PROCEDURES

493ss_getty_rf_impacted_wisdom_tooth.jpg

WISDOM TEETH AND EXTRACTIONS

When wisdom teeth appear, some may find that there is not enough space in their jaw and the teeth are blocked, or impacted. Wisdom teeth that only partially emerge or erupt crooked can cause, among other concerns, infections, decay of adjacent molars, and crowding of other teeth.  In many cases, routine x-rays are not enough for a full evaluation of the wisdom teeth, jaw and surrounding structures. A panoramic x-ray (Orthopantomogram) is needed for a complete assessment of the jaw and teeth. Dr Berezowski has extensive experience in diagnosing and removing problematic wisdom teeth.

Dental%20implants_edited.jpg

DENTAL IMPLANTS

Dental implants are small, titanium posts that are surgically placed into the jawbone where teeth are missing or have been lost. These implants act as a substitute for the root of your natural tooth. The bone bonds with the titanium, creating a strong foundation for the artificial tooth or teeth to be subsequently made The dental implants are placed into the relevant sites in direct contact with bone. It takes some time for the implants to fuse with the bone before the final tooth restoration is made Small posts, called abutments, protrude through the gums and allow the crown to be attached. Implants  and teeth require maintenance or replacement and your dentist is able to render this service. Your dentist is also able to clean your implant with special instruments that will not damage it or the surrounding gum tissue. Dr Berezowski can help you with all your implant needs and questions.

tm joint.jpg

TM JOINT DISORDERS & FACIAL PAIN

The temporomandibular joint (TMJ) is the joint connecting the jaws and skull. Any problem that prevents this complex system of muscles, ligaments, discs and bones from working normally and asymptomatically is called a TMJ Disorder. In some cases, TMJ can be treated conservatively with medication that can help to relieve swelling, discomfort and severe pain. Splints or night guards can also help as they decrease the impact of clenching and teeth grinding. In some cases, crowns, bridges and orthodontic treatment may be used to offer relief from TMJ disorders and to provide long-term solutions. Facial pain is a common complaint and a thorough history and investigation is needed to assess this problem.Dr Berezowski treats the vast majority of patients with facial pain by a variety of conservative methods and the use of surgery is rarely needed.

facial-trauma_edited.jpg

FACIAL FRACTURES AND INJURIES

Facial trauma often occurs as a result of any type of accident, sports injuries and incidents of interpersonal violence. In these types of cases, bones and teeth can often be broken, misplaced or fractured. Facial bone fractures can be a simple mandible (lower jaw) fracture, but can also involve the frontal bone (forehead), orbits (eye sockets), zygomatic bones (fractured cheekbone), maxilla (top jaw) and nasal bones. Fractures of teeth especially in children can also occur. Management of maxillofacial trauma may require extensive surgery including open reduction under general anaesthesia with the use of titanium micro plates and screws. Dr Berezowski has extensive experience in this field.

Dental-Cyst-3D-Rendering.jpg

SOFT TISSUE INJURES

Injuries to the face result in great emotional as well as physical trauma to patients as well as families. Treating facial injuries requires special training, a hands-on approach, and an understanding of how the treatment would influence the patient’s long term functionality and appearance. Injuries to soft tissue in the facial region can be repaired with a variety of modalities. Repairs are performed with utmost care as to avoid damage to adjacent structures.

orthognathic surgery 2.jpg

ORTHOGNATHIC SURGERY

Orthognathic surgery; also known as corrective jaw surgery, readjusts the jaws and teeth to improve their appearance and functionality. Orthognathic surgery is often performed entirely inside your mouth leaving no facial scars. While the patient’s appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is also performed to correct functional problems and can improve chewing, speaking and breathing. After undergoing jaw surgery, patients typically find that they can bite and chew more easily than before, and that wear and tear on teeth is reduced. The procedure corrects imbalance in the face and re-establishes symmetry to the facial features.

Lesion joint.jpg

ORAL PATHOLOGY, CYSTS AND TUMORS

Oral Pathology is concerned with the nature, identification and management of diseases affecting the face, jaws and mouth. Cysts are fluid filled, gaseous or semi solid lesions that can develop anywhere in the mouth and are often related to teeth and tooth structures. They can develop under the mouth lining, in the saliva glands, inside the jawbones and be associated with the roots of the teeth. If cysts become infected they can cause pain and can also damage teeth and jaws. Cysts are removed surgically and then sent for microscopic examination in a laboratory so that your doctor can confirm the diagnosis. Tumours are growths which are either benign or malignant. They are usually removed under a general anaesthetic in hospital. Because of the complex facial anatomy the surgery is performed very carefully to avoid adjacent structures. Dr Berezowski has extensive experience with these.

oral surgery.jpg

ORAL SURGERY

This is a general term which covers all surgery carried out in the mouth and is performed under local anaesthesia, sedation or general anaesthetic. This can be in an office environment or hospital where it is often a day case procedure.

Surgery before Orthodontic Treatment-

 Patients may need surgery in preparation for orthodontic treatment. Unerupted eye teeth are a common finding and exposure of these teeth is needed for the orthodontic treatment .Attachments can be placed on teeth to assist orthodontic movement or eruption of teeth. The removal of retained baby teeth, or unerupted and extra teeth for orthodontic reasons is also often needed.

Nurse Making Notes

APICOECTOMY

This is a surgical procedure whereby a tooth's root tip is removed. Apicoectomies are carried out when root canal treatment or re-root canal treatment has failed in a tooth. An apicoectomy can remove the persisting infection or cyst as bacteria can remain within the lateral canals or other areas which are not able to be cleaned effectively through normal endodontic procedure.

Female white toothy smile

PREPROSTHETIC DENTAL SURGERY

These help to prepare the mouth for dentures (both partial or complete). This surgery ensures that the dentures fit correctly and that the bone on which the dentures will rest is the correct shape and size. In some cases procedures that can be performed include smoothing and reshaping of bone, removal of bone and removal of excess gum and tissue .Pre prosthetic surgery also includes the placement of dental implants which is carried out in conjunction with your dentist or prosthodontist.

Model's Lower Face

REMOVAL OF BROKEN TEETH AND ROOTS

Broken teeth are extracted because they cause pain or infection. Teeth and roots may also be removed if surgery is needed for repair of a fractured jaw or if a cyst is present. The extraction of more difficult roots and broken teeth may also require some removal of bone in order to remove the root remnants. Whether the teeth or roots are removed under local or general anaesthetic is discussed at the consultation with Dr Berezowski .You will be prescribed medication after the procedure in order to limit any discomfort and minimise infection.

Dental Assistant

LICHEN PLANUS OF THE MOUTH

Lichen Planus is usually a white lesion found on the side of the tongue and inside of the cheeks.  It can affect gums and the roof of the mouth as well. It often presents as a lace-like pattern of streaky white patches that become thickened and can be symmetrical.  Some people may get red patches or sores. A biopsy is performed to confirm the diagnosis.

Female white toothy smile

BIOPSIES

A biopsy is a procedure where a piece of tissue is removed from a swelling, lump or ulcer so it can be examined under a microscope. Excisional biopsies aim to remove the area completely while incisional biopsies remove only a small portion of an abnormal area. There may be some bleeding, pain or swelling after the procedure, but these disappear relatively quickly. Once this has been  examined under the microcope a review appointment is made so that the results of your biopsy can be discussed with you  and if necessary further treatment arranged.

Model's Lower Face

REMOVAL OF BONY GROWTHS OF MANDIBLE OR MAXILLA (TORI)

Mandibular  tori are bony growths of the lower jaw usually on the tongue side near the premolars and often occur on both sides of the mouth. Unlike in the mandible when a torus arises from the upper jaw or maxilla in the palate it may project downwards.  Tori will need to be  surgically removed to accommodate upper or lower dentures or partial dentures. Tori may also be removed to minimize food impaction under the excess bone.

Nurse Making Notes

BURNING MOUTH/TONGUE SYNDROME

Also known as Oral Dysaesthesia this is a burning or soreness of the mouth or tongue which can persist for a long period of time and can be affected by stress levels. Symptoms often include a burning or altered sensation in your mouth or tongue. Some patients may have a bad taste or dry mouth as well. To make a diagnosis, you will be questioned about your circumstances, health and medication and sometimes blood or other tests may be needed. You will also be checked for any mouth infections and if you wear dentures these will be checked. Dr Berezowski will give you advice on this.

Female white toothy smile

ULCERS IN THE MOUTH

These can be very painful, bothersome or distressing and a diverse number of causes can contribute to these forming. Dr Berezowski will take a full history from you before discussing and treating these often painful lesions.