Patient Services

Service is the cornerstone of our practice philosophy. At Santarelli & Tiboris Oral and Facial Surgery, we take great pride in our ability to provide patients with a multitude of surgical solutions to their oral and facial surgery and periodontal needs. Our specialists have trained for years and we are strong proponents of multidisciplinary care. What can we do for you?

Dental Implants

Complex Cases

Have you ever been told you aren’t a candidate for dental implants? Let our experts provide you with a solution. There is no substitution for the advanced training of the board certified specialists at STOFS. Creativity and innovation guide the therapy to make anyone eligible for implant therapy.

CT Guided Placement
CT Guided Surgery

Gone are the days of guesswork and approximation in implant dentistry. There simply is no excuse for avoiding the use of three-dimensional imaging to improve precision in surgery. At STOFS, we use the latest radiography and software to plan your case and maximize accuracy.

Full Arch Solutions
Full Arch Solution

There can be many reasons to consider supporting a full arch of teeth with strategically placed implants. Whether it’s no longer worth the time and expense to repair teeth individually or removable dentures just aren’t retentive or rigid enough to feel natural, the predictability of placing 4-6 implants to support a full arch of teeth has become a mainstay. We work closely with your restorative dentist to streamline a transition to full arch stability, no matter what your goals are.

Replacement of Compromised Implants

Due to the popularity of dental implants nationwide, there is also an increasing number of patients who may have experienced a less than ideal result after implant placement. Our specialists are highly trained in dental implant salvage and replacement in the instances of compromised or failing cases. No referral is necessary and we are always discrete.

So call to see how one of our board certified specialists can help you.

Third Molars

Importance of Consultation and Timing

Not everyone requires removal of their third molars (also called wisdom teeth). However, removal of impacted third molars can be an important aspect of preventive medicine. Research has established that the majority of people who have impacted wisdom teeth will experience symptoms of one or more of those teeth over the course of their lives. Having wisdom teeth removed as a teenager or young adult is the best way to avoid complications from extraction and provide the best chance for predictable healing.

Early clinical and radiographic evaluation by a board certified oral and maxillofacial surgeon is essential in order for patients to understand the risks or benefits of delaying treatment. At Santarelli & Tiboris Oral and Facial Surgery, we are committed to patient education so you can make the best decision for yourself and your loved ones.

Wisdom Teeth Management

If you decide to pursue removal of your wisdom teeth, our specialists will discuss what you can expect before, during and after the procedure. Although removal of impacted wisdom teeth is a routine procedure, we approach each case with the discipline and care we would want for our own family members.

Management of Impacted Teeth

Overview

What is an Impacted Tooth?

A tooth becomes impacted when there is a lack of space in the dental arch and its growth and eruption are prevented by overlying gum, bone or another tooth. A tooth may be partially impacted, which means a portion of it has broken through the gum, or totally impacted and unable to break through the gum at all.

How Serious is an Impacted Tooth?

Impacted and partially impacted teeth can be painful and lead to infection. They may also crowd or damage adjacent teeth or roots. More serious problems may occur if the sac surrounding the impacted tooth becomes filled with fluid and enlarges to form a cyst. As the cyst grows it may hollow out the jaw and permanently damage adjacent teeth, the surrounding bone and nerves. Rarely, if a cyst is not treated, a tumor may develop from its walls and a more serious surgical procedure may be required to remove it. Complications may arise from partially impacted teeth and totally impacted teeth.

Exposure (frequently canines) for Orthodontic Treatment

Impacted canines (sometimes referred to as “eye teeth”) are a common occurrence. Often times, these teeth need guidance to be properly positioned in the arch. There are many things to consider when deciding when and how to guide impacted canines into the arch. Consultation with your orthodontist is an important first step.

There are several ways to help “guide” an impacted canine (or any other tooth) into an appropriately erupted position. Here is an example of a typical procedure we refer to as: exposure and bonding.

Tooth Extraction

Overview

You and your doctor may determine that you need a tooth extraction for any number of reasons. Some teeth are extracted because they are severely decayed. Others may have advanced periodontal disease or are broken in a way that cannot be repaired. Other teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth) or in preparation for orthodontic treatment. The removal of a single tooth can lead to problems related to your chewing ability, problems with your jaw joint, and shifting teeth, which can have a major impact on your dental health. To avoid these complications, your doctor will discuss alternatives to extractions as well as replacement of the extracted tooth.

Tooth Extraction Process

At the time of extraction your doctor will need to numb your tooth, jawbone, and gums that surround the area with a local anesthetic. During the extraction process you will feel a lot of pressure. This is from the process of firmly rocking or rotating the tooth in order to widen the socket, allowing for tooth removal. You feel the pressure without pain as the anesthetic has numbed the nerves stopping the transference of pain, yet the nerves that transmit pressure are not profoundly affected. If you do feel pain at any time during the extraction, please let us know right away.

Sectioning a Tooth

Some teeth require sectioning. This is a very common procedure done when a tooth is so firmly anchored in its socket or the root is curved and the socket can’t expand enough to remove it. The doctor simply cuts the tooth into sections then removes each section one at a time.

 

After Care Instructions

Bleeding

Some bleeding may occur. Placing a piece of moist gauze over the empty tooth socket and biting down firmly for 30 minutes can control this.

Blood Clots That Form In The Empty Socket

This is an important part of the healing process and you must be careful not to dislodge the clot.

  • Avoid rinsing or spitting for 24 hours after the extraction.
  • Avoid use of a straw, smoking, or drinking hot liquids.

Swelling

If swelling occurs, you can place ice on your face for ten minutes and off for 20 minutes. Repeat this cycle as you feel necessary for up to 24 hours.

Pain & Medication

If you experience pain, you might use non-prescription pain relief medications such as acetaminophen or ibuprofen.

Eating

For most extractions, make sure you do your chewing away from the extraction site. Stay away from hot liquids and alcoholic beverages for 24 hours. A liquid diet may be recommended for 24 hours.

Brushing & Cleaning

After the extraction, avoid brushing the teeth near the extraction site for one day. After that you can resume gentle cleaning. Avoid commercial mouth rinses, as they tend to irritate the extraction site.

Beginning 24 hours after the extraction, you can rinse with salt water (one teaspoon salt in a cup of warm water) after meals and before bed.

Dry Socket

Dry socket is when a blood clot fails to form in the socket where the tooth has been extracted or the clot has been dislodged and the healing is significantly delayed.

Following the postoperative extraction instructions will reduce the chances of developing a dry socket. Dry sockets manifest themselves as a dull throbbing pain that usually doesn’t appear until three to four days after the extraction. The pain can be moderate to severe and radiate from the extraction area. Dry socket may cause a bad taste or bad breath and the extraction site appears dry.

Your doctor may decide to apply a medicated dressing to the socket to soothe the pain.

Healing

After a tooth has been extracted there will be a resulting hole in your jawbone where the tooth was. In time, this will smooth and fill in with bone. This process can take many weeks or months. However after 1- 2 weeks you should no longer notice any inconvenience.

Bone Grafting

Overview

Over a period of time, the jawbone associated with missing teeth atrophies, or is resorbed. 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 unless the site is augmented with grafting procedures.

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.

 

Harvesting and State of the Art Materials (PRP, BMP)

There are a wide variety of available bone grafting materials, each with their own unique properties and benefits. Bone can be harvested from the patient (autograft), from cadavers (allograft) and animals (xenograft). Bone can also be regenerated with the use of Bone Morphogenetic Proteins (rhBMP-2) when the surgical site is compromised or traditional materials alone are inadequate.

Sinus Lift Bone Graft

Maxillary sinus floor augmentation (also termed sinus lift, sinus graft, sinus augmentation or sinus procedure) is a surgical procedure which aims to increase the amount of bone in the posterior maxilla (upper jaw bone), in the area of the premolar and molar teeth, by lifting the lower Schneiderian membrane (sinus membrane) and placing a bone graft.

When a tooth is lost the alveolar process begins to remodel. The vacant tooth socket collapses as it heals leaving an edentulous (toothless) area, termed a ridge. This collapse causes a loss in both height and width of the surrounding bone. In addition, when a maxillary molar or premolar is lost, the floor of the maxillary sinus expands, which further diminishes the thickness of the underlying bone. Overall, this leads to a loss in volume of bone that is available for implantation of dental implants, which rely on osseointegration (bone integration), to replace missing teeth. The goal of the sinus lift is to graft extra bone into the maxillary sinus, so more bone is available to support a dental implant. – source Wikipedia

Anesthesia

Overview

We offer a wide range of anesthesia options. In addition to local anesthesia, which numbs the surgical area, we can use nitrous oxide (laughing gas), oral sedation (pre-medication) and moderate or deep sedation (IV sedation) to provide patients with the most relaxing experience possible. At STOFS, our doctors and staff are highly trained to administer anesthesia and monitor patients during their procedures. Your doctor will work with you to discuss which anesthesia options are best, and safest, for your procedure.

In Addition to Nitrous Oxide and Oral Sedation, We Offer Moderate and Deep Sedation

Moderate Sedation/Analgesia (“Conscious Sedation”) is a reduction of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function is usually maintained.

Deep Sedation/Analgesia is a reduction of consciousness during which patients cannot be easily aroused but respond purposefully following repeated stimulation. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. Cardiovascular function is usually maintained.

Pathology

Overview

Oral and maxillofacial surgeons are the experts in diagnosis and management of oral pathology.  Abnormalities of the mouth, face and jaws are actually quite common. One of the best ways to identify oral pathology is to see your dentist at regular intervals. Your dentist should be performing a methodical intraoral and extraoral examination at each check up. If a lesion or abnormality is noted, your dentist will often refer you to a surgeon who determines whether or not a biopsy should be performed.

We always encourage our patients to be advocates for their own health.  Performing regular self-exams while you brush and floss will help in the care and diagnosis of any oral abnormalities.  If you happen to see or feel something that doesn’t seem normal it is always best to have it examined by an oral and maxillofacial surgeon.

Biopsies

A biopsy is a minor surgical procedure that allows your surgeon to take some or all of the abnormal tissue and send it to a pathologist who can then view the specimen under a microscope and help aid in diagnosis. Biopsies are usually performed under local anesthesia and you should consider the post-operative experience to be similar to that of tooth removal. You will be required to return 1-2 weeks after the biopsy procedure to have the surgical site examine and discuss the results of the pathology report.

Management of Cysts and Tumors

Cysts and tumors of the jaws are not uncommon. No one is better equipped to treat cysts and benign jaw tumors than an oral and maxillofacial surgeon. Sometimes, after an initial biopsy is performed, further surgery must be performed to definitively remove the cyst or tumor. Often times, there can be more than one treatment modality. Your surgeon will discuss any potential options and make recommendations based on current principles for management.

Periodontal Therapy

Deep Cleaning

If caught early and treated, periodontal disease and its effects can be drastically decreased with proper gum disease treatment and continued maintenance. If left untreated, periodontal disease can lead to tooth and bone loss.

Gingivitis can be one of the first signs of infection and gum disease. The build-up of bacteria that is causing the inflammation of your gums is plaque. If the plaque is not brushed away properly it hardens into tartar and calculus, which we cannot remove on our own. The bacteria in the hardened plaque eats away at the connective tissue between your teeth and gums creating “pockets”. At this stage the effects of periodontal disease are still reversible. In some patients, their gum disease is diagnosed early enough to where they can avoid needing gum surgery. Instead their gum disease can be treated with a special deep dental cleaning called scaling and root planing.

Scaling and root planing is a non-surgical gum disease treatment. We will be able to numb the treatment areas with local anesthesia if necessary. One of our highly-trained hygienists will use ultrasonic tools and hand instruments to clean out the tartar above and below the gum line. The roots of your teeth are freed from calculus and smoothed to encourage reattachment of your gum tissue which decreases the pocket depths. It is important that periodontal patients continue diligent at-home care and also continue to get regular periodontal maintenance cleanings from their hygienist. We will be able to control your disease and keep track of how your pockets are improving.

Clinical Crown Lengthening

Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration and is used to improve the esthetic or function of your smile. The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to-tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. When the procedure is completed, sutures, and a protective bandage are placed to help secure the new gum-to-tooth relationship. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing.

There are two types of crown lengthening, esthetic and functional.

Esthetic Crown Lengthening

This technique is used to improve a gummy smile. Soft tissue and bone are augmented and removed to expose more of the teeth, thus “lengthening” the teeth, to create a wider, fuller smile. Esthetic crown lengthening can be performed on one tooth, but is commonly used to improve your entire smile.

Functional Crown Lengthening

This method is used in order to complete a cosmetic or restorative procedure. Sometimes, if a tooth has too much tooth decay present, is broken below the gum line, or is without enough structure to properly support a restoration, gum tissue will need to be removed in order for the tooth to receive the restoration. The gums will be trimmed and reshaped along with your jaw bone to allow for a successful outcome when restoring a structurally compromised tooth.

Laser Perio Treatment (LANAP)

Overview

An FDA-cleared laser treatment called the LANAP protocol offers a less painful, more successful treatment alternative to conventional surgery. LANAP=LAR is the only scientifically, research proven methodology that results in true periodontal regeneration, new bone growth and gum tissue reattachment. This treatment is one of the most successful protocols in treating gum disease because it can target the source of the inflammation without hurting or removing any healthy gum tissue, slow or stop attachment loss and decrease pocket depth, and allow the body to recover from the chronic infection without the need for scalpel or sutures.

Our laser treatment device offers patients a virtually pain-free option that is as effective or more effective than traditional treatment methods. Using the dental laser, we are able to perform many procedures without a shot or a drill!

Our laser uses YSGG laser energy and a patented spray of water to gently and effectively cut soft tissue and bone, often with less reported instances of swelling or post-operative sensitivity or pain. We can also use it to perform a variety of soft tissue procedures such as gingivectomy, scaling and root planing, gingival contouring, laser disinfection, and periodontal surgery. If you’re ready to learn more about laser dentistry, call us today to get started.

Gum Recession

Gum Grafting

A gum graft is a periodontal procedure which is used to treat receding gums. There are many different options for treating gum recession, but gum grafting is the most tried and true solution for severe recession, especially if there’s just one or two areas affected. The technical term for a gum graft is “subepithelial connective tissue grafting,” or just simply, a “connective tissue graft.” This procedure involves removing some of the tissue from underneath your gums on the roof of the mouth and placing it over the area of recession. The graft grows together with the remaining gum in the affected area, blending perfectly and permanently thickening and strengthening the gum attachment to the exposed root. If several teeth are affected, procedures like the Pinhole Procedure can also repair the receding gum line without grafting if it is caught early.

The procedure is completed with local anesthetic, making sure that the area being treated is thoroughly numb before beginning. Even though we will ensure that you will not experience any pain during the procedure, some patients like the peace of mind offered by sedation. We utilize the most current techniques to complete the procedure, including the use of growth factors like Emdogain to accelerate healing and minimize discomfort during the healing process. Patients experience very minimal discomfort afterwards with very little down time. Most patients need nothing more than everyday ibuprofen (advil) for a few days afterwards, although stronger pain medications are available if desired. Also, there is no need for a liquid diet as patients are encouraged to eat as soon as the numbing agent has begun to ware off. Detailed post-operative instructions are reviewed prior to the procedure, like avoiding brushing or chewing on the area for a few weeks afterwards. Our helpful doctors and team are readily available before and after your procedure to help ease your concerns and help ensure minimal discomfort and a rapid recovery. Your comfort is our top priority!

There are also many different surgical techniques that have been developed for different unique situations, including root coverage procedures without any graft at all! During your consultation, we will perform a comprehensive examination to diagnose your unique circumstance, discuss all your treatment options, work with you to treat your current condition and help you maintain your newly restored smile.

Osseous Surgery

Periodontal disease is an oral infection causing damage to the structures supporting the teeth – the gums, periodontal ligament and alveolar bone tissue. When periodontal infection progresses to the point of moderate to advanced bone determination, the teeth become at significant risk of being lost. Furthermore, systemic health conditions linked to periodontal disease also become a concern, as harmful oral bacteria make their way into other areas of the body.

Osseous surgery, also referred to as flap surgery, is a procedure often performed to treat advanced periodontitis. When other gum disease treatments have not proven successful at arresting the disease process or the condition is diagnosed in the advanced stage, we may recommend osseous surgery as a treatment option. The goal of this surgical procedure is to rid the mouth of active periodontal infection, preserving remaining bone structure and the teeth it supports. Saving teeth is our ultimate goal, as we work towards helping you create a healthy mouth and body.

Osseous surgery is typically performed in quadrants, or sections of the mouth. To begin, we anesthetize the treatment site for maximum comfort, and retract the gum tissue covering the roots and bone, gaining access to deep areas of infection. The tooth roots are cleaned of plaque and tartar deposits and the bone smoothed of any rough surface areas created by bacteria. We then expertly trim infected gum tissue and suture the site for healing to begin.

This surgical gum disease treatment offers a number of benefits to periodontal patients:

  • Reduces periodontal pockets depths
  • Eliminates active infection
  • Halts disease process
  • Fosters healthier oral environment
  • Enables better homecare techniques
  • Allows for more comfortable dental visits

Corrective Jaw Surgery

What is corrective jaw surgery?

Corrective jaw, or orthognathic, surgery is performed by Oral and Maxillofacial Surgeons to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, can improve chewing, speaking and breathing. While the patient’s appearance may be dramatically enhanced as a result of their surgery, orthognathic surgery is performed to correct functional problems.

 

What’s Involved in Corrective Jaw Surgery?

It’s important to understand that your treatment, which will probably include orthodontics before and after surgery, may take a few years to complete. Your surgeon and orthodontist understand that this is a long-term commitment for you and your family. They will try to realistically estimate the time required for your treatment.

Before your surgery, orthodontics will help to position teeth so they will fit well the day of surgery. Often times, in the months leading up to surgery, your “bite” may feel even worse as your orthodontist is moving teeth into that pre-surgical position. When your surgeon repositions the jaws during surgery, however, your teeth should fit together properly.

In the vast majority of cases, corrective jaw surgery is performed under general anesthesia in a hospital. The surgery may take from two to eight hours to complete. In some cases, bone is added, removed or reshaped to facilitate an ideal result. Surgical plates, screws and wires are used to hold the jaws in their new position. This hardware is not expected to be removed unless it causes a problem in the future. It is uncommon to need hardware removed after surgery. Incisions are almost always done inside the mouth, though some cases require very small skin incisions, which are carefully placed to minimize their appearance.

After surgery, your surgeon will give you specific instructions on diet, hygiene and activity. You should expect to be on a non-chew diet for about 6 weeks from surgery. Pain is easily controlled with medication and patients should expect to return to work or school as early as 2-3 weeks, depending on how they are feeling. The initial healing phase will require weekly surgical follow-ups for 6-8 weeks, after which patients will return to the orthodontist for fine tuning of the occlusion.

Who Needs Corrective Jaw Surgery?

People who may benefit from corrective jaw surgery include those with an improper bite resulting from misaligned teeth and/or jaws. In some cases, the upper and lower jaws may grow at different rates. Injuries and birth defects may also affect jaw alignment. While orthodontics can usually correct bite, or “occlusion,” problems when only the teeth are misaligned, corrective jaw surgery may be necessary to correct misalignment of the jaws. Following are some of the conditions that may indicate the need for corrective jaw surgery:

  • Difficulty chewing, or biting food
  • Difficulty swallowing
  • Chronic jaw or jaw joint (TMJ) pain and headaches
  • Open bite (space between the upper and lower teeth when the mouth is closed)
  • Unbalanced facial appearance from the front, or side
  • Facial injury or birth defects
  • Receding chin
  • Protruding jaw
  • Inability to make the lips meet without straining chronic mouth breathing and dry mouth
  • Sleep apnea (breathing problems when sleeping, including snoring)

Facial Trauma

Overview

Injuries to the mouth, face and jaws are best treated by an oral and maxillofacial surgeon (OMS). An OMS has unique training and skills to diagnose and treat these traumatic injuries. Often times, these injuries require long term follow up and reconstructive efforts to restore form and function. Understanding the sequence of treatment following traumatic injuries to the mouth, face and jaws requires specific attention to detail and hands-on experience that only a board certified OMS can provide. Our doctors maintain hospital privileges at both area hospitals to deliver emergency room coverage for the following conditions:

  • Intra oral and facial lacerations
  • Avulsed (knocked out) teeth
  • Fractured facial bones (cheek, nose or eye socket)
  • Fractured jaws (upper and lower jaw)

The Nature of Maxillofacial Trauma

There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence, and work-related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Soft Tissue Injuries of the Maxillofacial Region

When soft tissue injuries, such as lacerations, occur on the face, suturing repairs them. In addition to the obvious concern of providing a repair that yields the best cosmetic result possible, care is taken to inspect for and treat injuries to structures such as facial nerves, salivary glands, and salivary ducts (or outflow channels). Our doctors are well-trained oral and maxillofacial surgeons and are proficient at diagnosing and treating all types of facial lacerations.

Bone Injuries of the Maxillofacial Region

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture, the age, and general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and obviates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of rigid fixation has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary, are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.

Injuries to the Teeth & Surrounding Dental Structures

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out. These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth. Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

The proper treatment of facial injuries is now the realm of specialists who are well versed in emergency care, acute treatment, long-term reconstruction, and rehabilitation of the patient.

Surgical Management of TMJ Conditions

Overview
TMJ

Temporomandibular Joint Disorder (TMD) is common in developed, industrialized countries. Approximately 60% of the population experiences “popping” or “clicking” from one or both of the TMJs. In the absence of persistent pain or limitation on range of jaw movement, surgical intervention is rarely indicated. Often times, mild TMD can be managed with the use of an oral appliance and other conservative therapies. However, some people fail to get improvement with non-invasive, reversible modalities alone. Although great care is taken in selection of surgical candidates, oral and maxillofacial surgeons are the only specialists formally trained in the surgical management of temporomandibular joint disease.

Botox

Overview

With real, noticeable results, no surgery and no recovery time, there are many reasons why Botox has been chosen by millions of men and women. Botox injections are a non-invasive way to help soften lines, wrinkles and in some instances reshape the face.

Botox is a prescription medicine that is injected directly into the muscles and used to reduce moderate-to-severe frown lines between the brows for a temporary period of time. It works by blocking nerve impulses to the injected muscles. This reduces muscle activity that causes lines to form between the brows. After treatment you will look more relaxed and confident because the wrinkles in these areas become smoother, often raising the brow and opening the eyes wider.

Botox is the first botulinum toxin to be approved by the FDA to temporarily treat moderate to severe lines between the brows. Approximately 11.8 million Botox procedures have been administered in the United States since its introduction in 2002. This simple, nonsurgical treatment is recommended for people ages 18 to 65.

Click here for additional information about Botox Cosmetic.

Pelleve

Overview

As seen on “The Dr. Oz Show” and “The Doctors.”

Santarelli & Tiboris Oral & Facial Surgery is the only location in southeastern Wisconsin to offer this revolutionary treatment.

Pellevé is an FDA approved, non-surgical treatment to remove fine lines and facial wrinkles. It safely and effectively treats facial wrinkles with no pain, no anesthesia, and no downtime. With just a single treatment you could be on your way to firmer, tighter skin.

With Pellevé, the side effects and discomfort are minimal, and no drugs or anesthetics are used during the procedure. Pellevé fits easily into busy schedules and can provide lasting improvement for up to six months. A full facial treatment typically takes about 45-60 minutes.

Unlike other skin tightening systems, Pellevé doesn’t require anesthesia or skin cooling. Because the skin is not numb, you can describe the depth of feeling to the doctor, which helps provide the best result in the area being treated. The outcome is a noticeable improvement in skin quality and appearance.

First, a protective gel is applied to the face. Patients say they feel a deep warming sensation when the doctor touches the area being treated with the Pellevé handpiece. No anesthetic is used, so you will act as a guide to describe the depth of the sensation as the doctor moves the handpiece across your face.

Pellevé delivers constant, gradual energy to the skin, causing heat to build up where the skin and fat layer come together. The increasing heat modifies the collagen bundles deep inside the skin, causing them to contract and stimulating the growth of new collagen over time. This results in firmer, tighter skin.

Mild swelling and redness may occur, but studies have shown that this usually goes away within a few hours to a day.

Many people see results immediately after just one treatment, with continuing improvement for up to six months as the skin produces new collagen. Additional treatments may improve results. Consult with our doctors for a recommended number of treatments.

Click here for additional information about Pellevé Wrinkle Reduction System.

Hygiene

Overview

At Santarelli & Tiboris Oral & Facial Surgery we are proud to have a full-time dental hygienist on our staff to better serve our patients. There are two major benefits to having a dental hygienest in our office:

  • To work directly with patients who have periodontal disease. Having regular, deep cleanings is a huge part of managing periodontal disease. We wanted to make it as convenient as possible for our patients to have the cleanings they need. By bringing a dental hygienest into our office, we can handle these deep cleanings for our patients in one convenient location.
  • To help patients maintain their dental implants. Dental implants are an investment.  In addition, the surgery is a personal committment . A big part of the success and longevity of dental implants depends on how well they are taken care of. Implants are like brand new teeth that never get cavities. However, if they are not cleaned properly, on a regular basis, they WILL fail! Our dental hygienist is here to offer their expertise to our dental implant patients. Those patients can literally protect their investment from the moment they decide to commit to dental implants.

“The people in the office are just fantastic”

Steven H,
Wisdom & Impacted Teeth

Schedule your consultation: 262.654.6770