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Oral Surgery

Oral Pathology | Bone Grafting | Orthognathic Surgery | Wisdom Teeth | TMJ Disorders

Oral Pathology


Because the inside of the mouth is normally lined with a special type of skin (mucosa) which is smooth and pink in color, changes can easily be seen,
and oral cancer can be detected in the early stages.
Performing self-examinations regularly will help in early detection of pathologic processes. Ideally, self-examinations should be done once a month.
If you are a smoker, drinker, or a user of smokeless tobacco, you are at higher risk of oral cancer and should see an oral surgeon for an exam.

The following can be signs of a pathologic process or cancerous growth:

  • Reddish patches
  • Whitish patches
  • A sore that fails to heal and bleeds easily
  • A lump or thickening of tissue
  • Chronic sore throat, hoarseness
  • Difficulty chewing and swallowing

Pain does not always occur with pathology and is often not associated with oral cancer. However, if you experience pain without an obvious cause,
you may be at risk for oral cancer.

Please contact us for an appointment so that we may schedule an oral examination.

Bone Grafting


Bone Grafting is a surgical procedure in which new bone is grown to replace the missing bone needed to support implants.
After tooth loss occurs, over time the jawbone around the missing tooth atrophies or is reabsorbed.
The bone is left in a condition unsuitable for the insertion of dental implants.
This procedure gives the opportunity to use implants of the proper length and width, and to restore esthetics and functionality.

Orthognathic Surgery


Orthognathic surgery is also known as corrective jaw surgery.
It is used to treat a variety of facial and jaw abnormalities in which the facial bones and teeth are not correctly developed.
This results in difficulty with chewing, speech, and jaw function. In many cases, the facial appearance is affected by this problem.
Orthognathic means "straight jaws", and orthognathic surgery corrects these jaw and facial deformities, usually in conjunction with an orthodontist,
so that after the jaws are corrected, the teeth will come together properly.

Orthognathic surgery is needed when jaws don't meet correctly and/or teeth don't seem to fit with jaws.
Teeth are straightened with orthodontics and corrective jaw surgery repositions misaligned jaws.
This not only improves facial appearance, but also ensures that teeth meet correctly and function properly.

Who Needs Orthognathic Surgery? People who can benefit from orthognathic surgery include those with an improper bite or jaws that are positioned incorrectly.

Jaw growth is a gradual process and, in some instances, the upper and lower jaws may grow at different rates.
The result can be a host of problems that can affect chewing function, speech, long-term oral health and appearance.

Injury to the jaw and birth defects can also affect jaw alignment. Orthodontics alone can correct bite problems when only the teeth are involved.
Orthognathic surgery may be required when the jaws need repositioning.

Difficulty in the following areas should be evaluated:

  • difficulty in chewing, biting or swallowing
  • speech problems
  • chronic jaw or TMJ pain
  • open bite
  • protruding jaw
  • breathing problems

Any of these can exist at birth or may be acquired after birth as a result of hereditary or environmental influences or the result of trauma to the face.
Before any treatment begins, a consultation will be held to perform a complete examination with x-rays.
During the pre-treatment consultation process, feel free to ask any questions that you have regarding your treatment.
When you are fully informed about the aspects of your care, you and your dental team will make the decision to proceed with treatment together.

Sometimes, braces alone can correct a problem with the bite, but when it is severe, usually orthognathic surgery is required.
Abnormal jaw and facial development can be genetic or acquired due to disease or injury.
When the jaws are not properly developed or proportioned, problems such as difficulty chewing, jaw and facial pain,
speech abnormalities and dental problems can result.
Using sophisticated surgical techniques, the facial bones can be repositioned in order to restore proper function and facial appearance.


 In the past, thin wires were used to support the bones in the new positions,
but because this was not stable, the patient also had to endure periods of 6 to 12 weeks
of "intermaxillary fixation," or having their teeth and jaws wired together.
Not only was this uncomfortable,
but oral hygiene was difficult and post-operative weight loss was a problem.

   wires.JPG (49915 bytes)

Today, miniature titanium plates and screws are used to fixate the facial bones in their
new relationship. This is much more comfortable for the patient,
but it is also more stable and predictable.  


plates.JPG (43560 bytes)
screws.JPG (35155 bytes)


This, in combination with new instruments and anesthetic techniques, has allowed orthognathic surgery to be safer and more effective,
and is much easier for the patient to undergo.
New advances in orthodontics have also allowed the total treatment times to be shortened.
We also use the latest in digital imaging technology, which allows for computerized treatment planning,
and visualization of the anticipated surgical changes to the patient's facial appearance.
This helps the patient understand both the functional and esthetic benefits of the procedure.

In addition, some patients may decide to have other cosmetic procedures done in conjunction with orthognathic surgery to further
enhance their facial appearance.
These include procedures to the chin, cheeks, eyes, nose, neck and facial skin.


If the upper jaw is in normal position, but the lower jaw is retruded, the lower jaw is brought forward to its proper position. Small screws hold the bones in their new positions. 

  retro.JPG (28757 bytes)    adv.JPG (32863 bytes) 

Sometimes, the problem is in both the upper and lower jaws. Here, the upper jaw is brought down and forwards, and the lower jaw is moved back. A combination of plates and screws stabilize the surgical result. 

   prog.JPG (29477 bytes)    sb2jaw.JPG (32597 bytes)

Orthognathic surgery is performed in the hospital or outpatient surgical center. Patients generally stay in the hospital 1-2 nights,
depending on the extent of surgery done.
Most patients state that the post-operative discomfort is much less than they were expecting. Almost all patients agree that they are happy
with the results and would go through the surgery again, without hesitation.
The improvement in jaw function and facial appearance is remarkable. Most patients experience a great improvement in their self-confidence
and quality of life after orthognathic surgery.

Wisdom Teeth

What are wisdom teeth?

Wisdom teeth, also known as the third molars, are the last set of teeth to develop.
The third molars usually grow in at around age 17 to 20. Since this is considered the age when teens become wiser,
the third molars have adopted the nickname, "wisdom teeth".

Why should I remove my wisdom teeth?

Sometimes when the third molars emerge, the jaw has enough room, but most of the time, space is limited.
Usually, one or more of these teeth emerge out of alignment or fail to fully emerge, in which case they become "impacted",
or trapped between the bone and the gum line.
Impacted wisdom teeth can cause many problems, including pain, swelling, and infection of the gum.
Impacted teeth can also cause permanent damage to the gum and nearby teeth, and can lead to the formation of cysts or tumors.            
Therefore, the removal of impacted wisdom teeth is recommended.

What treatment options are available?

If one or more of your wisdom teeth are likely to cause problems, early removal is often recommend.


TMJ Disorders


What is TMJ?

The TM (Temporomadibular) joint is one of the most complex joints in the body, combining rotational and translation movements when chewing and speaking.
Located on each side of the head, the TM joint is a ball-and-socket joint located where the upper and lower jaws meet.
When the joint is properly aligned, smooth muscle action such as speaking, talking, and chewing can take place.
When they are not aligned, several problems may occur.

What is Temporomandibular Disorder (TMD)?

Temporomandibular disorders are disorders of the jaw muscles, TM joints, and/or nerves associated to chronic facial pain.
TMD is primarily caused by excessive strain on the muscle group that controls chewing, swallowing, and speech.
This strain may be a result of bruxism, severe clenching of the teeth, or other physical and mental strain.

What are the symptoms of TMD?

  • Jaw pain and/or stiffness
  • Headaches, usually around the temple
  • Sensitive teeth
  • Locking of the jaw
  • Clenching and grinding of teeth
  • Clicking and/or popping of the jaw
  • Dizziness
  • Ringing in the ear and earaches
  • Limited mouth mobility

Treatment Options

Every person with TMD is different. Our specialists will tailor a treatment plan to your specific needs.
If you have experienced any of these symptoms please call our office to set up an examination.

"The contents of our website, such as text, graphics, images, information and other materials are for informational purposes only.
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Always seek the advice of your dentist or other qualified health provider with any questions you may have regarding a dental or medical condition."

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Professional Affiliations
Dental Specialty Partners of New England are proud to be affiliated with the following organizations: