Oral and Maxillofacial Surgery

• surgical treatment of odontogenic sinusitis
• removal of neoplasms on the face and in the oral cavity, with subsequent histological examination
• orthosurgical operations (changing the size and shape of the jaws in case of traumatic or congenital abnormalities)
• diagnosis, surgical and prosthetic treatment of temporomandibular joint dysfunctions
• zygomatic dental implant placement in case of total upper jaw atrophy
• surgical treatment of facial bone fractures

The accomplishment record of our maxillofacial surgeon is 36 years, including 8 years of work as a doctor on duty in an emergency trauma department. Over 2000 successful maxillofacial operations have been performed.

Thanks to a balanced approach in diagnosis and treatment of every clinical case, we achieve a minimum number of complications.

We treat odontogenic sinusitis

We use state-of-the-art equipment for surgical treatment of sinusitis, such as a piezotome (an ultrasonic knife).

We remove oral neoplasms

There are not many benign neoplasms in the mouth, but those that exist can be successfully removed by us.

We perform orthosurgical operations

We correct bone deformities of the jaws when one jaw significantly lags behind the other in development.

Oral and maxillofacial surgery is a fairly extensive field that addresses a wide range of tasks. Unlike surgical dentistry, maxillofacial surgery in Kyiv is not as widely represented: not all clinics undertake complex operations and often refer patients to us.

The chief doctor of “Osadchiy Dental Clinic” — Igor Oleksandrovych — has extensive experience in maxillofacial surgery: for over 17 years he performed operations, including at the emergency department of the maxillofacial ward of Kyiv’s Hospital No. 23. The Department of Maxillofacial Surgery of Kyiv Medical University was also based in that ward.

Subsequently, Igor Oleksandrovych went into private practice — dentistry and maxillofacial surgery. The experience of the doctors at “Osadchiy Dental Clinic” allows them to perform operations of any complexity, as well as to address complications arising from operations performed at other clinics.

Typically, half of our maxillofacial surgery requests involve addressing complications after surgical interventions performed at other clinics. We recommend that our patients carefully choose facilities and specialists, as complications can lead not only to a decreased quality of life, but also to a fatal outcome.

• Wisdom teeth.

Complex tooth extraction falls within the competence of a maxillofacial surgeon. Atypical removal of third molars, both erupted and unerupted, can prove quite problematic. That is why wisdom tooth removal should be performed by a maxillofacial surgeon;

• Supernumerary teeth.

Patients also have problems with supernumerary teeth. Such teeth remain unerupted and may not cause any concerns. In this case, surgical intervention can be avoided. However, if a supernumerary tooth becomes mobile, starts to hurt, or a neoplasm appears around it, one should immediately consult a dental surgeon or a maxillofacial surgeon.

It should be noted that quite often doctors refuse to extract complex teeth, even if they are dental surgeons by specialization. Sometimes dental surgeons perform operations with serious complications, which we then correct. That is why we recommend tooth extraction in maxillofacial surgery. This will help avoid complications and additional expenses, as the cost of tooth extraction by a dental surgeon and a maxillofacial surgeon is the same.

Injuries to the soft tissues of the face and neck, as well as injuries to the facial skull, fall exclusively within the competence of a maxillofacial surgeon; in these cases, a dental surgeon has no right to perform operations.

While patients with upper or lower jaw fractures do seek specialists, those with soft tissue injuries do not always act responsibly. We insist that even with minor facial injuries, a consultation with a maxillofacial surgeon and an X-ray examination are necessary.

If the skin of the face is broken due to an injury, one should visit the clinic immediately. Such injuries are sutured within 1–2 hours. If the patient comes later, the wound will already be infected, making reconstruction much more difficult.

We advise our patients that only timely treatment at a specialized clinic will eliminate the consequences of an injury and prevent scarring on the face. “Osadchiy Dental Clinic” has the necessary competence and experience, and is equipped with special atraumatic suture and other materials and instruments.

Maxillofacial surgery operations are also performed to remove neoplasms. Our clinic’s approach in such cases is as follows:

• a surgery is performed to remove the neoplasm;
• the tissues are sent for histological examination.

If the histology results show that the neoplasm was malignant, we refer the patient to specialized oncology departments. Dentistry and maxillofacial surgery involve manipulations only with benign tumors; anything else is the competence of oncologists.

Problems related to jaw defects, jaw overdevelopment, reverse (mesial) bite, large lower jaw, etc. are resolved exclusively through surgical intervention.

Correcting them with braces is impossible, and those doctors who still try to use bracket systems only significantly worsen the situation, up to the point of needing to extract the patient’s teeth.

We recommend that our patients with such problems immediately consult a maxillofacial surgeon. Before the operation, we create a lithographic model, and during the surgical intervention, we move the bones of the facial skull in the correct direction. Yes, prices for maxillofacial surgery are high and treatment is lengthy, but this is the only way to eliminate defects and achieve an aesthetically attractive result.

The competence of maxillofacial surgeons also includes:

• treatment of inflammatory processes:
• periodontitis (inflammation of the periodontium — tissues around the tooth root);
• abscess or phlegmon (acute inflammation with pus formation);
• lymphadenitis (inflammation of the lymph nodes);
• odontogenic sinusitis (inflammation of the mucous membrane of the maxillary sinus);
• treatment of salivary gland stone disease;
• diagnosis and treatment of the temporomandibular joint (clicking in the joint, joint arthritis);
• reconstructive surgery (restoration of parts of the facial skull);
• plastic surgery:
• otoplasty (ear reshaping);
• rhinoplasty (nose reshaping);
• blepharoplasty (eyelid surgery);
• lip surgery;
• dental implantation.

• injuries from tooth extraction surgeries.

In our practice, we constantly face the need to address complications. In particular, those caused by the actions of other doctors.

Sometimes dental surgeons break patients’ jaws or tear off maxillary tuberosities during complex tooth extractions. Addressing such consequences requires the intervention of a maxillofacial surgeon;

• neglected chronic conditions.

Chronic periodontitis leads to abscesses and even phlegmons (acute diffuse purulent inflammation). Both abscesses and especially phlegmons must be drained and sanitized. They are life-threatening.

Patients do not always take a responsible attitude toward their health, so often problems caused by neglected diseases have to be resolved surgically. We tell our patients a simple truth: if the pain has decreased or you can tolerate the pain, it does not mean the disease is gone. Pain is the first symptom that should be addressed immediately.

Do not ignore the following symptoms:

• clicking in the joint;
• swelling of the face or neck;
• lumps on the face or neck;
• neoplasms in the oral cavity or on the tongue;
• dry mouth;
• injuries to the facial skeleton.

Surgery is always complex, and maxillofacial surgery is particularly complex and extensive. That is why, globally and especially in Ukraine, maxillofacial surgery does not interest most young specialists. Today, across the country and even in Kyiv, maxillofacial surgery is represented by a critically small number of specialists, especially when it comes to experienced doctors.

In practice, we see that patients cannot always get help. In the best case, other clinics will refuse to perform a complex operation and refer them to us. In the worst case, they will attempt the operation and cause complications, after which the patient will come to us anyway.

Maxillofacial surgery, the cost of which may seem very high, is a field of medicine that depends on extensive resources. Maxillofacial surgery operations require complex equipment, the involvement of allied specialists, and rehabilitation in a hospital — hence the high final cost.

Some operations can be performed on an outpatient basis — under local anesthesia. In such cases, less equipment is needed and the final cost of maxillofacial surgery will be lower. However, in complex cases, general anesthesia, intensive care, and hospitalization are required — all of which entail additional costs.

Often, private maxillofacial surgery costs patients even less than treatment in public hospitals. Moreover, public hospitals use outdated and highly traumatic techniques.

At “Osadchiy Dental Clinic” we know the techniques and are able to perform operations minimally invasively with rapid rehabilitation. We do not inflate the cost of services and always try to save patients’ time and money, but only in ways that do not affect the final result.