Oral Surgery

In Europe, Oral Surgery is the area of medicine concerned with correcting problems or damage to the mouth, teeth and jaws. It is often also referred to as Odontostomatology which combines oral surgery with surgery on some the structures of the dento-facial skeleton.

Oral surgery is commonly performed to remove wisdom teeth, bony cysts,bony lesions, prepare the mouth for dentures, repair jaw problems.

Oral surgeons may also perform more advanced procedures as required after dento alveolar trauma or severe diseases damaging the structures of the mouth. Some oral lesions are not of surgical interest such as: traumatic mucositis, lichen, pemphigus,different type of tongue inflammation/infection(glossitis), stomatitis. Many of them require medical therapy.

Oral surgery also often includes pre-implantological surgery and implantology ,to replace the missing teeth. Most common investigations are: orthopanoramic x-ray,CT scan, dental scan.Ultrasound surgery( piezosurgery) is a very useful tool when doing oral bone-surgery. A new field of interest in oral & maxillofacial surgery is the jaw osteonecrosis related to the adverse side effect of bisphosphonate therapy.

Patients with multiple myeloma and metastatic carcinoma to the skeleton, or women in therapy for osteoporosis and who are receiving intravenous, nitrogen-containing bisphosphonates ,are at greatest risk for osteonecrosis of the jaws. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60% of cases are preceded by a dental surgical procedure. Oversuppression of bone turnover is probably the primary mechanism for the development of this condition, although there may be contributing comorbid factors. All sites of potential jaw infection should be eliminated before bisphosphonate therapy is initiated in these patients to reduce the necessity of subsequent dentoalveolar surgery. Conservative débridement of necrotic bone, pain control, infection management, use of antimicrobial oral rinses, and withdrawal of bisphosphonates are preferable to aggressive surgical measures for treating this condition.