Facts about Wisdom Teeth Removal

A graduate of the Harvard School of Dental Medicine, Dr. George Hatzigiannis practices oral and maxillofacial surgery from his private practice in Boston. As an oral surgeon, Dr. George Hatzigiannis conducts an array of procedures, with one of the most common being the removal of wisdom teeth.

The last teeth in the mouth to develop are the third molars, known more commonly as wisdom teeth. People usually begin to develop wisdom teeth around the age of 10, but these molars may not erupt until individuals are in their late teens and 20s. If these teeth do not fully erupt and grow in a way that causes them to be misaligned between the gums and jaw bone, they can potentially cause damage to the surrounding teeth and tissues.

Statistics suggest that as many as 85 percent of people have a need for wisdom tooth extraction procedures in their lifetime, although not everyone will need to have all four teeth extracted. The lower molars are more commonly removed than the upper molars and are more likely to cause oral diseases such as pericoronitis if left in the mouth.

A Brief Introduction to Orthognathic Surgery

Dr. George Hatzigiannis is an experienced oral and maxillofacial surgeon located in Boston, Massachusetts. Dr. George Hatzigiannis is knowledgeable in various areas, including orthognathic surgery.

Orthognathic surgery involves a surgeon adjusting certain parts of a patient’s facial skeleton to achieve proper functionality. Most often, the procedure is used to straighten a patient’s jaw. Jaw misalignment can lead to a number of serious health problems, including deformities throughout the cranio-orbital skeleton.

An orthognathic procedure can be viewed as a holistic surgery in that it necessitates a collaboration between the surgeon, various dental professionals, and potentially a restorative prosthodontist. In the United States, between 1.5 million and 2 million individuals could benefit from orthognathic intervention, with 500,000 people living with Class III deformities. 

Individuals interested in learning more about the potential benefits of orthognathic surgery should discuss the matter with their dentist, though they may need to obtain a referral to an experienced maxillofacial surgeon.

A Case of Cardiac Sarcoma Metastasizing in the Maxilla

With more than a decade of experience as a dental practitioner, Dr. George Hatzigiannis is a respected presence in the Boston dental community. Focusing on oral and maxillofacial surgery, Dr. George Hatzigiannis has published extensively in this field. Among the papers he co-authored is “Undifferentiated Cardiac Sarcoma Metastatic to the Maxilla: Report of a Case.”

The paper looks at primary cardiac sarcomas, which are aggressive, rare, malignant mesenchymal neoplasms. A form of abnormal growth associated with cancer, the condition is extremely difficult to counter. While comprising a very small percentage of the heart’s primary neoplasms, the tumors are adept at metastasis and usually invade vital anatomic structures that lie adjacent.

The paper concerns a case of lesions impacting a patient’s molars and premolars. The patient’s recent medical history was important since he had been diagnosed with undifferentiated high-grade sarcoma of the left atrium, which had metastasized into the brain. 

Surgical resection had removed the primary tumor, but the patient had suffered a cerebrovascular accident in the immediate postoperative period and received medication and radiation treatment. The core interest of this case is in the links between oral and maxillofacial pathologies and cardiac sarcoma conditions that are more common in other parts of the body.

Treatment Options for Maxillary Sinus Cancer

An oral and maxillofacial surgeon, Dr. George Hatzigiannis has led an independent practice in Boston since 2007. Dr. George Hatzigiannis comes to this role with an in-depth knowledge of treatment options for cancer of the maxilla and nearby structures, such as the maxillary sinuses. 

If cancer cells have begun to develop in the tissue that covers the maxillary sinus, located inside of the cheekbones on each side of the nose, physicians may classify the situation as a stage 0 cancer. Also known as carcinoma in situ or pre-cancer, this diagnosis indicates the potential for, but not the presence of, a cancer situation.

If the cancer begins to grow, it starts within that initial origin point of the maxillary sinus. This is known as stage 1 cancer, which means that the cancer has not yet spread to other nearby tissues. Once the cancer begins to invade the sinus floor or bony tissue that covers the sinus opening, but has not yet invaded the back of the sinus or elsewhere, the diagnosis is stage 2 cancer.

Most patients with stage 1 or stage 2 maxillary sinus cancer undergo surgery and often radiation to attempt to remove the tumor. This is also a likely treatment plan for a patient with stage 3 maxillary sinus cancer, which has begun to grow into the sinus bones or an adjacent lymph node. Patients with this stage of cancer may receive chemotherapy as well. 

If the cancer has spread to more than one lymph node and caused one node or more to grow bigger than 3 centimeters, or if the tumor has spread into adjacent structures such as the eye, skull, or frontal sinuses, the cancer is stage 4. This stage is also diagnosed if the tumor is classified as T4 for size or has metastasized to other body systems. Patients with this stage of cancer may still undergo surgery if the tumor is removable by such a technique, though some stage 4 cancers have progressed beyond this point and may instead call for radiation and/or chemo as a primary mode of treatment.

Uses of Dental Bone Grafting

For over a decade, Dr. George Hatzigiannis has served as an oral and maxillofacial surgeon. Throughout his career, Dr. George Hatzigiannis has performed many bone grafting procedures.

An oral and maxillofacial surgeon may perform bone grafting for patients who have experienced jawbone deterioration. Bone loss inevitably occurs following the loss of a tooth, as the tooth root protects the structural integrity of the jawbone. When a tooth is removed and not replaced, a patient could lose up to 25 percent of bone width within the first year following tooth loss.

For this reason, many patients receive a bone graft immediately following an extraction, so as to prevent future bone loss. Others receive a graft before dental implant surgery if their jawbone cannot support the implant post. This may occur because the patient does not have sufficient bone tissue, although it may also be due to a loss of density in the bone and a resulting softness that cannot stand up to the weight of the implant.

Bone grafting not only boosts the success of these procedures, but it also improves the overall appearance of the face. Bone provides the structural integrity that keeps the face from collapsing, which can lead to a prematurely aged appearance. An intact bone can maintain the look of the face and, in turn, help a patient to feel more confident.

What to Expect after a Bone Grafting Procedure

For more than a decade, Dr. George Hatzigiannis has served as an oral and maxillofacial surgeon in Massachusetts. Currently in private practice, Dr. George Hatzigiannis is experienced in a variety of dental procedures, including bone grafting, a topic on which he has given several lectures.

Following a bone grafting procedure, patients should avoid eating or drinking for at least an hour. For about 4-6 weeks following the grafting procedure (unless it was for a single tooth only), patients should minimize any chewing on the side where the bone graft was placed, and should avoid foods that break into sharp pieces, such as chips and popcorn. 

There is typically some discomfort following a grafting procedure, and most of it is a result of local swelling. While prescribed pain medicine, along with ibuprofen (as long as there are no allergies), can help with the discomfort, the most effective management is to minimize swelling. Keep your head elevated as much as possible during the day, and sleep on an extra 2-3 pillows in the evening for the first three days. Ice packs for the first 24 hours (20 minutes per hour) are also helpful. Dr. Hatzigiannis may also have prescribed a medication specifically designed to reduce swelling.

What is TMD and How Does it Differ from TMJ?

Award-winning oral and maxillofacial surgeon Dr. George Hatzigiannis previously practiced at Small Smiles Dental Centers and at a Massachusetts private practice. A graduate of Harvard School of Dental Medicine, Dr. George Hatzigiannis completed a six-year OMFS residency at UConn Health Center and is an expert in conditions such as temporomandibular disorder (TMD).

TMD refers to a dysfunction with the temporomandibular joint and the muscles that surround it. This can be caused by a variety of issues ranging from jaw injuries to arthritis to teeth clenching to autoimmune diseases. Symptoms of these include pain around the ear or pain in the jaw or neck. Other symptoms of TMD include popping in the jaw joint when the mouth is opened or closed, chronic headaches, and discomfort while chewing and swelling.

Despite TMD’s commonality, many confuse this condition with TMJ. This is technically incorrect. TMJ refers to the temporomandibular joint that allows people to talk, chew, and move their mouths, instead of a type of condition. The symptoms that most people attribute to TMJ are actually symptoms of TMD, and thus, it is more accurate to refer to such problems either as TMD or as TMJ disorders.

Massachusetts-Based Dentist Dr. George Hatzigiannis

An oral surgeon in Massachusetts, Dr. George Hatzigiannis practiced with Salem Peabody Oral Surgery for almost four years before moving on to a role as a dentist with Small Smiles Dental Centers, which operates in Brockton, Lawrence, and Worcester, Massachusetts, in addition to Manchester, New Hampshire. Dr. George Hatzigiannis focuses on community care and has previously volunteered with Dentistry With A Heart, for which he spent a day providing treatment to 122 patients.

Beyond this, Dr. Hatzigiannis lectured on a range of subjects between 2006 and 2010, covering subjects such as bone grafting in oral surgery and the applications of cone beam technology, among others.

Dr. Hatzigiannis began his formal education at Harvard College, from which he graduated cum laude with a bachelor’s degree in biology. He has since earned not only his DMD from the Harvard School of Dental Medicine, but also his MD from the University of Connecticut School of Medicine.

Dr. George Hatzigiannis - Patient-Centered Oral Surgery Care

Dr. George Hatzigiannis is a respected Massachusetts oral surgeon with experience treating patients for a wide range of conditions. He practiced with Salem Peabody Oral Surgery in Peabody for four years where he maintained a strong community focus. Along with his fellow dentists, Dr. George Hatzigiannis offered a day of Dentistry With A Heart, which involved treating 122 total patients.

Next engaging as a dentist at Small Smiles Dental Centers, Dr. Hatzigiannis provided services that included dental implant rehabilitation and facial trauma care for the underserved. He continued to emphasize the treatment of community members in need through MassHealth.

Dr. Hatzigiannis earned his bachelor’s at Harvard College cum laude and pursued his doctor of medicine in dentistry at the Harvard School of Dental Medicine. He subsequently pursued advanced dentistry studies at the University of Connecticut and completed a residency at the UConn Health Center. Dr. George Hatzigiannis is of Greek heritage and maintains a focus on the Orthodox faith in his daily life.