Apical Surgery

Apical surgery is used as an adjunct to root canal treatment. Root canal treatment is usually undertaken by a Dentist or Endodontist if the pulp (nerve) in the tooth is infected. This infection may spread to cause an abscess beneath the tooth root. Untreated, an abscess will slowly enlarge and ultimately result in a more serious infection.

Surgery to remove the infection in the bone below the tooth is called apical surgery. Apical surgery may involve removal of the abscess, part of the infected tooth root and a filling placed in the apex of the tooth root to seal the root in an effort to prevent the infection recurring.

 


Pre-prosthetic Surgery

A prosthesis is an object used to replace natural tissue, such as a denture, a bridge or a crown. Pre-prosthetic surgery is a procedure used to improve the shape of hard or soft tissues of the oral cavity to allow for a better fabrication and fitting of the prosthesis.         

The most common type of pre-prosthetic surgery is removal of excessive soft tissue that has formed in association with a poorly fitting denture. Removal of the excessive soft tissue allows a new denture to be constructed with improved comfort and stability.

Some people have problems with the shape of their jaw bone and so fitting a denture without the removal of a bone lump would cause issues with mouth ulcers and pain when wearing the denture. The most common places to have excessive bone are in the midline of the hard palate and on the tongue and side of the lower jaw. These bone lumps are referred to as a torus.

 


Exposure of Impacted Teeth

Exposure of impacted teeth is sometimes needed to assist an Orthodontist who is correcting dental crowding. The most common tooth that is impacted (apart from the third molar teeth), is a maxillary canine tooth.

In order to move these teeth into the correct position in the oral cavity, it is often necessary for a surgical procedure to be performed. This usually involves removal of a small amount of overlying tissue to expose the crown of the impacted tooth, and then an orthodontic bracket with a chain attached is glued to the surface of the impacted tooth.

Your Orthodontist is then able to exert gentle force on the impacted tooth via the chain allowing movement of the impacted tooth into its correct position in the oral cavity.

 


Fraenectomy/Tongue-tie   

Tongue -tie is a condition present at birth that restricts the tongue's range of motion. With tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth. A person who has tongue-tie might have difficulty sticking out his or her tongue. Tongue-tie can also affect the way a child eats, speaks and swallows, as well as interfere with breast-feeding. Sometimes tongue-tie may not cause any problems but then some cases may require a simple surgical procedure for correction known as a  lingual fraenectomy, which is the removal of a band of tissue, or lingual frenulum, that connects the underside of the tongue with the floor of the mouth.

 

Oral & Maxillofacial surgeons manage facial trauma including fractures to the mandible (lower jaw), maxilla (upper jaw), zygoma (cheek bone) and orbit (eye socket). These injuries may be the result of assaults, falls, sporting injuries or road accidents.  

Following an incident or accident, patients with facial injuries will usually present to their local hospital emergency department, or GP/medical centre where Xrays or CAT scans are arranged to diagnose a facial fracture.  Our practice is trained in the diagnosis and management of all types of facial fractures, so when treatment is recommended we will discuss the surgical options and anticipated outcomes, hospital admission, risks, side effects and recovery times. Sometimes the fracture may be ‘undisplaced’ and may not require surgical intervention, but care and monitoring for several weeks. Any associated visual disturbances will need to be assessed and so a referral to an Opthalmologist may also be required in these cases.

Orthognathic surgery may also be known as corrective jaw, or facial, surgery. Orthognathic surgery addresses conditions, or  jaw deformity, that may be due to either developmental or traumatic factors and primarily aims to improve the relationship between the upper and lower jaw.  

Such conditions may present as jaw overdevelopment, underdevelopment or facial asymmetry. This can sometimes contribute to problems chewing, breathing (obstructive sleep apnoea), swallowing or cause pain.

Surgery may be on the upper or lower jaw (single jaw surgery) or both jaws (bimaxillary surgery). It involves carefully placed cuts in the bone, known as an osteotomy. The most common osteotomy performed on the lower jaw is the bilateral sagittal split osteotomy. The most common on the upper jaw, is the Le Fort I osteotomy. An osteotomy moving the chin alone, is known as a genioplasty.

Orthognathic surgery is always carried out in conjunction with orthodontic treatment and is part of a treatment regime designed to achieve a balance between the cosmetic appearance of the jaws, facial bones  and a functional occlusion (bite).

You will require a referral from your orthodontist whom we will liaise with throughout your treatment. At the time of consultation,  a clinical examination to determine the problems you are experiencing, or may experience, as a result of your jaw deformity will be performed, along with viewing X-rays, Photographs, Dental models and any computer imaging. Dr Curtis will then discuss the diagnosis, treatment options and treatment plan.

Prior to undertaking any surgery you will be fully informed of all aspects of your treatment, including item numbers, surgical fees and risks associated with your proposed orthognathic surgery. The surgery is carried out in hospital under a general anaesthetic and involves a stay of approximately 2-5 days. All aspects of this are discussed with you before surgery. The duration of surgery and the period off work vary with the complexity of the surgery.

If you are privately insured we advise you check with your private health insurance provider if your level of cover will provide a rebate for this type of surgery. Although this surgery is not cosmetic in nature and is to correct a functional and growth abnormality, it should be covered by Medicare under the specialty of Oral & Maxillofacial Surgery. Cosmetic cases such as ‘facial augmentation’ are not covered by Medicare rebates.

Dental Implant Surgery is usually performed in 2 stages. Stage I involves the placement of the implant itself, followed by 4-6 months of healing to allow the jaw bone to ‘anchor’ to the implant. Stage II is a short procedure to expose the implant and attach a connector piece, known as an ‘abutment’. You are then referred back to your dentist or prosthodontist who then proceeds with the crown placement.

More complex surgery may involve bone grafting or the placement of more than one implant and is usually carried out as a day stay procedure under a general anaesthetic in a private hospital. Patients need to be in good overall health, have healthy gums and sufficient bone to help support an implant. Dental Implants aren’t necessarily for everyone and so your Surgeon will assess your suitability for this type of treatment.

Generally, the success rate of dental implants is more than 90% (and may reduce to approximately 80% if bone grafts are done or if there is low bone density). There is a risk that implants may not “take” or fuse to your bone. This is disappointing for everyone, but there is often the ability to try again after the bone has had time to heal. Most of the time, implant failure will be noted early, and within the 3 to 6 months healing period, but also may fail months or years later. This often occurs due to gum disease called peri-implantitis  and so you will need to maintain the implant with a high level of oral hygiene and regular check-ups with your dentist avoid this complication.

A prosthesis is an object used to replace natural tissue, such as a denture, a bridge or a crown. Pre-prosthetic surgery is a procedure used to improve the shape of hard or soft tissues of the oral cavity to allow for a better fabrication and fitting of the prosthesis.         

The most common type of pre-prosthetic surgery is removal of excessive soft tissue that has formed in association with a poorly fitting denture. Removal of the excessive soft tissue allows a new denture to be constructed with improved comfort and stability.

Some people have problems with the shape of their jaw bone and so fitting a denture without the removal of a bone lump would cause issues with mouth ulcers and pain when wearing the denture. The most common places to have excessive bone are in the midline of the hard palate and on the tongue and side of the lower jaw. These bone lumps are referred to as a torus.

We are a referral based surgical practice specialising in Oral & Maxillofacial Surgery (OMS), and have been serving the Central Coast community for over 20 years. An initial consultation is required prior to any surgical treatment.

Then, according to your needs, our doctors can provide procedures under local anaesthetics in our rooms (Gosford or Macquarie Street, Sydney), or can also provide treatment under general anaesthesia in a number of fully accredited Private Hospitals across the Central Coast, Northern Beaches and Sydney regions.

About Us

Our Central Coast rooms are located in the heart of Gosford, close to public transport and with our own onsite parking and level wheel chair access. Our practice is led by three highly experienced and dedicated practitioners, Dr Nigel Curtis, Dr Stephen Cox and Dr Ying Shi Chang who are supported by a friendly, professional and empathetic reception and clinical team.

Our practice is committed to  providing the  highest quality patient care whilst at all times respecting your individual needs and privacy.

Our Services

  • Wisdom Teeth removal
  • Dentoalveolar Surgery
  • Temporomandibular Joint (TMJ) Disorders
  • Facial fractures
  • Oral Pathology
  • Dental Implants
  • Orthognathic (corrective jaw) Surgery