Conditions Treated by an Oral and Maxillofacial Surgeon

Many patients first encounter an oral surgeon when it’s time to have their wisdom teeth removed, but oral and maxillofacial surgeons are qualified to do many procedures beyond surgical extractions. They can repair deficiencies or deformities in various facial structures, and treat discomfort and even sleep problems that can arise from malocclusions.

All oral surgeons must complete a residency after graduating from dental school. This extensive specialized education experience gives them extensive knowledge of the many facial structures that must work in concert to facilitate proper jaw movement.

Patients may choose the best oral surgeon to complete one of the following procedures or interventions:

  • Orthognathic surgery – Corrective jaw surgery can significantly improve a patient’s appearance and address malocclusions that can prevent a patient from chewing effectively and in some cases cause discomfort.
  • Cleft lip and palate surgery – A cleft lip or palate is a serious deformity that can have long-lasting effects on a patient’s appearance and well-being. An oral surgeon can correct a cleft through a series of surgeries that often begin during the first year of a child’s life.
  • Craniofacial surgery – This collection of procedures may target deformities in any of the facial structures, including the forehead, cheeks, orbits and nasal structures, in addition to the jaw.
  • Obstructive sleep apnea treatment – Sleep apnea treatment may not necessarily involve a surgical procedure. Our oral surgeon may instead design an appliance to hold the jaw in a certain position during sleep.
  • Temporomandibular joint (TMJ) disorders – When any of the jaw’s multiple components are out of sync, it can lead to a painful TMJ disorder. An oral surgeon may be involved in treatment of this condition to ease patients’ symptoms.

Many patients are apprehensive when faced with the prospect of oral surgery, but a skilled oral surgeon and support team will make sure that the patient is thoroughly educated on what to expect from the procedure in advance. Oral surgeons also have numerous strategies for ensuring maximum patient comfort during the surgery.

If you have questions or would like to schedule an appointment, please contact Dr. Larry Wolford’s office using our online contact form or call 214-828-9115.

Condylar hyperplasia (CH) is a generic term describing enlargement of the condyle.  There are a number of different condylar pathologies that enlarge the mandibular condyle, with subsequent adverse effects on the morphology and function of the TMJ and mandible.  This may result in the development or worsening of a dentofacial deformity such as; mandibular prognathism (symmetric or asymmetric), and unilateral enlargement of the condyle, ramus, and body, facial asymmetry and malocclusion. 

Wolford has developed a simple, but encompassing classification that will allow the clinician to better understand the nature of the various CH pathologies, progression, and treatment options that have proven to eliminate the pathological process and provide optimal functional and esthetic outcomes.  The classification (Table 2 and Figure 29) also begins with the most common occurring form of CH and progresses to the least common occurring form.

CH Type 1:  This condition develops during puberty, is an accelerated and prolonged growth aberration of the normal condylar growth mechanism, is self-limiting but can grow into the 20’s, and can occur bilaterally (CH Type 1A) or unilaterally (CH Type 1B).

CH Type 2:  These condylar pathologies can develop at any age (although 2/3s develop in the 2nd decade), are unilateral condylar vertical and/or horizontal over-growth deformities, and are the most common occurring mandibular condylar tumors; osteochondroma (CH Type 2A) and less common osteoma (CH Type 2B).

CH Type 3:  These are other rare benign causing condylar enlargement. 

CH Type 4:  These are malignant conditions that can cause condylar enlargement.

The more common forms of CH (Types 1 and 2) will be presented relative to the clinical and radiographic findings, growth characteristics, effects on the jaws and facial structures, histology, and treatment considerations that are highly predictable in the elimination of the pathology and provide optimal treatment outcomes. 

FIGURE 29 Description

A-C) normal TMJ with balanced joint spaces.
D-F) CH Type 1 with relatively normal condylar shape, elongated condylar head and neck, and narrow joint space related to thin articular disc or displaced disc.  In the coronal view the condylar head is more rounded.
G-I) CH Type 2Av; an osteochondroma with a vertical growth vector without significant horizontal condylar enlargement or exophytic horizontal growth. This is a “young” osteochondroma with only about 3 years of growth.
J-L) CH Type 2Ah; an osteochondroma with horizontal (as well as vertical) enlargement of the condyle and exophytic outgrowth of the tumor. This tumor has been present for 6 years. Notice the significant increased vertical height of the mandibular body and ramus.

FIGURE 29