Oral / Maxillofacial / Craniofacial Surgery

Various conditions originating in the mouth, jaws and related structures: TMJ, salivary glands, facial muscles and perioral skin.

A minor surgical procedure to confirm the clinical finding and establish a correct treatment strategy.

Frequently wisdom teeth are not erupting due to their position or tooth/jaw size discrepancy. In some cases orthodontic abnormality may be the reason. In both instances surgical intervention is required.

Lost teeth can be safely and predictably replaced with dental implants to restore oral function and aesthetics. 

Sinus lift or maxillary sinus floor augmentation is a surgical procedure to increase the amount of bone in the upper jaw, between molars and premolars, by lifting the membrane and placing a bone graft. Bone grafting can be also done in the other areas to replace a missing bone or repair bone fractures.

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are natural, autologous (obtained from the patient) substances which greatly improve the outcome of surgery. These biologic materials contain concentrated growth factors, infection fighting substances as well as anti-inflammatory molecules which greatly enhance the healing capacity at the operated site.

Jaw bones may be insufficient in volume for reconstruction due to trauma or atrophy. In these cases, ridge augmentation is performed to transplant the bone or enhance the anatomy.

Apicoectomy is necessary in cases of periapical pathology due to a failed root-canal treatment. In some cases it is possible to alleviate the condition and preserve the tooth by removing the affected/infected tip of the root and occluding the affected root canal.

If the inferior alveolar nerve is close to the ridge of the
lower jaw and patient requires dental implants the nerve can be surgically manipulated and safely retracted from the dental implant path.

Sometimes the nerves in the maxillofacial region may be
damaged due to trauma, disease or surgical intervention. In these cases, these may be reconstructed through a variety of procedures depending on the affected nerve.

Different procedures are performed to preserve or regenerate the bone from the alveolar defect after tooth extraction.

Some babies are born with a “tongue tie” with interferes with their feeding and later may affect the speech.

Ankyloglossia is a simple surgical procedure to correct this condition.

After numerous maxillofacial surgical procedures, such as dental implants, removal of teeth or traumatic events, patients are rendered numb because of the damage to their nerves. This protective function can be restored through nerve grafting procedures. Dr. Anastassov has an extensive experience in nerve reconstruction.

Sleep and breathing disorders affect large part of the population. Sleep apnea syndrome is one of the most devastating conditions, which may lead to daytime somnolence, cardiovascular abnormalities and decreased quality of life.

Surgical interventions for the condition are most effective for lasting results in decreasing the severity of the condition.

Abnormalities in the craniofacial skeleton may be congenital or acquired, varying in the cause and severity. They can be successfully addressed via craniofacial interventions.  

The aetiology of fractures of the craniofacial sekeleton is diverse: falls, accidents, interpersonal violence, military injuries, etc. These are usually repaired in the acute phase once the patient has been stabilized and there are no other medical priorities to be addressed.

In cases, when the initial reconstruction was not possible or there are secondary deformities present, the sequelae of these injuries are addressed later.

There are multiple congenital isolated or syndromic craniofacial deformities requiring reconstruction. These are usually addressed at an early stage.

These conditions have to be addressed on time or they will lead to severe deformities which are more difficult to correct later in life. They may also lead to functional abnormalities such as blindness, breathing difficulties, etc.

A corrective surgery to address conditions of the jaw, that cannot be treated only with orthodontic procedures.

These conditions can be elegantly corrected through a surgical repositioning of the jaws.

In some cases the surgery is performed by an oral surgeon in collaboration with an orthodontist.

Temporomandibular joint is an extremely complex double articulation which may be affected by a host of conditions, such as rheumatoid arthritis, juvenile arthritis, osteoarthritis, clenching, grinding etc.

Interventions may be conservative or surgical and depend on the causes for the condition.

Chronic disease in the maxillary sinus, which is resistant to minimally invasive intervention, foreign bodies in the sinus or oral-antral communications require debridement of the sinus and re-establishement of a new nasal drainage mechanism.

Gradual lengthening of the bones and stretching of the surrounding soft tissues is recommended when the jaw-size discrepancies are severe, the overlying soft tissue envelope insufficient and/or a surgical intervention carries a risk for relapse.

Cleft Lip and Palate are the most common craniofacial congenital abnormality. It can affect the lip, palate and be one or two side. The severity of the deformity varies widely as well. Usually, these deformities are repaired at 3 months of age for the lip, nose and alveolus (gingiva-periosteoplasty) and, between 6 and 9 months for the soft and hard palate. The first surgical interventions are the most critical. Often, we see patients where the initial repair was not adequate. In these cases, secondary interventions are necessary.

Certain congenital and post-traumatic situations affect medial part of the orbit, the normally acute angle of the eye is blunted and needs reconstruction. This is accomplished via medial canthoplasty and/or epicanthoplasty. Later canthoplexy/canthoplasty is performed if the lateral corner of the eye is malposition.

The consequences of ablative surgery can be devastating to the patient and their family. Reconstructive techniques have significantly advanced in the last 20-25 years and can offer adequate normalization of form and function to these patients.