Jaw Surgery
Oral and maxillofacial surgery assessment: the cause of the complaint is investigated first, surgical and non-surgical options are discussed together, and the procedure and follow-up plan are set individually.
What Is Oral and Maxillofacial Surgery?
Oral and maxillofacial surgery is the specialty concerned with assessing and surgically treating conditions of the teeth, the jawbones and the surrounding tissues. Impacted teeth, implant surgery, bone augmentation and lesions of the jaw are among the things it covers.
Coming for an assessment does not mean you need an operation. The source of the complaint, whether the existing teeth can be kept, and the non-surgical options are considered first. In the consultation with Uzm. Dt. Aykut Gürel, the purpose of any procedure, its alternatives and the follow-up it needs are explained.
What Is Assessed
Impacted Teeth
Impacted tooth treatment is considered where there is recurrent infection, decay, or damage to a neighbouring tooth. Some teeth that are causing no problem can be kept under review. For lower wisdom teeth close to the nerve, coronectomy may be discussed alongside complete removal in suitable cases.
Missing Teeth and Implant Planning
A dental implant is one of the options for replacing missing teeth. Bone, gums, general health and the prosthesis to be made are assessed together. An implant, or fixed teeth on the day of surgery, is not appropriate for every patient. Bridges and removable prostheses are part of the same planning conversation.
Insufficient Bone and the Sinus Region
Where bone support for an implant is inadequate, grafting procedures, sinus lifting in the upper back jaw, or different implant and prosthetic plans may come up. The benefit, risk and effect on treatment time of any additional surgery are compared. Not every bone deficiency requires a graft.
Jaw Cysts and Other Lesions
Not every change seen on a radiograph is a cyst. Diagnosis needs examination, appropriate imaging and, in some cases, biopsy and pathological examination. The treatment and review plan depend on the type and size of the lesion and how close it lies to neighbouring structures. Not every lesion has to be removed in one session, and the cavity does not always have to be filled with graft.
Problems at the Root Tip
Where a root-treated tooth continues to give trouble, the cause is investigated. Whether the tooth can be kept, and whether the root canal treatment should be redone, are assessed; in suitable situations apical surgery may be an option. Where indicated, the plan is made together with an endodontist.
What the First Appointment Covers
When the complaint began, previous treatment, your medication and your medical history are all reviewed. Existing radiographs and a medication list make the consultation easier. Whether imaging is needed follows from the examination; a CBCT scan is not required at every visit.
Tell us about all your treatment, including blood thinners and drugs affecting bone metabolism. Do not stop your medication on your own. Where necessary, planning is done together with the doctors who look after you.
Where the Procedure Happens, and the Anaesthetic
Many oral surgical procedures can be done under local anaesthesia. More extensive surgery, or a different anaesthetic requirement, needs planning with an appropriate facility and the relevant teams. What can be done where is settled at the examination. This page does not mean that every hospital operation within the specialty is offered at either clinic.
Digital case planning or a surgical guide can help in suitable situations. Technology does not replace the surgical decision, or the assessment made during the procedure itself.
Risks and Recovery
Bleeding, infection, swelling and pain are among the possible consequences of surgery. Depending on the site, altered nerve sensation, damage to a neighbouring tooth, a communication with the sinus, or the need for further treatment are discussed. The risks are not the same for every procedure.
Recovery time varies with the surgery performed, general health and the findings at review. Swelling settling, soft tissue closing and bone healing happen on different timescales. You are given individual instructions for returning to work, eating, oral hygiene and review appointments.
What the Published Evidence Reports
Figures from studied groups, with the limits their authors state — not predictions for one person.
What follows is not a promise about your case; it is why the assessment looks at anatomy and medical history rather than quoting an average.
- Bui and colleagues (2003) reviewed 583 patients having third molars removed and found an overall complication rate of 4.6%. Increasing age, a positive medical history, and the position of the tooth relative to the inferior alveolar nerve were associated with higher risk.
- Susarla and Dodson (2004) timed 250 third molar extractions in 82 patients: mean operating time 6.9 minutes, with a standard deviation of 7.6 — the spread being the point. Difficulty was governed mainly by anatomical and operative factors, with little influence from demographic ones.
When to Seek Urgent Help
Bleeding that does not stop, increasing pain, fever or worsening swelling need dental assessment without delay. If you have difficulty breathing or swallowing, or rapidly spreading swelling of the face or neck, do not wait for a WhatsApp reply — call the emergency services or go to an emergency department.
Appointments and What the Fee Covers
Write to us about an assessment and the treatment options. Contact is directly with Uzm. Dt. Aykut Gürel's personal line. International patients are seen at Dentopol Ümraniye on Mondays, Wednesdays and Saturdays, 09:00-18:00 Istanbul time.
The fee depends on the procedure, imaging, any pathology and the need for additional surgery. Clarify in the consultation which items are included in the plan.
Frequently Asked Questions
Are these procedures painful?
Pain during the procedure is controlled with anaesthesia. Afterwards there can be pain and swelling, to a degree that depends on what was done. Complaints that are worse than expected, or increasing, need to be checked.
How long will I be off work?
It depends on the extent of the surgery and on your job. This is set individually at the examination rather than quoted as a fixed number of days in advance.
Is there an age limit?
There is no fixed age limit. Suitability depends on general health, and for older patients or those with systemic conditions a more detailed assessment is made and the plan adjusted.
Is general anaesthesia necessary?
Most procedures can be carried out under local anaesthesia. For more extensive cases, sedation or general anaesthesia may be planned with an appropriate facility. The method is decided together, based on your condition and the scope of the procedure.
Are jaw cysts dangerous?
Behaviour varies by type, which is why diagnosis comes before any statement about risk. Some lesions grow slowly and without symptoms and are found incidentally; the type, size and position determine both the treatment and how long follow-up continues.
Scientific References
- Marciani RD. Third molar removal: an overview of indications, imaging, evaluation, and assessment of risk. *Oral and Maxillofacial Surgery Clinics of North America*. 2007;19(1):1-13. PMID 18088860. DOI
- Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. *Journal of Oral and Maxillofacial Surgery*. 2003;61(12):1379-1389. PMID 14663801. DOI
- Susarla SM, Dodson TB. Risk factors for third molar extraction difficulty. *Journal of Oral and Maxillofacial Surgery*. 2004;62(11):1363-1371. PMID 15510357. DOI
- American Association of Oral and Maxillofacial Surgeons (AAOMS). Parameters of Care: Clinical Practice Guidelines for Oral and Maxillofacial Surgery (AAOMS ParCare 2017).