Facial Trauma

The most common causes of facial injuries include falls, motor vehicle accidents and sports injuries. Injuries to the facial region can impart not only physical injury but emotional trauma as well. Oral and Maxillofacial Surgeons have received a minimum of 4 years of intensive hospital based surgical training and are uniquely trained in repairing both soft tissues (facial lacerations) and bony injuries to maxillofacial region( nose, cheek bones, jaw bones and eye sockets) and oral cavity (intraoral lacerations and knocked out or displaced teeth) to restore function and achieve esthetics.

If facial bones have been fractured or broken, they will be treated in much the same way as any other broken bone. Unlike other bones of the body, a plaster cast cannot be applied to a cheekbone, but the bones can be held firmly together by either wiring or the insertion of small plates and screws. Soft tissue lacerations are treated immediately by way of suture (stitching). Depending on the nature of the injury, treatment can take place in the hospital or in the office.

Bone Grafting

Bone grafting is often closely associated with dental restorations such as dental implants. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration.

There are several major factors that affect jaw bone volume:

  • Periodontal Disease – Gum disease can affect and permanently damage the jaw bone that supports the teeth. Affected areas progressively worsen until the teeth become unstable.
  • Tooth Extraction – Studies have shown that patients who have experienced a tooth extraction subsequently lose bone surrounding the extraction site during the following three years. Loss of bone results in what is called a “bone defect”.
  • Injuries and Infections – Dental injuries and other physical injuries resulting from a blow to the jaw can cause the bone to recede. Infections can also cause the jaw bone to recede in a similar way.

Oral Examination

Initially, the doctor will thoroughly examine the affected area in order to assess the general condition of the teeth and gums. If periodontal disease is present or the adjacent teeth are in poor condition, these factors will be fully addressed before the bone grafting procedure can begin. The doctor will also recommend panoramic x-rays in order to assess the precise depth and width of the existing bone. On occasion, a CAT scan may be recommended to determine the bone condition.

What Does Bone Grafting Involve?

There are several sources for obtaining bone grafts.

  • Autogenous Bone Graft – Harvested from the patient’s own body (usually from the posterior part of the lower jaw or the chin).
  • Allograft Bone Graft – Cadaver or synthetic bone is used in this type of graft.
  • Xenograft – Cow bone is used in this type of graft.

The healing period after the bone grafting procedure can take anywhere from 4-6 months to complete. Bone is typically harvested from your own body (or on rare occasions obtained from a “bone bank”) and added to the affected site. This bone will fuse with the existing bone and the migration of cells will cause firm adhesion and cell growth. Supplementing the jaw with bone will result in greater bone mass to help support and anchor the implant(s).

Dental and Wisdom Teeth Extractions

This is the generic term for the set of 3rd molars. These “wisdom teeth” may or may not have to be removed. Factors such as decay, inability to keep them clean or not enough room in the arch for them to erupt normally, can all be reasons for extraction of these teeth.


The soft tissue of the mouth is normally lined with mucosa, which is a special type of skin that should appear smooth in texture and pink in color. Any alteration of the color or texture of the mucosa (lesion) may signal the beginning of a pathologic process. These changes may occur on the face, neck, and areas of the mouth (e.g., gums, tongue, lips, etc.). The most serious of these pathologic changes (which may or may not be painful) is oral cancer. The following can be signs of a suspicious pathologic process such as oral cancer:

    Red patches or white patches or a combination red/white patch in the mouth
  • An ulcer or lesion that has persisted for 2 weeks or longer
  • A lump or mass that is growing rapidly
  • An area that bleeds easily when touched
  • A lump or mass that feels “fixed” or does not move easily
  • Difficulty in swallowing or hoarseness

Depending on the history, clinical and possibly radiographic exam, your doctor will determine if there are cell changes present, the doctor will take a biopsy of the affected area and send it away to be analyzed by laboratory specialists. When definitive results are obtained, the course of treatment can be determined.

If you are experiencing any pain or symptoms that cause you concern, we encourage you to contact us today to schedule an appointment.