Lucca Oral and Facial Surgery is a specialty practice limited to Oral and Maxillofacial Surgery. Oral and maxillofacial surgery is a dental specialty where doctors are trained alongside medical residents in internal medicine, general surgery, otolaryngology, plastic surgery, emergency medicine, and medical and surgical intensive care. Oral and maxillofacial surgeons also train extensively with anesthesiologists. No other medical or dental specialty requires this level of anesthesia training – which makes oral and facial surgeons uniquely qualified to administer in-office ambulatory sedation and general anesthesia services. With a minimum of four additional years of surgical training in a hospital-based residency program after dental school, oral and maxillofacial surgeons are the true surgical specialist of the dental profession, able to perform advanced surgeries that can encompass the entire maxillofacial region.
Dr. Lucca’s extensive education and oral and maxillofacial training makes him uniquely qualified to treat diseases, defects, injuries and esthetic aspects of the mouth, teeth, jaws and face. At Lucca Oral and Facial Surgery, we offer a number of oral & facial surgical services that we provide in the office, some of which are listed below.
Our staff invest in diverse continuing education and performance improvement programs in anesthesia and receive advanced High Fidelity Human Simulator (SIM MAN) training in anesthesia techniques and emergency management annually. Our assistants are enrolled in the intensive Dental Anesthesia Assistant National Certification (DAANCE) program where they receive certification by the American Association of Oral and Maxillofacial Surgeons.
As Oral and Maxillofacial Surgeons, our doctors have trained with anesthesiologists during their hospital-based residency programs, distinguishing their education from all other surgical specialties and making our doctors uniquely qualified to administer in-office ambulatory anesthesia services. Our doctors are certified in Advanced Cardiac Life Support (ACLS), are members of the American Dental Society of Anesthesiology, and participate with the American Society of Oral & Maxillofacial Surgeons Office Based Emergency Airway Management (OBEAM) program.
Our doctors are licensed by the Massachusetts Board of Registration in Dentistry to provide a full range of anesthesia care including: Local Anesthesia, Nitrous Oxide, Minimal, Moderate, and Deep Sedation, and General Anesthesia. Our anesthesia services are customized to meet the needs of each individual patient.
Local Anesthesia (“Novocaine”) will produce a numb feeling in the area being operated on and you will be aware of a feeling of pressure during surgery. You will be awake and recall the surgery, but there should be no significant discomfort. Local Anesthesia can be used alone, and is also used in combination with Nitrous Oxide, IV Sedation and General Anesthesia to ensure a pain-free experience after your surgery.
Nitrous oxide, sometimes referred to as “laughing gas,” is an effective and safe sedation agent that is inhaled through a mask that fits over your nose to help you relax. Mixed with oxygen, nitrous oxide allows you to breathe normally through your nose and within minutes you should start to feel the effects. You may feel light-headed or a tingling in your arms and legs. Some patient’s comment that their legs and arms feel heavy. Ultimately, you should feel comfortable and calm. The effects of nitrous oxide wear off quickly after the small mask is removed. Talk to the doctor about whether nitrous oxide would be a good option for you.
Mild, Moderate and Deep Sedation (IV Sedation) and General Anesthesia
Procedures that are performed with the assistance of sedation are psychologically less traumatic for patients who will experience profound relaxation and reduced consciousness. Patients often have no memory of the procedure although they remain responsive throughout their care. Anesthetic medications are administered intravenously (through an I.V.) and make patients feel relaxed, often relaxed enough that they fall asleep. Patients that are sedated are continuously monitored with a pulse oximeter, blood pressure cuff, an EKG, and capnography throughout the procedure.
General anesthesia is a medically induced state of unconsciousness that feels like a deep sleep. Patients remain un-arousable throughout the procedure. Anesthetic medications are administered intravenously (through an I.V.) and inhalational medication (inhaled through a mask) may also be administered. General anesthesia may also be performed with the aid of an airway supportive device such as a Laryngeal Mask Airway (LMA) or an endotracheal tube (ET Tube), placed after you are asleep, to help you breathe safely during the procedure. Patients receiving general anesthesia are continuously monitored with a pulse oximeter, blood pressure cuff, an EKG, and capnography throughout the procedure.
Wisdom teeth (also known as third molars) are the last teeth to develop and erupt into the mouth, usually between the ages of 16 and 24. Wisdom teeth frequently require management because most people do not have adequate space in the oral cavity to accommodate these teeth.
When a tooth doesn’t fully erupt into the mouth, it is considered impacted. The tooth becomes unable to break completely through the gums, because there isn’t enough room. In some cases, a cyst or tumor can form around an impacted tooth, which can lead to more serious problems, including damage to adjacent teeth or other surrounding structures.
But even Wisdom teeth that have “grown in,” most always erupt incompletely and/or are mispositioned and very difficult to keep clean. Because hygiene is impaired in this area of the mouth, a wisdom tooth is more vulnerable to cavities and gum disease that can also infect neighboring teeth.
Ultimately, both impacted and non-impacted wisdom teeth can damage adjacent teeth and lead to chronic oral disease.
As oral surgeons, we are the experts in wisdom tooth management. Even if no symptoms are present, we encourage you to minimize potential health risks by seeking a consultation with us at our Boston office. The absence of symptoms does not necessarily equate to an absence of disease, and third molar treatment often becomes more complicated as we age. Earlier and sooner is best when it comes to talking to us about your wisdom teeth.
Impacted wisdom and cuspid (or canine) teeth are fairly common. For impacted wisdom teeth, the most common procedure is extraction. For impacted canine teeth, several treatment modalities are available.
Surgically Assisted Orthodontics can involve removing primary (baby teeth) or exposing the tooth to place an orthodontic bracket which is utilized to help bring the tooth into proper alignment.
If children are undergoing orthodontic treatment, orthodontic anchorage can be a useful tool to assist in tooth movement. The surgical placement of a small anchorage device can assist in pulling teeth forward or pushing teeth back or moving teeth in to the correct position. We will work with your child’s orthodontist to coordinate our treatment plans.
Platelet-rich fibrin (PRF) is a new approach to tissue regeneration. PRF derives from the centrifugation of a patient’s own blood and contains growth factors that influence wound healing. This is important in tissue repair mechanisms. The use of PRF in surgical practice has beneficial outcomes, reducing bleeding and enhancing soft tissue healing and bone regeneration.
Every day, people are getting dental implants to replace missing teeth. Dental implants are the best long-term state-of-the-art solution for the replacement of missing teeth.
Dental implants are small anchors made of biocompatible metal called titanium, which are inserted into the jawbone. After insertion, the anchors then begin to fuse with the surrounding bone. This critical biological fusion process known as “osseointegration” takes 3 to 4 months to occur, after which time, the final attachment of replacement teeth may be completed by your restorative dentist. When restored by your dentist, the look and feel of a dental implant is virtually indistinguishable adjacent to your natural teeth.
Dental implant placement is surgery – and is best performed by a trained surgeon. Oral and Maxillofacial Surgeons are experts in dental implant procedures and this surgery is a specialty of Dr. Lucca and our Boston oral surgery team.
Dental implants are considered the gold standard for tooth replacement. Some of the health and functional benefits of dental implants include:
- Replacement of one or more missing teeth
- Enjoying the look and feel of natural teeth
- Having the ability to eat the food that you love
- Preservation and maintenance of bone health
At Lucca Oral and Facial Surgery, we understand that dental implants are implantable medical devices. As a practice philosophy, we invest in implant systems exclusively from trusted industry leaders with strong research and development and quality control programs. At Lucca Oral and Facial Surgery, we provide Straumann, Keystone Dental, Zimmer/Biomet 3i, and Nobel BioCare implant technology.
If you require removal of a non-salvageable tooth, in certain circumstances, dental implants may be placed at the same time as tooth removal. Immediate dental implant placement requires preservation of healthy surrounding bone and gum tissue around the tooth extraction socket. An ideal tooth socket allows implant placement into the extraction socket at a the appropriate angulation with good initial stability.
When possible, the benefits of immediate dental implants include:
- Shorter Treatment Duration
- Fewer Procedures
- Faster Reconstruction
- Less Pain
With the placement of 2 to 4 implants, dentures can be connected to a bar or special locators that help minimize movement of your prosthesis while eating and speaking. This type of denture is more retentive than a conventional denture, but it is designed to be removable.
Another way to rehabilitate a full arch of failing or missing teeth is with a collaborative team-based treatment strategy (sometimes known as “teeth in a day,” “all on four,” “all on X,” et. al.) where a fixed (not removeable) full arch prosthesis can be delivered with the look, feel, and confident function, of natural teeth.
Working with our trusted dental lab technicians, anesthesia providers, and your restorative dentist, our Boston oral surgery team and Dr. Lucca are expertly trained to deliver this transformative implant solution that allows the replacement of a full arch of teeth secured by four, six, or eight implants, in just one day. This technique creates a prosthesis that is fixed to the implants and eliminates the compromise of loose and uncomfortable removable dentures.
With an implant retained full arch restoration, there is no plate covering the roof of the mouth that can impair speaking and tasting food. Additionally, esthetics and function are more natural and comfortable. Patients do not experience the typical rocking and movement, or gum irritation, associated with conventional dentures.
Easy to care for, this type of restoration simulates the look and feel of natural teeth and stays fixed in place with the implants acting as anchors for new teeth. Patients can experience renewed confidence with speaking, eating, laughing, and smiling.
Full arch restorations can often be placed in one office visit. Dr. Lucca’s talented team of lab technicians can be present on site during the procedure to provide a custom-designed, esthetic, functional, and immediate temporary prosthesis the same day as the implant surgery.
Dr. Lucca and our Boston oral surgeons will provide consultation utilizing our state-of-the-art technology to discuss in detail a customized full arch dental implant solution that may be right for you.
Since dental implants require a healthy bone foundation and lost bone cannot regrow or self-regenerate, successful dental implant placement often involves a need to rebuild and re-establish the correct bone volume through bone grafting. Bone grafting is the bridge between tooth loss and tooth replacement and is the first step to your new smile. As oral and maxillofacial surgeons, we are experts in advanced bone grafting techniques, materials, and technology to assist the restoration of oral function.
When INFUSE® Bone Graft is used during oral surgery, the rhBMP-2 protein is mixed with sterile water. This solution is then soaked onto an absorbable collagen sponge, which is crafted from a material found in bone and tendons. The absorbable sponge releases the protein over time in the treated area, providing a foundation on which new bone can grow. As the graft site heals, the ACS is resorbed and replaced by bone.
When used during jaw bone resorption, rhBMP-2 may be placed in the section or sections of the jaw bone that need to be built back up in preparation for dental implants.
Novel technology for these types of gum grafts allow your oral surgeon to avoid use of palatal tissue which eliminates the need for two surgical sites. With the use of volume stable collagen matrix, Dr. Lucca can restore healthy keratinized gum tissue to provide long-term support and protection for your dental implants. These collagen matrixes act as a three-dimensional porous scaffold that promotes cell interaction and support optimal ingrowth of these cells for healthy tissue formation. This solution is highly successful and reduces treatment time while also reducing pain.
Dr. Lucca may recommend and perform a biopsy where a small representative sample of the affected oral tissue will be excised and delivered to an oral and maxillofacial pathologist for definitive diagnosis.
With noticeable results without surgery or recovery time, there are many reasons why Botox® Cosmetic treatments could be right for you. Botox® offers noticeable changes to your appearance without surgery or recovery time, and is ideal for erasing facial lines on the forehead and around the eyes, leaving you looking more youthful and feeling more beautiful for up to a year.
Juvederm® is an FDA Approved gel filler that can be used to smooth away wrinkles around the nose and mouth. One treament can offer natural looking results for up to a year.
A Labial Frenectomy, or lip release, is performed on the tissue that connects the lip to the gums. This may be performed on children or adults to aid with orthodontic treatment or even help with the proper fitting for a denture or appliance.
A Lingual Frenectomy may also be referred to as the release of tongue-tie (ankyloglossia). This procedure is performed on the connective tissue under the tongue. The procedure is often performed on neonatal patients to assist with nursing or on toddlers or older patients who need the surgery to help correct speech issues caused by limited movement due the the frenum.