Introduction to Oral & Maxillofacial Surgery

Oral and Maxillofacial Surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region.

Dr. Yarmand provides surgery services for the mouth such as tooth extraction and bone grafting.. Oral surgery might be recommended by your general dentist for a particularly complex tooth extraction or for the placement of dental implants.

Dr. Yarmand also provides treatment for maxillofacial problems such as deformities of the jaw. Maxillofacial procedures might be recommended for a range of difficulties due to problems of congenital, developmental, and traumatic origin.

A treatment plan for oral surgery frequently requires collaboration between Dr. Yarmand and your general dentist. A consultation and an evaluation of your needs will help Dr. Yarmand to create a treatment plan that will have you smiling again in no time.

The treatment goal for maxillofacial problems is the proper form and function of the mouth, upper and lower jaw. Patients undergo maxillofacial treatment in order to speak and eat without pain or difficulty.

Wisdom Teeth Removal

The educational material provided in this section gives you important information about your Wisdom Teeth (also known as Third Molars) reasons for their removal, possible problems associated with their removal and expectations about the post-removal experience.

  • What are Wisdom Teeth?
  • What Detrimental Effects can Wisdom Teeth Have?
  • So, Do I Really Have To Have Them Removed?
  • What is The Best Age To Have Them Removed?
  • What If I Don't Have Them Removed Now?
  • If I Decide to Do It, When Should I Have Them Removed?
  • What Happens On The Day They're Removed?
  • What Happens Afterwards and What Will I Feel Like?
  • Can There Be Any Problems?
  • What are Dry Sockets?
  • What Does It Cost and Will My Insurance Cover It?
  • What If I Have Questions Before Surgery?

Dental Implants

Dental implants are changing the way people live. They are designed to  provide a foundation for replacement teeth which look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything, knowing that teeth appear natural and that facial contours will be preserved. Patients with dental implants can smile with confidence.

  • What types of prostheses are available?
  • What are Dental Implants?
  • Why Dental Implants?
  • Are you a candidate for dental implants?
  • Why would you select dental implants over more traditional types of restorations?
  • What does the surgery involve?
  • Who actually performs the dental implant placement?
  • Do dental implants need special care? 

Bone Grafting

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants. Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance. 

Major Bone Grafting

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip or tibia (below the knee.) Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Major bone grafts are typically performed to repair defects of the jaws.
These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patient’s own bone. This bone is harvested from a number of different sites depending on the size of the defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia), are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

Sinus Lift Procedure

The maxillary sinuses are behind your cheeks and on top of the upper teeth. Sinuses are like empty rooms that have nothing in them. Some of the roots of the natural upper teeth extend up into the maxillary sinuses. When these upper teeth are removed, there is often just a thin wall of bone separating the maxillary sinus and the mouth. Dental implants need bone to hold them in place. When the sinus wall is very thin, it is impossible to place dental implants in this bone.

There is a solution is a procedure referred to as a sinus ugmentation or more commonly, a "sinus lift". The dental surgeon enters the sinus from where the upper teeth used to be. The sinus membrane is then lifted upward and donor bone is inserted into the floor of the sinus. Keep in mind that the floor of the sinus is the roof of the upper jaw. After several months of healing, the bone becomes part of the patient’s jaw and dental implants can be inserted and stabilized in this new sinus bone.  The sinus graft makes it possible for many patients to have dental implants when years ago there was no other option other than wearing loose dentures.

If enough bone between the upper jaw ridge and the bottom of the sinus is available to stabilize the implant well, sinus augmentations and implant placement can sometimes be performed as a single procedure. If not enough bone is available, the Sinus Augmentation will have to be performed first, then the graft will have to mature for several months, depending upon the type of graft material used. Once the graft has matured, the implants can be placed. 

In many cases, we can use allograft material to implement bone grafting for dental implants. This bone is prepared from cadavers and used to promote the patient’s own bone to grow into the repair site. It is quite effective and very safe. Synthetic materials can also be used to stimulate bone formation.  These surgeries are performed in the out-office surgical suite under IV sedation. After discharge, bed rest is recommended for one day and limited physical activity for one week.

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