Oral Surgery: What should I expect at my initial consultation?

The prospect of oral surgery can be intimidating to many patients, but knowing what to expect throughout the treatment process can help to ease any fears or anxieties that arise. For example, if you realize that your initial consultation is unlikely to involve much more than a visual examination and x-rays, then you can approach that appointment with a more positive attitude.

The best oral surgeon will also take advantage of that first appointment to begin to establish a productive working relationship with the patient, and that can also be important in achieving the desired treatment outcomes.

Patients may see an oral surgeon for any number of reasons, including corrective jaw surgery to repair a congenital defect or damage done by trauma, wisdom tooth extraction, or to have suspicious tissue removed and biopsied. Oral surgeons can provide interventions for conditions as varied as sleep apnea and temporomandibular joint (TMJ) disorders that can have a negative effect on your health and well-being.

Regardless of the specific nature of your treatment, your oral surgeon will begin treatment planning at the initial consultation by collecting a significant amount of data that will be needed to inform your treatment plan. The surgeon will visually inspect your jaws and take x-rays.

The surgeon may also discuss pre-operative and post-operative instructions with you the first time that you come to the office. It’s important to be sure that you understand these directions to reduce your chances of complications with the surgery and increase the likelihood that you’ll have an uneventful recovery.

The initial consultation also gives you the opportunity to discuss any concerns that you may have and get answers to your questions. Feel free to ask the surgeon anything. No question is too minor or silly.

If you are in need of oral surgery, your first appointment is unlikely to cause you any physical discomfort. In fact, it can actually help to set the stage for a positive treatment experience. 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