Monday, 2 February 2015

Anterior Maxillary Osteotomy & Subapical Osteotomy

Space Infection


Oral Cancer

Lip Shaping



Vertical Maxillary Excess

Prognatic Mandible

Prognatic Mandible

Prognatic Mandible

Prognatic Mandible

Prognatic Mandible

Prognatic Mandible

Chin Surgeries

Cysts & Tumours

Submucous Fibrosis

Space Infection

Friday, 30 January 2015

Facial Cosmetic Surgery

Thanks to their surgical and dental background, oral and maxillofacial surgeons (OMSs) are uniquely qualified to perform cosmetic procedures involving the functional and aesthetic aspects of the face, mouth, teeth and jaws. Extensive education and training in surgical procedures involving skin, muscle, bone and cartilage finely attune the oral and maxillofacial surgeon to the need for harmony between facial appearance and function.
With the development of advanced medical devices and biomaterials, many facial cosmetic procedures are minimally invasive and can be performed in an office setting using local and/or intravenous anesthesia. Some procedures may require use of an outpatient or same day surgery center or hospital.
Many cosmetic
procedures are
minimally invasive
and can be
performed in
an office setting.
The following are some of the procedures available to you. Your OMS may perform other surgeries not listed here. Make an appointment to discuss your personal situation.
  • Cheekbone Implants 
  • Chin Surgery 
  • Ear Surgery
  • Eyelid Surgery 
  • Facelift 
  • Facial and Neck Liposuction 
  • Forehead/Brow Lift 
  • Lip Enhancement 
  • Nasal Reconstruction 
  • Skin Treatments
  • Botox® Injections
  • Chemical Peel
  • Dermabrasion

Chin Implants


For a patient with a small or recessed chin, an implant can completely transform the facial profile.


·         Small or recessed chin
·         Normal sized jaw
·         Normal “bite” (how the teeth come together)
·         Healthy patient
·         Reasonable expectations


As an independent procedure, a chin implant can be performed under mild sedation and local anesthesia. A small incision is either placed in the mouth or under the chin. The implant is placed over the bone. Implant materials vary. Dr. Jess Prischmann prefers the soft nature of Mersilene Mesh. This procedure can be combined with neck liposuction, rhinoplasty, facelift, or submentoplasty (neck liposuction).


Downtime following a chin implant is typically 5-7 days. Bruising and swelling may last for a few weeks following surgery. Infection is rare (less than 5 percent).

Thursday, 22 January 2015


Prognathism is an extension or bulging out (protrusion) of the lower jaw (mandible). It occurs when the teeth are not properly aligned due to the shape of the face bones.


Prognathism may cause malocclusion (misalignment of the biting surfaces of the upper and lower teeth). It can give a people an angry, or fighter's, appearance. Prognathism may be a symptom of other syndromes or conditions.


An extended (protruding) jaw can be part of a person's normal face shape that is present at birth.
It can also be caused by inherited conditions, such as Crouzon syndrome or basal cell nevus syndrome.
It may develop over time in children or adults as the result of conditions such as gigantism or acromegaly.

When to Contact a Medical Professional

A dentist or orthodontist may be able to about treat abnormal alignment of the jaw and teeth. Your primary health care provider should also be involved to check for underlying medical disorders that can be associated with prognathism.
Call a health care provider if:
  • You have difficulty talking, biting, or chewing related to the abnormal jaw alignment.
  • You have concerns about jaw alignment.

What to Expect at Your Office Visit

The health care provider will perform a physical examination and ask questions regarding your medical history. Questions may include:
  • Is there any family history of an unusual jaw shape?
  • Is there difficulty talking, biting, or chewing?
  • What other symptoms do you have?
Diagnostic tests may include:
This condition may be treated with surgery. An oral surgeon, plastic facial surgeon, or ENT specialist may perform this surgery.

Alternative Names

Extended chin


Taub DI, Jacobs JMS, Jacobs JS. Anthropometry, cephalometry, and orthognathic surgery. In: Neligan PC, ed.Plastic Surgery. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2013:chap 16.

Update Date: 2/25/2014

Updated by: Sameer Patel, MD, Assistant Professor of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team

Oral Cysts Explained

Oral Cysts Explained
When you hear the phrase oral cysts you might envision a long list of possible problems. The most basic explanation of this condition, however, is an unexpected sac filled with fluid of some sort and appearing in the area in or around the mouth. This includes the lips, tongue, palate (roof of the mouth), gums, floor of the mouth, the throat, and the salivary glands. Many dentists and physicians also consider that oral cysts can form on the bones in the mouth area.
There are a few types of cysts, and we will consider each in turn. Before we do that, let's just understand what the most common symptoms and causes for oral cysts will be. The symptoms include:
• Lump inside of the mouth or along the jaw;
• Formation of sacs;
• Pain near the teeth; and
• Signs of infection.
The last symptom is important to note because infection is often a leading cause of cyst formation. This is due to the simple fact that the first stage of most cyst formation is the buildup of infected material inside or around the tooth. The body then encapsulates the infected fluid or material inside of a cyst. Even then, the body can reabsorb the infected material and spread the problem to other areas of the mouth or the body.
Ultimately, most dentists are going to want the majority of cysts to be removed, and also to be analyzed for signs of malignancy. Though most cysts are not cancerous, it is best to be sure that it is indeed a cyst and not a tumor that is being dealt with through removal. If there are any questions about the matter, a good dentist will first perform a biopsy before attempting to remove the growth.

The Types of Cysts
As already indicated, there are few kinds of cysts, and they include:
• Periapical- These are quite uncomfortable because they are caused by any sort of infection in the pulp area of the tooth. The fluid created by the infection will escape at the small opening in the bottom of the tooth and become trapped by the surrounding tissue; forming the fluid-filled cyst.
• Dentigerous - When a wisdom tooth becomes impacted it is usually going to have at least one cyst of this type nearby. They develop in the dental follicle and are often unnoticed because they cause no pain - though they can force third molars out of their natural position.
• Odontogenic - Cyst that grows in the jawbone. They can cause a bulge in the bone and most dentists will want their patient to have the cyst removed. The reason for removing an otherwise harmless cyst is because this type tends to grow; weakening and even fracturing bone and teeth;
• Mucocele - This is the "mucus" cyst that appears when the tissue inside of the mouth has been overly irritated or injured. These are painless growths that tend to rupture on their own and which heal quickly without intervention of any kind. If it does not rupture, and continues to increase in size, a dentist can lance and drain it.

Oral Cancer

Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissue. Oral cancer appears as a growth or sore in the mouth that does not go away. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat), can be life threatening if not diagnosed and treated early.
What Are the Symptoms of Oral Cancer?
The most common symptoms of oral cancer include:

·         Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas inside the mouth
·         The development of velvety white, red, or speckled (white and red) patches in the mouth
·         Unexplained bleeding in the mouth
·         Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
·         Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks
·         A soreness or feeling that something is caught in the back of the throat
·         Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
·         Hoarseness, chronic sore throat, or change in voice
·         Ear pain·         A change in the way your teeth or dentures fit together
·         Dramatic weight loss
If you notice any of these changes, contact your dentist or health care professional immediately.
Who Gets Oral Cancer?
According to the American Cancer Society, men face twice the risk of developing oral cancer as women, and men who are over age 50 face the greatest risk. It's estimated that over 35,000 people in the U.S. received a diagnosis of oral cancer in 2008.
Risk factors for the development of oral cancer include:

·         Smoking. Cigarette, cigar, or pipe smokers are six times more likely than nonsmokers to develop oral cancers.
·         Smokeless tobacco users. Users of dip, snuff, or chewing tobacco products are 50 times more likely to develop cancers of the cheek, gums, and lining of the lips.
·         Excessive consumption of alcohol. Oral cancers are about six times more common in drinkers than in nondrinkers.
·         Family history of cancer.·         Excessive sun exposure, especially at a young age.
It is important to note that over 25% of all oral cancers occur in people who do not smoke and who only drink alcohol occasionally. 
What Is the Outlook for People With Oral Cancer?
The overall 1-year survival rate for patients with all stages of oral cavity and pharynx cancers is 81%. The 5- and 10-year survival rates are 56% and 41%, respectively.
How Is Oral Cancer Diagnosed?
As part of your routine dental exam, your dentist will conduct an oral cancer screening exam. More specifically, your dentist will feel for any lumps or irregular tissue changes in your neck, head, face, and oral cavity. When examining your mouth, your dentist will look for any sores or discolored tissue as well as check for any signs and symptoms mentioned above.
Your dentist may perform an oral brush biopsy if he or she sees tissue in your mouth that looks suspicious. This test is painless and involves taking a small sample of the tissue and analyzing it for abnormal cells. Alternatively, if the tissue looks more suspicious, your dentist may recommend a scalpel biopsy. This procedure usually requires local anesthesia and may be performed by your dentist or a specialist. These tests are necessary to detect oral cancer early, before it has had a chance to progress and spread.
How Is Oral Cancer Treated?
Oral cancer is treated the same way many other cancers are treated -- with surgery to remove the cancerous growth, followed by radiation therapy and/or chemotherapy (drug treatments) to destroy any remaining cancer cells.
What Can I Do to Prevent Oral Cancer?
To prevent oral cancer:

·         Don't smoke or use any tobacco products and drink alcohol in moderation (and refrain from binge drinking).
·         Eat a well balanced diet.
·         Limit your exposure to the sun. Repeated exposure increases the risk of cancer on the lip, especially the lower lip. When in the sun, use UV-A/B-blocking sun protective lotions on your skin, as well as your lips.
You can take an active role in detecting oral cancer early, should it occur, by doing the following:·         Conduct a self exam at least once a month. Using a bright light and a mirror, look and feel your lips and front of your gums. Tilt your head back and look at and feel the roof of your mouth. Pull your checks out to view the inside of your mouth, the lining of your cheeks, and the back gums. Pull out your tongue and look at all surfaces; examine the floor of your mouth. Look at the back of your throat. Feel for lumps or enlarged lymph nodes in both sides of your neck and under your lower jaw. Call your dentist's office immediately if you notice any changes in the appearance of your mouth or any of the signs and symptoms mentioned above.
·         See your dentist on a regular schedule. Even though you may be conducting frequent self exams, sometimes dangerous spots or sores in the mouth can be very tiny and difficult to see on your own. The American Cancer Society recommends oral cancer screening exams every 3 years for persons over age 20 and annually for those over age 40. During your next dental appointment, ask your dentist to perform an oral exam. Early detection can improve the chance of successful treatment.

WebMD Medical Reference
View Article Sources 
Reviewed by Elverne M Tonn, DDS on May 13, 2012 , © 2012 WebMD, LLC.

Mouth Cancer


Mouth cancer, also known as oral cancer, is where a tumourdevelops on the surface of the tongue, mouth, lips or gums.
Tumours can also occur in the salivary glands, tonsils and the pharynx (the part of the throat from your mouth to your windpipe) but these are less common.
  • red or white patches on the lining of your mouth or tongue
  • ulcers
  • a lump
See your GP if these symptoms do not heal within three weeks, especially if you're a heavy drinker or smoker.

Types of mouth cancer

A cancer that develops on the inside or outside layer of the body is called a carcinoma and these types of cancer are categorised by the type of cells the cancer starts in.
Squamous cell carcinoma is the most common type of mouth cancer, accounting for nine out of 10 cases. Squamous cells are found in many places around the body, including the inside of the mouth and under the skin.
Less common types of mouth cancer include:
  • oral malignant melanoma – where the cancer starts in cells called melanocytes, which help give skin its colour
  • adenocarcinomas – cancers that develop inside the salivary glands

What causes mouth cancer?

Mouth cancer occurs when something goes wrong with the normal cell lifecycle, causing them to grow and reproduce uncontrollably.
Risk factors for developing mouth cancer include:
  • smoking or using products that contain tobacco
  • drinking alcohol – smokers who are also heavy drinkers have a much higher risk compared to the population at large
  • infection with the human papilloma virus (HPV), the virus that causes genital warts
Read more about the causes of mouth cancer.

Who is affected by mouth cancer?

Mouth cancer is an uncommon type of cancer, accounting for one in 50 of all cancer cases.
In the UK, just over 6,767 new cases of mouth cancer were diagnosed in 2011 (the latest reliable data).
Most cases of mouth cancer first develop in older adults who are between 50-74 years of age.
Mouth cancer can occur in younger adults, but it's thought that HPV infection may be responsible for the majority of cases that occur in younger people.
Mouth cancer is more common in men than in women. This is thought to be due to the fact that, on average, men drink more alcohol than women.

Treating mouth cancer

There are three main treatment options for mouth cancer. They are:
  • surgery – where the cancerous cells are surgically removed and, in some cases, some of the surrounding tissue
  • chemotherapy – where powerful medications are used to kill cancerous cells
  • radiotherapy – where high energy X-rays are used to kill cancerous cells
These treatments are often used in combination. For example, a course of radiotherapy and chemotherapy may be given after surgery to help prevent the cancer returning.
Read more about treating mouth cancer.

Complications of mouth cancer

Both surgery and radiotherapy can make speaking and swallowing difficult (dysphagia).
Dysphagia can be a potentially serious problem. If small pieces of food enter your airways and become lodged in your lungs, it could trigger a chest infection, known as aspiration pneumonia.
Read more about the complications of mouth cancer.

Reducing the risk

The three most effective ways to prevent mouth cancer from developing – or prevent it reocurring after successful treatment – are:
  • not smoking
  • keeping to the recommended weekly limits for alcohol consumption (21 units for men and 14 units for women (read more about alcohol units)
  • eating a 'Mediterranean-style diet', with plenty of fresh vegetables (particularly tomatoes), citrus fruits, olive oil and fish (read more about healthy eating)
It's also important that you have regular dental check-ups because dentists can often spot the early stages of mouth cancer.


If mouth cancer is diagnosed early, a complete cure is often possible using a combination of radiotherapy, chemotherapy and surgery.
The outlook for mouth cancer can vary depending on which part of the mouth is affected and whether it has spread from the mouth into surrounding tissue. The outlook is much better if the cancer is diagnosed early.
Overall, an estimated 40% of people with cancer affecting the mouth and pharyx will live at least five years after their diagnosis and many people live much longer. However, the outlook is better for cancer affecting certain areas of the mouth, such as the lip, tongue or oral cavity.

Mouth cancer

Carrie Newlands, consultant oral and maxillofacial surgeon, talks about the causes and symptoms of mouth cancer.
Media last reviewed: 19/07/2014
Next review due: 19/07/2016

Head and neck cancers

Mouth cancer is a type of cancer that comes under the umbrella term 'cancers of the head and neck'. Other types of head and neck cancers include:
Page last reviewed: 05/06/2014

Next review due: 05/06/2016