These procedures often involve bone transplantation and grafting of gum tissue from one position to another in the oral cavity.

7. Reconstruction of Facial Cleft Deformities. The surgery performed to close and correct cleft deformities of the face.

Cleft deformities of the face can include: cleft lip, cleft lip and
alveolus (jaw bone), cleft hard palate, cleft soft palate or any combination of the conditions. These clefts can occur on one side of the face only or sometimes bilaterally. Nose deformities often result from cleft lips and palates.

Resolving speech problems and difficulty in eating and swallowing are the main reasons why cleft deformities need to be surgically corrected.

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Periodontal Surgery

Periodontal Surgery involves the gum and the bone surrounding the teeth. The main reasons why Periodontal Surgery is performed is:

• To stop infection and gum disease.
• To improve the health of soft tissues (gums) surrounding the teeth.
• To modify and improve areas of visible gum tissue that looks displeasing.

Periodontal Surgery includes:

Open Flap Surgery
Advanced periodontal (gum) infections lead to bone loss around one or more teeth. This causes deep pockets adjacent to teeth that cannot be cleaned effectively. Cleaning these areas to initiate healing, requires the gum to be surgically lifted, the surface of the teeth and their roots, as well as the surrounding bone to be cleaned and treated with special antibiotic solutions.

Guided Bone Regeneration (GBR)
Bony defects (pockets) adjacent to the roots of one or more teeth can result from longstanding and advanced gum disease. These defects can sometimes be surgically repaired and filled with artificial bone.

The affected area is anaesthetized, the gum is opened and the roots, bone and surrounding tissues are cleaned meticulously. The root/s of the tooth is etched with a mild acid to remove all bacterial toxins and artificial bone is packed against the root/s and around the tooth. This is covered with a special teflon membrane to keep gum tissue out of the way and to allow the bone to re-grow and mature without interference from the soft gum tissues. The bone is thus guided to regenerate.

GBR can be successful in cases where patients are dedicated to excellent home care and committed to regular follow-up and professional cleanings of the treated areas.

Aesthetic Gingival Surgery
Where gums are asymmetrical, enlarged, discoulored or are receding, various surgical techniques can be performed to improve the aesthetic appearance of gum tissues.

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