Procedures
Dental Implants are artificial teeth that replace missing or damaged teeth. Unlike removable dentures, which rest on the gum, or fixed bridges, which anchor to adjacent teeth, dental implants are surgically placed in the jawbone to provide a foundation for replacement teeth. Dental implants look and feel like real teeth. With good dental care they can last a lifetime. Dental implant surgery typically involves threading a titanium support post into the jawbone in the location of the missing tooth, and attaching the new tooth onto the support. The bone fully heals and fuses around the newly implanted tooth support structure before the new artificial tooth can be attached. This is called osseointegration. If multiple teeth need to be replaced the Center is has advanced experience in all dental implant technologies and techniques for fixed implant supported prostheses. Utilizing the office’s 3-D imaging technology, both TEETH-IN-A-DAY and All On Four revolutionary dental implant procedures significantly reduce the time needed for treatment. Both procedures involve implanting supports and the teeth prosthesis in one procedure. The Center performs dental and oral implants, craniofacial implants, bone grafting for implants, sinus lifts, zygomatic implants and guided implant surgery. We encourage you to call with questions about the Faces of the Mission Oral & Maxillofacial Surgery’s expertise in the area of dental implants.
Wisdom teeth are usually the last four of 32 teeth to surface in the mouth, generally making their appearance between the ages of 17 and 25. In most cases, inadequate space in the mouth does not allow the wisdom teeth to come in properly. Wisdom teeth then can become impacted in a potentially harmful position. If left untreated, impacted wisdom teeth can contribute to infection, damage to other teeth and other problems.
There are several degrees of impaction based on the depth of the teeth within the jaw. These include soft tissue impaction, partial bony impaction and complete bony impaction.
Not all wisdom teeth require removal. Wisdom teeth extractions are most often performed because of an active problem such as pain, swelling, decay or infection. Some are removed as a preventative measure to avoid serious problems in the future.
Wisdom teeth or third molar removal is a common procedure at the Center, generally performed under local anesthesia, intravenous (IV) sedation, or general anesthesia.
Sleep apnea is serious condition that impacts a person’s breathing during sleep. People experience abnormally low breathing or pauses in breathing (called apnea). They are not typically aware of having any breathing difficulty when awake. The impact impaired breathing during sleep causes fatigue, vision or memory problems, and other effects associated with sleep deprivation, as well as low blood oxygen.
Obstructive sleep apnea, the most common form of sleep apnea, typically happens when the muscles in the throat relax and block the airway. Individuals with low muscle tone and soft tissue around the airway, and those who have oral structural features that give rise to a narrowed airway are at high risk for obstructive sleep apnea.
The Center has extensive experience in the obstructive sleep apnea surgery. For our patients with severe obstructive sleep apnea, we perform maxillomandibular advancement, orthognathic surgery, genioplasty, tongue reduction and tracheostomy.
Dr. Luque is a facial trauma expert. He has performed countless facial reconstructive surgeries in the aftermath of accidents, falls, automobile crashes and violence. Both at home in San Francisco and in his service abroad, Dr. Luque finds his work in facial trauma reconstruction to be a defining element of his practice.
Some of the main types of facial injuries are lacerations, fractured teeth, fractured jaws, fractured facial bones, knocked out teeth and intraoral lacerations.
No facial injury should be taken lightly. Aside from the obvious aesthetic reasons for repairing damage to the face, there are also a number of serious oral & maxillofacial health concerns that can arise from even a small amount of trauma. Depending on the exact location of the injury, respiration, speech, chewing and swallowing can be greatly impaired. If teeth become misaligned, this can lead to TMJ, uneven teeth wear and other complications.
Dr. Luque performs facial emergency surgery at the hospitals where he is on staff. He typically handles follow up procedures for facial trauma at the Center.
Jaw surgery, or orthognathic surgery, refers to surgical correction needed to fix substantial abnormalities of the maxilla (upper jaw), the mandible (lower jaw), or both. The abnormality may be a congenital malformation, a growth defect, or the result of traumatic injuries to the jaw area.
When the teeth come together improperly, such as an overbite or underbite, you have malocclusion. Orthognathic surgery is necessary when orthodontic treatment has not or will not be effective to treat malocclusion. Jaw surgeries performed at the Center include the reconstruction of the mandible or maxilla, mandibular ramus, maxilla osteotomy, and mandibular osteotomy, apertognathia, open-bite deformity and dentofacial deformities.
Left untreated, malocclusion of the teeth can cause uneven wear on teeth, chronic jaw, muscle pain, TMJ, headache, loose teeth, tooth sensitivity, and difficulty swallowing, chewing or biting food.
Temporomandibular joint (TMJ) disorders are a group of painful problems of the jaw. Temporomandibular problems are characterized by severe headaches, jaw pain, grinding teeth, and an intermittent ringing in the ears. TMJ pain can usually be relieved by noninvasive treatment such as medications, physical therapy, mouth or bite guards and arthrocentesis. Problems with jaw muscles and joints causing the TMJ pain also cause teeth grinding. The grinding teeth symptom is particularly common and usually occurs at night. The grinding eventually erodes the structure of the teeth and leads to severe dental problems. Untreated TMJ is one of the primary causes of eroded jawbones and loose teeth.
If noninvasive treatment does not relieve the TMJ, the Center performs partial or total join replacement, diskectomy, disk repair or repositioning.
Dr. Luque treats patients with benign and malignant cysts and tumors and infections of the oral cavity, salivary glands, jaws, and neck. During the course of a regular check up, Dr. Luque will thoroughly inspect the soft tissue of the mouth and take serious note of any changes or issues. Some conditions treated at the Center include:
- Odontogenic cysts.
- Odontogenic tumors.
- Amleoblastoma.
- Odontogenic keratocyst.
- Central Giant Cell Lesions.
- Cherubism.
- Fibrous Dysplasia.
- Tongue Cancer.
- Basal Cell Carcinoma.
- Sialolithiasis/Salivary gland stones.
- Pleomorphic adenoma.
- Warthins Tumor.
- Salivary gland tumors.
- Oral Cancer.
Oral cancer refers to any type of cancer affecting the tongue, jaw, and lower cheek area. Since it is impossible for the dentist to decisively diagnose a pathological disease without taking a biopsy sample of the affected area, seeking immediate treatment when changes are first noticed is critical.
An oral cancer screening is usually performed during a comprehensive exam. Screening is painless and only takes a few minutes. Dr. Luque will use a laser light to assess the soft tissue for cell changes that might be indicative of oral cancer. If such cell changes are present, a small biopsy will be taken and sent to a laboratory for review. If the biopsy indicates that oral cancer is present, an excision (removal) will generally be performed.
When a tooth that has already had a root canal treatment becomes inflamed and infected, an apicoectomy or root end surgery may be required. An apicoectomy is the removal of the apex (or root tip), followed by a filling procedure to seal the root from further infection. When left untreated, infected roots can damage other teeth, spread infection, and cause regression of the jawbone. Infected and inflamed soft tissue around the root of a tooth can be exceptionally painful. The purpose of an apicoectomy is to eliminate the infection in the tissue and to ultimately preserve the function of the tooth and save it from extraction. This surgery does not require an overnight stay. If you are experiencing any pain or swelling associated with a tooth that has had a root canal, we encourage you to contact our office to schedule an appointment.
Cleft lip and cleft palate are two common but markedly different birth defects that affect about one in every 700 newborns. These developmental deformities occur in the first trimester of a woman’s pregnancy; cleft lip in week seven, and cleft palate in week nine. A cleft lip is essentially a separation of the two sides of the lip. In many cases, this separation will include the bone and gum of the upper jaw. A cleft palate occurs when the sides of the palate fail to “fuse” as the fetus is developing, which results in an opening in the roof of the mouth.
The cleft can occur on one side of the mouth (unilateral) or both sides of the mouth (bilateral). Surgery will typically be performed in the child’s first six months to close the openings. Dental restoration caused by the deformity is handled later in the child’s life.
Dr. Luque and his team handle hundreds of cleft lip and palate surgeries annually. Cleft lip and palate surgeries performed at the Center include primary closure of cleft lip, secondary revision of cleft lip and hard and soft palate; repair of oral-nasal fistula, cleft orthognathic surgery, maxillary osteotomy, mandibular osteotomy and alveolar cleft grafting.
SINUS LIFT OR MAXILLARY SINUS FLOOR AUGMENTATION (also termed sinus lift, sinus graft, sinus augmentation or sinus procedure) is a surgical procedure which aims to increase the amount of bone in the posterior maxilla (upper jaw bone), in the area of the premolar and molar teeth, by lifting the sinus membrane and placing a bone graft.
When a tooth is lost, the alveolar process begins to remodel. The vacant tooth socket collapses as it heals leaving an toothless area, termed a ridge. This collapse causes a loss in both height and width of the surrounding bone. In addition, when a maxillary molar or premolar is lost, the maxillary sinus pneumatizes in this region which further diminishes the thickness of the underlying bone. Overall, this leads to a loss in volume of bone that is available for implantation of dental implants, which rely on bone integration, to replace missing teeth. The goal of the sinus lift is to graft extra bone into the maxillary sinus, so more bone is available to support a dental implant.
BONE GRAFT A dental bone graft adds volume and density to your jaw in areas where bone loss has occurred. The bone graft material may be taken from your own body (autogenous), or it may be purchased from a human tissue bank (allograft) or an animal tissue bank (xenograft). In some instances, the bone graft material may be synthetic (alloplast).
Once the bone graft has been placed, it holds space for your own body to do the repair work. In other words, a dental bone graft is like a scaffold on which your own bone tissue can grow and regenerate.
In some cases, we combine a dental bone graft with, Leukocyte and platelet rich fibrin (LPRF). This is taken from a sample of your own blood and is used to promote healing and tissue regeneration.