Oral and Dental Surgery

At MFACE, we conduct the whole range of oral and dental surgery procedures including implantology, periodontal surgery and general dental surgery. This includes wisdom tooth removal, apicoectomies, treatment of bone necrosis, tooth transplants, removal of jaw cysts and tumors of the oral cavity, gingival surgery, osteodistraction, and the treatment of chronic pain in the facial area.

Implantology

When it comes to tooth replacement, implants are the superior alternative to conventional dentures like bridges or prostheses. Implants are artificial dental roots that are surgically inserted into the jaw bone at the position of the missing tooth to carry either removable or permanent dentures. The biggest advantages are that implants feel like real teeth without the sensation of having a foreign body in your mouth and also provide excellent aesthetical results. Especially eating and speech is not impaired by loose dentures, so that you can enjoy your new smile and function in any moment of Your everyday life with a heightened self-esteem. Dental implants also benefit your general oral health since they do not have to be anchored to other teeth, like bridges.

 

Implants need a good bone quality and amount for the proper hold and stability. If there is a lack of these qualities, we offer different surgical solutions to enhance and augment the bone before implantation.

 

Jaw bone augmentation
Many of our patients decide to have dental implants but lack sufficient bony tissue for a successful implantation. The most common cause is fuctional atrophy after tooth loss; fortunately, this can be treated with a variety of surgical options. These procedures can also be combined to reverse bone loss and facilitate sufficient implant anchoring. We recommend to conduct this kind of surgery under general anesthesia to ensure minimal pain and maximum patient safety. Because we use minimally invasive and gentle techniques, we can offer these procedures on an outpatient basis.

 

Bone transplantation
Bone transplantation is used for the reconstruction after bone loss due to trauma or functional atrophy. For the patient’s own tissue is used to enhance the bony structure of the jaw, transplantation offers the best results for this indication with a success rate of 95-98%. In our clinic we use the chin, the jaw angle and the iliac bone (hip) as donor sites.

 

Sinus lift / elevation
If bone substance is missing in the upper jaw, a sinus lift or sinus elevation is the procedure of choice. It increases the height of your upper jaw by filling part of Your maxillary sinus with bone. The maxillary sinus is the area above your upper jaw on either side of your nose above the back teeth. This is done when the back part of the upper jaw does not have enough bone to allow implants to be placed.

 

Implantation
Implantation of the artificial tooth root is the actual surgical procedure that ensures the later placement of the dentures. During this surgery, a cut is made on your gum to expose the bone. Holes are drilled where the dental implant metal post will be placed deep into the bone. Since the post will serve as the tooth root, it’s implanted deep into the bone. At this point, there is still a gap where your tooth is missing. Usually, a type of partial, temporary denture can be placed for better appearance. In the healing process the implant is „osseointegrated“, meaning that the jawbone grows into and unites with the surface of the dental implant. This process can take up to six months and provides a solid base for your new artificial tooth. When osseointegration is complete, you may need additional surgery to place the abutment, which is the piece where the crown or bridge will eventually attach to the implant. This minor surgery is typically done with local anesthesia in an outpatient setting.

Dental Surgery

We offer a wide spectrum of oral and dental surgery, such as wisdom tooth extraction, extraction of fractured or displaced teeth, periodontal surgery and dental root apicoectomies. We also treat other oral health impairing conditions like cysts, caries and parodontitis.

 

Wisdom tooth extraction
The extraction of wisdom teeth is recommended when their position is slanted within the jaw bone and the resulting pressure on the dental arch leads to pain and/or tooth movement. If the wisdom tooth is completely grown out and the roots are straight, it can be extracted like any other thooth, mostly under local anaesthesia. In cases of partial or total bone coverage of the dental crown, tooth malrotation or root anomalies, surgical removal is coduncted under sedation or general anesthesia. A three-dimensional DVT/CBCT image is made to assess the anatomical relationship between root and nerve and therefore minimize the probability of nerve injury.

We state the indication for wisdom tooth removal according to the newest S2k-guidelines of the German Society for Tooth-, Mouth- and Jaw Health Care (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde).

 

Apicoectomy
In some cases of impaired tooth health, for example due to caries or parodontitis, more complex measures of dental surgery treatment may be neccessary. An apicoectomiy is indicated as a last resort treatment if an infection on the tip of the root cannot be controlled by root canal treatments.  It is also conducted as part of a root canal treatment if the root tip is slanted and cannot be reached through retrograde endodontic fillings alone. A small incision (cut) is made in the gum is lifted away from the tooth and bone. The infected tissue is removed along with the last few millimeters of the root tip and the end of the tooth’s canal is cleaned and sealed.

 

Periodontal Surgery
Caries and periodontitis are common problems of oral health. While these issues can be adressed by improving dental hygiene in early stages, surgical interventions are needed for disease control if gum, periodontium and bone already suffered from atrophy. Modern concepts of periodontal surgery help avoid tooth loss, control local infections and replace lost bone substance. We use our medical, dental, surgical and reconstructive expertise to offer You the best and most integrated treatment possible and rehabilitate Your oral health.

Tumor surgery

At MFACE, the treatment of all benign and malignant tissue alternations of the head, neck, mouth and sinuses (i. e. squamous cell carcinoma, basal cell carcinoma, hemangioma) is a main focus. Mostly, surgical removal of the tumor is  the cornerstone of therapy; in rare and special cases however, a multimodal approach may be necessary.

 

We know that the head and neck is a highly delicate area for surgical intervention. No other area of the body requires more attention to functional and aesthetic detail. Therefore we always plan our tumor surgery focussing on an optimal reconstruction of the resulting defect in terms of function and aesthetics. Our background in Oral and Maxillofacial as well as Plastic and Reconstructive Surgery of the face ensures the whole range of microsurgical techniques to replace bone and soft tissue with minimal donor site morbidity by using the patient’s own tissue. Even when large tumors and parts of the jaw have to be removed, the right reconstruction ensures the possibility for complete functional rehabilitation of the jaws.

 

We conduct the treatment of head and neck tumors strongly according to the specific guidelines, for example the current S3-guidelines for the treatment of carcinomas of the oral cavity of the German Society of Oral and Maxillofacial Surgery (Deutsche Gesellschaft für Mund-Kiefer-Gesichtschirurgie).

Jaw bone necrosis

Structural impairment of the bone with the end point of bone destruction is referred to as jaw bone necrosis, which is mostly caused by radiation or certain medication (bisphosphonates for the treatment of bony metabolism), especially after dental durgery procedures. Sometimes however, necrosis occurs under these treatments alone and presents with symptoms like pain, swelling, purulent secretion, bad breath, impaired wound healing and numbness of the lower lip.

 

Treatment can be very time-consuming, and surgical measures like wound debridement and cleaning may be necessary to stop the progression of the disease.

 

At MFACE, we treat bisphosphonate-related osteonecrosis of the jaws according to the newest S3-guidelines of the German Society of Oral and Maxillofacial Surgery (Deutsche Gesellschaft für Mund-Kiefer-Gesichtschirurgie).

You can also learn more about our treatment services of orthognathic surgery under

Functional / Orthognathic Surgery