Dr. Mohammad Emranul Islam
Oral and Maxillofacial Surgery
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had an accident, and I fell from my scooter two months ago. After first aid, the doctor prescribed painkillers and antibiotics. A few days later, I also met an ENT surgeon, and he concluded after an X-ray that there was no fracture to be seen. Later after 20 days, I had pain in my upper jaw, so I went to visit a dentist. The dentist told me to have an OPG X-ray done. The OPG showed a fracture, and the dentist asked me to consult a better doctor. After that, unfortunately, my grandfather passed away, and I had to wait for a few more days before meeting another dentist. The next dentist said that it was already late, and also he mentioned that nerve involvement was also seen. He also checked the orientation of the teeth and told me to avoid surgery and have a semi-liquid diet with minimal use of the jaw in speaking and told me that hopefully, it would heal on its own after callus formation. After two days, we consulted another doctor, and he told to have surgery while my friend consulted a doctor with my reports, and he asked me to avoid any surgery. Currently, I do not have pain. But, my premolar and molar teeth are in position, touching one another from the upper and lower jaw, but my front teeth are not in occlusion. Please give me a clear idea of what to do. Should I get any surgery, or should I not?
I am attaching three pictures with different lower jaw movements. Kindly refer and help me.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query, and I can understand your concern.
The OPG (orthopantomogram) reveals a fracture on the right angle region involving the impacted wisdom tooth. The clinical picture shows that you have an improper and abnormal bite (attachments removed to protect the patient's identity).
I suggest you go for the surgery by open reduction and mini plating. The wisdom tooth also needs to be removed. You should consult with a maxillofacial surgeon instead of a general dentist. There is no other way to correct the bite. And do not fear it. The situation will get worse if you do not do any treatment. It will stress your jaw joints and may develop painful joints later. And there are chances of developing an infection on the affected site. It has been two months since the trauma, and it is not too late yet. But definitely, the surgery will be more complicated than a fresh case.
Do you have any numbness on the right side of the lower lip? If it is, then you should mention it to the maxillofacial surgeon.
Please let me know if you have any other questions.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. As of now, there is no numbness in my lower lips. One doctor said to avoid the surgery as nerves might be involved in the fractured site, and if something goes wrong, numbness will develop in the lips and hands. And this makes me anxious. Could you please tell me the approximate cost of this surgery?
Thank you.
Hello,
Welcome back to icliniq.com.
I am not sure why the doctor said so. I suggest you take advice from a maxillofacial surgeon.
The nerve is not so weak, and it has elasticity. And the tooth also might have to be removed. Screw and plates will be fixed below the nerve, close to the lower border. There are lots of more critical and complicated surgeries going on. It is not a very difficult case, but it can be difficult if you make a delay. More complications may arise, including infection and joint pain.
The cost can vary largely depending on the surgeon's experience and the type of hospital. You can also visit any government hospital for cheaper options and talk to a maxillofacial surgeon.
Please let me know if you have any other queries.
Thank you.
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Oral and Maxillofacial Surgery
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