Oral and Maxillofacial Surgery

Oral and Maxillofacial Surgery 2003 Division of Oral and Maxillofacial Surgery; Department of Dentistry, General Veterans Hospital-Taipei

台北榮民總醫院口腔顎面外科 服務項目特殊診療項目智齒拔除手術植牙手術贗復前手術正顎手術良惡性腫瘤手術重建手術顳顎關節手術口腔癌篩檢人工植牙諮詢門診時間每週一～週五上午第三診門診手術住院手術房門診諮詢 1959年～2003年

台北榮民總醫院口腔顎面外科近三年(2000-2002)發表論文台北榮民總醫院口腔顎面外科近三年(2000-2002)發表論文年代篇數雜誌分類 89年(2000) 90年(2001) 91年(2002) 共計 SCI 1 2 11 14 非SCI 10 12 6 28 共計 11 14 17 42

Our services • Removal of wisdom teeth • Pre-prosthetic surgery • Dental implants • Maxillofacial injury • Surgical correction of jaw deformities • Diagnosis, oral & maxillofacial pathology and medicine • Benign and malignant tumor management • TMJ therapy

Impacted Wisdom Teeth • Wisdom teeth often partially erupt or fail to erupt at all. They then may becomeimpacted against other molarsand cause overcrowding, or become moresusceptible to decay or gum infection.

Pre-prosthetic surgery • Before prostheticcrowns, bridges or denturescan be constructed, thesoft tissuesof the mouth and the jaw bones may require shaping. We will work with your dentist to provide both cosmetic and functional results. • Soft tissue pre-prosthetic surgery: vestibuloplasty ( lipswitch); freumectomy • Hard tissue pre-prosthetic surgery: alveoloplasty

Vestibuloplasty ( lipswitch )

Alveoloplasty

Dental implants Dental implants are tooth root substitutes which are surgically placed in the jaw bone and act as anchors to stabilize artificial teeth.

Who needs implants? You are a candidate for dental implants if: • You have enoughjaw bone, and dense enough bone, to secure the implants. • Youdo nothave a disease or condition thatinterferes with proper healing after implant surgery (e.g. uncontrolled diabetes, or radiation/ chemotherapy for treating cancer)

Types of maxillofacial injury  Dentoalveolar trauma Mandible fractures LeFort I, II, and III fractures I II III Zygoma fractures  Nasal-orbital-ethmoid fractures Orbital floor fracture

The following is an outline for the initial evaluation of patients with maxillofacial trauma. • Airway management • Hemorrhage control • Clinical evaluation

Surgical correction of jaw deformities • Ifdeformities of the teeth and jawsare too extreme for orthodontic treatment, orthognatic jaw surgery is the most effective procedure for facial correction. We will work closely with orthodontist to achieve ideal results.

Difficulty chewing or biting food Difficulty swallowing Speech problem Chronic jaw pain Excessive wearing of teeth Open bite (space between upper and lower) Front or back teeth when mouth is closed Unbalanced facial appearance Facial injury or birth defects Receding chin Protruding jaw Inability to make lips meet without effort Chronic mouth breathing with dry mouth Sleep apnea Who needs orthognathic surgery? The following are some of the conditions that may indicate a need for orthognathic surgery:

Diagnosis, oral facial pathology and medicine • For a variety of reasons,tumors and cystsmay form in either the jaw bones or the soft tissues of the mouth. While some may be benign, others may threaten the health and function of the surrounding tissue.

Examination of lip and mouth cancer The things to look for when performing an oral cancer self-examination are: • Reddish patches - erythroplasia • Whitish patches - leukoplakia • A sore that fails to heal and bleeds easily • A lump or thickening of the tissues • Chronic sore throat or hoarseness • Difficulty in chewing or swallowing

Management of benign or malignant tumor • Biopsy • Surgical treatment • Radiotherapy • Chemotherapy

Benign tumor • These lesions may be unsightly or may be traumatised repeatedly, for example during shaving. • Odontogenic cysts & non-odontogenic tumor • Soft tissue tumor and hard tissue tumor

Malignant tumor • The majority of these lesions spread slowly over years but some may spread more rapidly to involve lymph glands in the local area or more distant areas. All will cause great damage if neglected.

What is the TMJ? The temporomandibular joint (TMJ) is the small joint located in front of the ear where the skull and lower jaw meet. It’s is a “ball and socket” joint with a disc made of cartilage that serves as a cushion between the parts of the joint.

TMJ therapy • Temporomandibular joint dysfunction (TMJ)is a condition that afflicts the jaw joints of thousands of patients. Frequent indicators of TMJ include: • Popping and clicking of the jaw • Limited jaw function • Pain in the neck, shoulder and upper back • Pain in the face and ears

Thanks for your attention

Oral and Maxillofacial Surgery