Maxillofacial surgery in israel

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PROF. NARDI CASAP-CASPI

Head of the Maxillofacial Surgery Department

For the cancer treatment, as well as the preservation and restoration of aesthetic appearance, speech, swallowing function and the ability to eat normally, the Maxillofacial Surgery Department of the Israeli Hadassah hospital uses the most advanced and exclusive methods and technologies of maxillofacial surgery.

For example, in 2018, the doctors of the Hadassah clinic created a unique method of endoscopic laser lithotripsy in the salivary glands, which made it possible to remove large stones without incisions. With the help of the latest laser devices the clinic also successfully removes tumors, treats periodontitis and caries..

The doctors of the department prefer modern minimally invasive methods and, if the patient’s condition allows it, they try to replace traditional large-scale surgeries with them. Complex interventions are carried out in an innovative underground operating complex, the equipment of which has no analogues in Israel. Jaw prosthetics and many other surgery types in maxillofacial surgery are controlled by usage of a special CT device, which uses ASIR software, which allows to reduce the radiation level by 50% without losing image quality.

To make an appointment for a remote consultation with a leading Israeli specialist in maxillofacial surgery or for more detailed information about the treatment, please contact our staff.

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Treatment in the Maxillofacial Surgery Department: Major Diseases

  • Inflammatory diseases
  • Malignant and benign tumors
  • Birth defects
  • Salivary glands diseases
  • Fractures and deformations of teeth
  • Facial bone fractures
  • Jaw fractures
  • Jaw cysts
  • Temporomandibular joint (TMJ) dysfunction and pain
  • Stopping breathing during sleep (apnea)

Maxillofacial surgery in Israel: surgery types

The Maxillofacial Surgery Department of the Hadassah Clinic is the oldest specialised medical institution in Israel. Its specialists have accumulated the largest experience in the country in carrying out all types of non-surgical and surgical treatment related to this branch of medicine. Among the main procedures are:

  • ocular prosthesis
  • nasal prosthetics
  • auricular prosthetics
  • placement of external facial prostheses
  • reconstruction of the oral cavity using modern intraoral prostheses and obturators
  • elevation of the sinuses
  • dental implantation
  • tooth extraction
  • palatine bone implantation
  • autogenous bone graft (Free graft)
  • vascularized bone grafts
  • maxillary sinus augmentation
  • special care for patients undergoing radiotherapy for the treatment of head and neck tumors
  • osteodistraction or distraction osteogenesis with the aim of:
    ✔ treatment (correction) of asymmetry in the development of facial bones using bone augmentation of the upper or lower jaw
    ✔ augmentation of the alveolar ridge to carry out reconstruction using dental implantation
    ✔ displacement of teeth out of place if conservative treatment was unsuccessful

Doctors of the Maxillofacial Surgery Department – leading specialists in Israel

 

Dental implantation in Israel: modern treatment methods

Dental implantation often requires the participation of not only dentists, but also experts in maxillofacial surgery. For example, if the patient does not have enough bone tissue to perform implantation, and it is necessary to increase the alveolar ridge.

In the Hadassah clinic, dental implantation is performed in a specialized center, which is part of the Oral Cavity Reconstruction Department and has been operating for more than 15 years. The doctors of the center use both classical treatment methods and the most modern technologies such as computer navigation. Due to these, dental implantation can be completed within one day in many cases including all examinations.

Each patient is provided with an individual approach and given maximum attention. A team of doctors, consisting of a leading specialist in maxillofacial surgery, a dentist and representatives of related fields of medicine engaged if needed, monitors the patient from the beginning of the treatment process until its completion.

Unique laser lithotripsy in the salivary glands

This state-of-the-art technology is a joint development of Dr. Michael Alterman, a leading specialist of the Maxillofacial Surgery Department, and Professor Mordechai Duvdevani, Head of the Lithotripsy Unit at the Urology Department.

The conventional method of endoscopic removal only removes stones less than 5 mm in size, since larger stones do not pass through the salivary ducts. In other cases, doctors were previously forced to undergo open surgery with incisions in the mouth or face, which was painful and often caused serious cosmetic damage.

The new technique helps to remove stones of any size without incision. With the help of an endoscope, specialists in maxillofacial surgery bring a thin dental tube to the stone, inside which there is a laser fiber only 200 microns (0.2 mm) thick. The laser crushes the stone literally to a state of dust, and then these fragments are painlessly removed through the salivary ducts. As a result, there is no damage to the facial skin or the mucous membrane of the mouth, the work of the salivary glands is not disturbed at all. The procedure is performed on an outpatient basis, does not require hospitalization and subsequent long-term rehabilitation.

To learn more about the advantages of the Hadassah Clinic in the field of maxillofacial surgery and the latest techniques, contact our consultants.

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Innovation in the Maxillofacial Surgery Department: augmentation of the jaw bones

The department carries out the most modern surgeries using the latest computerized equipment, such as distraction osteogenesis, which is used to treat facial asymmetry or uneven tooth growth. The method of distraction osteogenesis is based on the same principle as the lengthening of the leg bones using the Ilizarov methodа.

The procedure is carried out as following:

A specialist in maxillofacial surgery makes an incision inside the mouth of the jawbone at a pre-calculated angle so as not to damage the local blood flow. A special device is inserted into the incision, equipped with a screw to displace bone fragments. Then within 3-7 days the wound is allowed to heal. Then the device is activated. The optimum displacement speed is 1 mm. in a day. The entire treatment period takes 8 weeks. The advantages of such a gradual increase in bone are the ability to do this without implantation causing much trauma to the body and better adaptation of soft tissues to the new size of the bone.

Removal of tumors and restoration of the jaw

Doctors of the Maxillofacial Surgery Department of the clinic not only brilliantly remove malignant and benign tumors of the jaws, but also perform the most complex surgeries to reconstruct the oral cavity, allowing the patient to live a normal life.

The restoration of the jaws is performed by fixing the remaining bones using special stainless steel composites. Then the peroneal skin and bone graft is transplanted. A fragment of the fibula taken from the patient with the muscles and skin attached to it is attached to a metal plate and, using microvascular surgery, is attached to the neck vessels.

The subsequent rehabilitation is provided by a multidisciplinary team of specialists, consisting of oncologists, maxillofacial surgeons, psychologists, speech therapists and other experts.

Surgical treatment for sleep apnea (stopping breathing during sleep)

Weakening of muscles or excess soft tissue in various parts of the airways causes them to constrict and stop breathing during sleep, which leads to disruption of blood supply and can lead to a number of cardiovascular disorders or impaired brain function. The most common symptoms of this phenomenon are:

  • constant fatigue
  • headaches, especially in the morning hours
  • lack of concentration
  • frequent mood swings

There is a number of treatment types available to help widen the airway and get rid of this dangerous symptom, including jaw advancement performed in the Maxillofacial Surgery Department.

The surgery is performed inside the oral cavity, without external incisions, and lasts 4-6 hours. To fix the jaws, special screws and metal plates are used. To achieve an optimal result, it is necessary to move the lower jaw forward by at least 1 cm. Of course, this can disrupt the aesthetics of the patient’s face, but in more than 90% of cases, such a procedure significantly improves the life quality.

Before deciding on a large-scale surgical treatment, the specialists of the clinic try to solve the problem by changing the lifestyle and using special splints to fix the jaw while sleeping. Only if all other means do not bring the desired result and apnea causes significant harm to the patient’s health, he is referred for surgery in the Maxillofacial Surgery Department. Before treatment, the patient undergoes diagnostics in a special laboratory and a consultation with a pulmonologist.

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