SEATTLE JAW SURGERY

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Do you need to replace an entire row of teeth? In many cases our doctors at Seattle Jaw Surgery can replace an entire row of teeth in one surgical appointment. There are several ways to replace your teeth and each situation is different. Some options allow for a removable denture that is held more tightly in place by dental implants. Other options allow for a denture that is permanently fixed to the dental implants and can be removed for cleaning by a dental professional. Learning about the best option for your individual case starts with a consultation appointment with one of our doctors at Seattle Jaw Surgery. Once a method for replacement of your teeth is established, we will obtain a CT scan of your dental arches and a digital impression of your teeth. This data is used to plan for and make your new dentures. After the planning phase you are ready for surgery. Often your teeth can be removed, implants placed, and a temporary set of dentures inserted all in the same appointment.

What are my options for replacing a full arch of teeth?

It is important to realize that the following options will not work for all patients.  Each treatment plan is custom tailored to the specific situation.  With that in mind the general categories for full arch replacement are as follows.

  1. Single implants for each tooth
    There are some advantages to this option.  With implants for every tooth there is good implant stability and preservation of your bone.  In select situations this option may be used.  The disadvantages include increased surgical time and increased cost.  For most cases, another option will provide a very good restoration at a reduced cost.

  2. Removable implant overdenture
    For this option, most commonly two or four implants are placed in each arch that is to be replaced.  A denture is then made with special attachments that allow it to snap in and out of the implants.  The denture is removable much like a standard denture, the implants help to provide additional retention and stability.

  3. All on four fixed complete denture
    The all on four procedure, also know as teeth in a day is an excellent option for full arch replacement for many patients.   This procedure most commonly involves the placement of four implants, however there are situations where more implants are required.  Often a temporary denture can be secured to the implants on the day of your procedure resulting in new teeth in a single day.  The denture is held to the implants using screws and can be removed by your dentist from time to time for cleaning.

Replacing teeth with implants and dentures is possible for many patients. Implants can be placed on an angle permitting use even in patients with significant bone loss. This also minimizes the need for bone grafting. If you would like to explore your options, contact our office for a consultation with one of our doctors.

The specifics of what to expect with be discussed at the consult appointment. Often sedation is used during the surgery. If this is the case, you will have to refrain from eating or drinking after midnight the night before your procedure. The duration of the surgery varies from about one hour to a few hours.

Yes. You will be on a soft diet for several weeks after surgery. It is also very important to keep the surgical area clean. You will be prescribed medications. These medications vary but often antibiotics and pain medication are prescribed. Your doctor will go over the specific instructions for medications on the day of surgery. Any questions that you may have will also be answered on the day of your surgery.

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There are several pathologic processes that can be associated with the soft tissue, teeth, and bones of the mouth.  Thankfully, many of these processes are benign.  If you or your dentist notice changes to the soft tissue in your mouth or something abnormal on x-ray, evaluation for a biopsy should be considered.  If biopsy is performed your oral surgeon may remove the entire lesion or just a portion depending on size and location.  The results of your biopsy will determine what further treatment is indicated, if any.  Malignant processes such as squamous cell carcinoma can also appear in the oral cavity.  Biopsy of any suspicious lesion should be completed in a timely manner so that a definitive treatment plan can be rapidly developed.  When a diagnosis comes back positive for malignancy, a referral to a head and neck cancer surgeon will likely be made.

Depending on the location and size of your lesion, your procedure may be completed with local anesthesia or sedation.  There are many factors that contribute to this decision and the type of anesthesia is determined on a case by case basis.  

Your surgery may involve complete removal of your lesion or taking a small sample of the lesion to send to a pathologist for a diagnosis.  After a diagnosis is made, a final treatment plan is formulated.

The treatment for pathology varies greatly based on diagnosis and so does the recovery process.  You will be given post-operative instructions on the day of your appointment and a general idea of what to expect can be determined at your consultation.

Our goal is always to preserve teeth but there are circumstances where it is just not possible to save a tooth.  If you need to have a tooth or multiple teeth removed, our doctors will guide you through the process in the most comfortable way possible.  We will work with your restorative dentist to formulate the best plan to replace the newly missing tooth (see here for more on implants).  Ever situation is different, and your tailored treatment plan will be discussed at the consultation appointment. 

The removal of your tooth or teeth may be done with local anesthesia, much like you would expect during a filling or under sedation. The type of anesthesia used will be discussed during your consultation appointment.  Our primary concern is for your safety and to make the procedure and comfortable as possible.  Once the teeth are removed gauze will be placed in your mouth to apply pressure at the surgical site.  Depending on the situation, your gums may be closed with a stitch.  

If local anesthesia was used for your extraction, then you are able to drive yourself home right away. However, if you are sedated for the surgery, you will need a responsible driver to take you home.

Yes. It is strongly recommended that you:

  • Avoid sucking through a straw for the first several days after extraction
  • Keep the extraction site clean and free of debris for the first couple of weeks after extraction
  • Take all medications exactly as prescribed by your surgeon
  • Notify your surgeon if you experience fever or discomfort that worsens after a few days

After wisdom teeth, the canine teeth are the next most common teeth to be impacted. The treatment for this condition varies and is often determined by your orthodontist. In some cases, the canine tooth may need to be removed. In other cases when there is space the tooth will need to be surgically exposed. An orthodontic bracket can be bonded to the tooth and a chain connected to the bracket will allow your orthodontist to aid in its eruption.

This procedure is most commonly completed under sedation in the office. After you are asleep the tooth is accessed surgically.  An orthodontic bracket is bonded to the tooth and an attached chain is secured to your braces with a wire or stitch.  Any incisions are closed with stitched that do not have to be removed.  Later, your orthodontist with put traction on the tooth to help it erupt.

It is common to have a small amount of swelling and soreness in your mouth after this procedure.  These will begin to improve after about three days in most cases.  You may be prescribed medications and should take them exactly as they are written.  Your oral surgeon will recommend eating only soft foods during the first several days following your procedure.  It is also important to follow all instructions for post-surgical care, including cleaning the surgical site.  Be sure to contact your surgeon if you experience any fever or discomfort that worsens after about three days.

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Traditionally, if your orthodontist suspects that you may need jaw surgery you will be referred for a jaw surgery consultation prior to the initiation of your orthodontic treatment.   At that time we will discuss the surgical options that are available and the typical timeline.  After your consultation with our office your orthodontist will begin your orthodontic treatment.  Keep in mind that you will typically be in braces for 6 months to 2 years prior to your jaw surgery.  When you are ready for surgery your orthodontist will notify you and our office.  We will see you in clinic 2-3 months prior to your planned surgical date to be sure that we are ready for your surgery.  You will be seen in our clinic one additional time 2-3 weeks prior to surgery for your pre-operative appointment.  After your surgery is completed you can expect to spend one night in the hospital.  Typically patients are discharged home the day after surgery.  We will then see you for follow up appointments at 1 week, 3 weeks, 6 weeks and 6 months.  About six weeks after your surgery your orthodontist will see you and begin the final stages of your orthodontic treatment to fine tune your teeth.

 

 

Joint replacement is a commonly performed surgical procedure. Each year in America, hundreds of thousands of knees, hips, and shoulders are replaced. For the temporomandibular joint (TMJ), it is more unusual. Many patients can benefit from the procedure. For TMJ, replacement is useful for patients with severe arthritis, severely limited mouth opening (ankylosis), joint tumors, trauma, infection, or failed previous devices.


Many times, issues with the joint can influence the overall function of the entire lower jaw. The goal for TMJ replacement is to restore function of the jaw joints. Replacing the TMJ can help reduce pain, improve mouth opening, make your upper airway bigger, correct a poor occlusion, and improve facial balance. Overall, our focus is to allow patients to improve their quality of life.


Dr. Bobek is known in the Pacific Northwest for his surgical expertise with TMJ joint replacement. He uses TMJ Concepts which fabricates custom titanium joints based on the patient’s actual anatomy. This allows for a customized and precise surgical planning with positive patient outcomes.


Recovery after joint replacement can take several weeks to months. After surgery, patients will spend 1-2 nights in the hospital and are followed in clinic with post-operative appointments at 1, 3 and 6 weeks. Patients start TMJ physical therapy about 2 weeks after surgery. At this time, they can generally return to work and begin many normal jaw functions. Given the core functions that the TMJ supports, we generally estimate that it takes 6 months before patients stabilize into their new normal state following joint replacement.

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