The Center for Maxillofacial Prosthodontics

The Center for Maxillofacial Prosthodontics is an example of how the College strives to expand its availability of services to patients of North Texas.

This clinic provides technology and services that improve the esthetics and quality of life for many victims of disease, trauma and birth defects.

Headed by Dr. Jorge A. Gonzalez, the recently added Center also focuses on educating dental students, dental postgraduate students and medical residents.

Students learn about the opportunities that embrace all the specialty areas of dentistry, including the fields of prosthodontics, periodontics, oral and maxillofacial surgery, pathology, and restorative dentistry.

Treatments utilize a multidisciplinary approach to complex facial problems that involve plastic surgeons, head and neck surgeons, oncologists, oncologic surgeons, speech therapists, occupational therapists, anaplastologists, audiologists, nurses, and other healthcare professionals.

Most importantly, the program provides an opportunity for integrating clinical patient care for this group of patients with research and education. The net result of this integrative, team management approach is vastly improved access to care for patients; enlightened professional patient care that utilizes advances in science and technology; expanded educational opportunities for many, diverse student groups and health care professionals in a multidisciplinary center; a better understanding of the causes of acquired and/or congenital craniofacial disfigurement.

The Center for Maxillofacial Prosthodontics is made up of the following highly experienced staff:

• Jorge A. Gonzalez, DDS, MS -- Dr. Gonzalez is Assistant Professor and Director of the Center for Maxillofacial Prosthodontics.
• Suzanne N. Verma, MAMS, CCA -- Ms. Verma, Assistant Professor,  is an Certified Clinical Anaplastologist who specializes in creating facial and somato prostheses for patients with missing or disfigured anatomical structures due to congenital abnormalities, trauma, or disease.
• Erick Lachner, DDS – Implant Fellow
• Steve Ruff, CDT -- Mr. Ruff is a highly skilled dental laboratory technician, with extensive experience working with complex implant restorations.
• Leilane Vicente, RDA -- Registered Dental Assistant
• Cornelius Brown, RDA - Registered Dental Assistant
• Frances Espinoza, RDA - Registered Dental Assistant

What is Maxillofacial Prosthodontics?

Maxillofacial prosthodontics is a subspecialty of dentistry which deals with the rehabilitation of patients with acquired and congenital defects of the head and neck region. These range from minor to major functional disabilities combined with cosmetic disfigurement. The development of titanium dental implants by Professor P.I. Branemark led to the refinement of bone-anchored prostheses for the face and adjacent structures. This technology has been under study at selected sites in the United States for over 20 years, and has been approved by the U.S. Food and Drug Administration for general use. This gives new hope for patients in need of these prostheses and has revolutionized the field.

What is Anaplastology?

Anaplastology is the art and science of restoring malformed or absent parts of the human body through artificial means. By combining technical, medical, and artistic skills with patience and compassion, the anaplastologist can create custom-made, lifelike prostheses that fit the needs of each patient. The field of anaplastology functions within the larger medical community, in which cross-disciplinary communication and cooperation is essential in order to provide patients with successful prosthetic restorations and a positive treatment experience.

Facial and somato prosthetic devices are an essential part in restoring the physical and psychological well being for patients with missing or disfigured anatomical structures due to congenital abnormalities, trauma, or disease such as head and neck cancer. Patients may be able to gain renewed function, aesthetics, and a sense of confidence after receiving a prosthetic ear, eye, nose, finger, or hand. This restoration of self-esteem is an invested accomplishment for both the patient and anaplastologist or maxillofacial prosthodontist. The primary goal of prosthetic rehabilitation is to help patients improve their quality of life and uphold their self-image during their traumatic psychological adjustment. A truly successful prosthesis may go unnoticed, allowing patients to go about life without drawing attention to that aspect of their physical appearance. Each patient's prosthesis is unique in its design, makeup and method of retention. Patients presenting with adequate bone quality and compliance may be candidates for osseointegrated implant retained prostheses. Titanium implants, similar to dental implants are surgically placed in the bone and used to anchor the silicone prosthesis with bar and clip, or magnet retention. This retention method makes the prosthesis more stable, aesthetic and durable. Due to the uniqueness of each patient's needs, it is important that their treatment plan for reconstruction is developed with the expertise of various members of a Craniofacial Team.

Advanced Dental Implant Solutions

Complete edentulous jaws are much more of a widespread handicap than most of us realize.  1 out of every 4 Americans over 60 years old has failing dentition and is becoming edentulous.  Traditionally, complete dentures had been the treatment of choice for the edentulous patient.   Today dental treatment has advanced with the use of dental implants.  Dental implants significantly improve retention and stability to such a level, that the prosthesis can be completely fixed depending on the number and location of implants.

The concept of implant retained full restorations offer a viable and cost effective implant based solution that produces immediate function and satisfaction.  The concept starts with the team approach, where our surgeon, prosthodontist, and dental laboratory technician work together.  Treatment requires planning, and utilizes advanced digital technology to formulate a plan that fits each patient’s unique anatomy.  Implants are placed by the Oral Maxillofacial Surgeon, according to the plan.  The teeth that have been prefabricated by the on-site technician are modified and placed by the restorative dentist immediately following surgery.  Such prosthetic designs should be understood as a “restorative chain”, which the main components are: bone, implants, abutments, screws, and prosthetic teeth.  With a screw retained implant system, the team is able to have easy access when providing follow up care on your prosthesis.  Also, by reducing the number of implants that are needed to properly retain a dental prosthesis, it makes the treatment more affordable.   Through the use of advanced technology and a team approach, we strive to offer patients improved cosmetic and functional outcomes and a better quality of life.

Center in Maxillofacial Prosthodontics Needed?

Rehabilitation of patients with head and neck disabilities is difficult and requires close interactions among several health science disciplines. The Maxillofacial Prosthodontist is the primary person involved in many facets of patient care, and is therefore the individual who is in the best position to coordinate the efforts required in this complex rehabilitative process. Members of the team include oral and maxillofacial surgeons, plastic surgeons, radiologists, oncologists, head and neck surgeons, neurosurgeons, otolaryngologists, periodontists, orthodontists, social workers, speech therapists, occupational therapists, among others. The team at Baylor College of Dentistry is one of several craniofacial teams in the Dallas - Fort Worth Metroplex that can bring together the needed specialists to evaluate and treat these patients.

Objectives of the Center

The fundamental objective of this Center is to provide prosthodontic reconstruction for those patients with orofacial defects resulting from birth defects, trauma, or following treatment for head and neck cancers. Defects of this type can lead to altered function and an inability to participate in normal activities, which has a negative impact on the patient's psychosocial behavior. The Center also addresses the need for a focal point for the education of medical, dental, and auxiliary dental health personnel. Clinical research is carried out as part of patient care and follow-up. Treatment procedures are linked to the overall teaching and research efforts of the College.

Birth Defects

Craniofacial deformities such as cleft lip, cleft palate, are managed by specialized teams of doctors and support personnel. The role of the maxillofacial prosthodontist is critically important in supporting the surgical care in such patients when closures of the openings between the nasal and oral cavities are achieved, or providing supporting structures for swallowing, chewing, and speech.

Trauma

Injuries resulting from motor vehicle, industrial and residential accidents, and gunshot wounds from assaults and/or suicide attempts account for a high incidence of residual orofacial defects which can result in disfigurement or compromise of function. These kinds of cases can often be assisted by this Center.

Cancer

There are approximately 50,000 new cases of head and neck cancer diagnosed each year in the United States. About 700 of these cases occur in North Texas per year. The main objective in the management of malignant disease is cure, but there are important secondary goals to be considered as well. Specifically, an attempt is made to preserve form and function and retain an acceptable quality of life for the patient. This includes the use of dental osseointegrated implants and appropriate dental restorations. In the mouth, the therapeutic strategy centers around retention and restoration of teeth, and restoration of the ability to chew and swallow. Facial disfigurement can be overcome by restoration of the eyes, ears, noses, or other facial structures, occasionally retained by cranial implants.

For more information or appointments contact:

Dr. Jorge A. Gonzalez

E-mail: jgonzalez@bcd.tamhsc.edu
Phone: 214-828-8990
Fax: 214-828-8382