# Dolman Oral Surgery — Full Site Content

> Premier Oral & Maxillofacial Surgery in Midtown Manhattan.

- Phone: (212) 696-0167
- Address: 16 E 52nd Street, #402, New York, NY 10022
- Hours: Mon–Fri: 8:00 AM – 6:00 PM
- Book an appointment: https://book2.getweave.com/cb9670c7-51da-48c3-8c60-eec3a311654f/request-appointment?source=WEBSITE
- Reputation: 5.0/5 (542 Google reviews)

## Services

### Wisdom Teeth Removal
URL: https://dolmanoralsurgery.com/services/wisdom-teeth-removal

Expert removal by a board-certified oral surgeon with comfortable sedation options and a well-supported recovery. Choosing the right oral surgeon is the single most important factor in your outcome.

A Common Procedure, Handled By An Expert
The removal of wisdom teeth is a highly common procedure. Early removal (late teens to early twenties) has proven to be easier, with a more rapid and comfortable recovery.
Wisdom teeth are one of the most common problems handled at Dolman Oral Surgery. Choosing a board-certified oral surgeon is a crucial factor in the care and outcome that you receive.
Wisdom Teeth 101
What are wisdom teeth?
Usually, an adult develops four wisdom teeth, one in each quadrant (corner) of the jaw. The first adult molar generally erupts around age 6, and is often referred to as the “6-year molar.” Around age 12, the second molar erupts directly behind it and may be referred to as the “12-year molar.”
The expectation is for the third molar to erupt directly behind the second molar around age 18 (17–25), or the time when one should be gaining wisdom, hence the term “wisdom tooth.”
Impacted Teeth
Problems with impacted wisdom teeth
When a wisdom tooth is unable to erupt or push through into the mouth, it is referred to as an impacted wisdom tooth. Impacted wisdom teeth may be fully embedded in the jawbone or may be partially exposed into the mouth.
Impacted wisdom teeth usually result from an inadequate amount of space in the jawbone and/or a misalignment of the tooth itself, meaning the wisdom tooth is tilted, angled or crooked.
These impacted wisdom teeth and their surrounding soft tissue may become inflamed, painful, infected, and/or decayed. They may compromise the periodontal health of the adjacent second molar and/or contribute to decay. Rarely, the tissue around wisdom teeth may develop into localized cysts which in turn may compromise the strength and integrity of the jawbone if not treated.

**Three reasons patients come to us**
- Pain, swelling, or halitosis (bad breath): Typically the patient will have a decayed wisdom tooth and/or infected soft tissue (pericoronitis) surrounding the wisdom tooth. They often have difficulty opening their mouth and their face and/or neck may be swollen. The pain may increase when biting. In more advanced scenarios fever may be present along with difficulty swallowing.
- A hidden problem: This group includes patients with a situation they are not aware of, such as decay (caries) or periodontal disease that is silent or dormant. Rarely, they may have a localized cyst or tumor. These patients are typically identified on a routine examination.
- Planned, early removal: The classic group of 16–25 year olds in whom impacted wisdom teeth are identified during routine radiographic work-up. Removal is generally beneficial to prevent the onset of pain, infection, periodontal disease and decay. Surgical removal in this group is often the easiest, with the quickest recovery and least amount of risk.

**Your Typical Wisdom Tooth Treatment**
At Dolman Oral Surgery, you will be thoroughly and comprehensively evaluated to determine whether your wisdom teeth need to be removed or whether retention is more appropriate. As with each patient, Dr. Dolman will listen carefully to your concerns, examine you fully using state-of-the-art technology, and completely customize your treatment.
1. A thoughtful first visit: At the initial visit, Dr. Dolman will carefully listen to your concerns. He will compile a complete medical and dental history followed by a thorough physical oral and head and neck examination inclusive of the TMJ.
2. Detailed imaging: This will be followed by detailed radiographic evaluation comprised of a panoramic radiograph and occasionally a 3-D image or I-CAT CT scan when required and as determined by the needs of the patient.
3. A plan made for you: Once all the information has been compiled and reviewed, Dr. Dolman will explain the nature of your situation, review all associated risks and benefits, and recommend the appropriate treatment specifically for you. All of your questions will be answered carefully and to your satisfaction in an unhurried manner.
4. Comfortable + careful surgery: An appropriate surgical date and time will then be arranged to accommodate your schedule. If required and desired, surgery may be possible on the same day.
On the day of surgery, your treatment will be reviewed again together with you, and all your questions will be answered. Informed consent will be reviewed and signed, and treatment will be completed in an unhurried, uninterrupted, comfortable and calm setting.
When done, you will remain in the office for a short time for observation and then be able to go home. If required, a car will be called on your behalf and you will be escorted to it. A follow-up will be pre-arranged for the week(s) following your surgery.

**Healing Comfortably After Surgery**
- Rest & limit swelling: Bite gently on the gauze, apply an ice pack 20 minutes on and off, and keep your head elevated. Take it easy, arrange a ride home, and skip strenuous activity for the day.
- Soft, cool & hydrated: Stick to soft, cool foods and plenty of fluids. For several days, avoid straws, smoking, and vigorous rinsing as each can disturb the clot and lead to a dry socket.
- Managing discomfort: Take any medication exactly as directed. Swelling usually peaks around 48–72 hours, then steadily improves. After the first day, gentle warm salt-water rinses keep the area clean.
- Reach us anytime: A follow-up is arranged for the weeks after surgery, and Dr. Dolman is available after hours by phone, text, or email. If anything concerns you, just call.

**FAQs**
- Q: Do all wisdom teeth need to be removed?
  A: No. Every case is different. Occasionally, a wisdom tooth will fully erupt into a normal position. Provided it can be easily maintained and it remains free of periodontal disease and decay, it can usually be left in place.
Additionally, it is important to evaluate its effect on the neighboring teeth. Oftentimes, your dentist or hygienist will recognize that your wisdom teeth are interfering with your ability to properly clean and maintain the adjacent second molars. Even though the wisdom teeth are not problematic per se, it may be decided to remove them to help you maintain the teeth directly in front. Dr. Dolman will examine you carefully and determine if in fact your teeth need to be removed.
- Q: How long will the extraction take?
  A: Of course, every case is different, some taking longer than others. Recognizing that often all 4 wisdom teeth are removed in one visit, it will usually take less than 1 hour for treatment to be completed.
- Q: Do I have to remove all four wisdom teeth at one time?
  A: No. Each treatment plan is specific to the patient and will be customized, combining Dr. Dolman’s recommendations and the patient’s needs and wants.
- Q: Is the treatment painful?
  A: No. Dr. Dolman will make your treatment fully comfortable. Should you desire, he will use intravenous sedation or general anesthesia as needed.
- Q: Do I have to go to sleep for the procedure?
  A: No. Dr. Dolman can perform your procedure with complete comfort and absolutely no pain without the need to go to sleep.
- Q: How long is recovery?
  A: Recovery varies from patient to patient. Typically, the usual recovery ranges from one to four days.
- Q: What happens if I have a problem after surgery?
  A: Dr. Dolman is easily available after hours. He can be reached directly on his cell phone and/or email or text messaging. You can feel fully at ease with the understanding that Dr. Dolman is easily accessible for any questions you may have.
- Q: What is a dry socket and what do I do if I get one?
  A: A dry socket is a situation when the blood clot in the extraction site dissolves too soon and leaves the area exposed. The site becomes very painful and will not typically respond to the use of analgesics (pain medication). This usually occurs on or around the 4th day after surgery. Should you have a problem at any time, you can easily reach Dr. Dolman on his cell phone, via texting or email.

### Dental Implants
URL: https://dolmanoralsurgery.com/services/dental-implants

Permanent, natural-looking titanium implants placed by a surgeon to replace one or more missing teeth. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

Permanent Solution, Expertly Placed
Within the field of dentistry and oral surgery, dental implants are arguably the most significant innovation in the last 50 years, providing patients with permanent replacements for their missing teeth.
The only true surgical specialty within the field of dentistry is oral and maxillofacial surgery. Implant placement is a surgical procedure. Dr. Robert M. Dolman is a board certified oral surgeon who has had extensive training and experience in implant surgery. The single most important factor in the success of your implant treatment is the surgeon rendering your care.
For anyone with one or several missing teeth, dental implants have become important options to anchor and support new teeth that resemble the missing ones.
Dental Implants 101
What Are Dental Implants?
Simply put, dental implants are titanium screws that are gently inserted into the jaw bone, where they serve as permanent, solid anchors for new teeth. These teeth provide patients with the comfort, function and esthetics similar to their own original teeth.
Patients Who Benefit From Dental Implants
Who Can Benefit From Implants?
Dental implants are the most solid and longest lasting treatment option for individuals who are missing one, many or all of their teeth. Two general patient categories exist:
Patients that are missing all of their teeth in either the upper and/or lower jaw (complete edentulism) and therefore must wear complete upper and/or lower dentures, or
Patients who are missing a single tooth or several teeth, but not all teeth (partial endentulism).
Patients With Complete Edentulism (Missing All Teeth)
Patients who wear complete dentures will often complain that their denture(s) is loose, or that they have pressure or sore spots in their mouth. This tends to get worse with time because the bone beneath the dentures resorbs and the dentures become less retentive and loose. These patients can really benefit from implants in a dramatic manner because the implants can reduce denture mobility and may even eliminate it completely, at the same time reducing or eliminating all sore spots or irritations.
Treatment options include:
2-4 implants with retentive anchors (locator abutments) that allow the dentures to snap into place.
5+ implants that allow for a denture or porcelain metal prosthesis to be screwed into the implants or cemented on the implants which creates a completely fixed result that cannot be removed.
"All on 4" is a treatment method that in select cases allows for the restoration of a full dentition on 4 implants.
Patients With Partial Edentulism (Missing Some Teeth)
Patients that are just missing a single or a few teeth, have the following treatment options:
Partial Denture: Partial dentures have the advantage of replacing many teeth with one single prosthesis with very quick results. The disadvantages however are the fact that a partial denture is removable, needs to be taken out at night, may become loose, can be unesthetic with the visibility of clasps or hooks on the remaining teeth, and can be uncomfortable.
Conventional Crown and Bridge Work: If the position of the remaining teeth allows, then crown and bridge work may be a possible solution for the replacement of missing teeth. This also tends to be a fast and stable solution. However, in order to fabricate a bridge, the adjacent teeth need to be prepared (filed down), and often a root canal is required as well. Additionally, with the teeth fused together, they become more difficult to clean and are more susceptible to periodontal disease. Moreover, should any of the anchoring teeth require future extraction, then the bridge may be lost.
Dental Implants: An implant can be placed in the location of each missing tooth, either a single tooth or several missing teeth. Often, a few implants can be used to act as anchors for many missing teeth. Implants preserve the adjacent natural teeth and leave them in an unused, unharmed condition. Should any treatment be required on these adjacent teeth, the implant can remain freestanding and untouched. Moreover, the implant will preserve the bone volume. Implant-supported teeth are easier to clean because they stand alone and dental floss can easily be slipped alongside, exactly like a natural tooth. A successful implant will outlast all other treatments.

**Evaluating Your Candidacy For Dental Implants**
- Requirements For Dental Implants: Regardless of the number of missing teeth, the minimum requirement for the placement of a dental implant is the availability of sufficient bone height and bone thickness in an anatomically appropriate location.
At Dolman Oral Surgery, Dr. Robert M. Dolman will combine a thorough clinical examination together with the required radiographic images. Our onsite I-Cat CT scanner will be used when indicated to determine bone availability and to assist in the precise placement of the implant.
- Contraindications For Dental Implants: There are few situations when implant surgery is not appropriate. An absolute contraindication for implant placement would be the lack of bone volume. Bone grafting and augmentation procedures would therefore be required in preparation for the placement of dental implants.
Although smoking is not a contraindication to implant treatment, it is a known compromising factor and success rates have been shown to fall by 30%.
Additionally, certain immuno-compromised patients may not be candidates for implant surgery. Moreover, patients on bisphosphonates (drugs used to treat bone loss and osteoporosis) would require additional work up, testing and evaluation with the potential for treatment determined on a case by case basis.
Certainly, each case and case history will be closely evaluated by Dr. Robert M. Dolman to make sure that there is no specific contraindication for your implant surgery.

**The Team Approach Towards Dental Implants**
Implant placement is a surgical procedure. By choosing Dolman Oral Surgery, you are choosing to have your treatment rendered by a board-certified oral and maxillofacial surgeon with extensive clinical experience.
The surgeon however is only part of an implant team. While the oral surgeon places the implants, it is the restorative dentist that will subsequently place teeth on top of the implants. This approach gives patients the true benefit of specialty care and optimal results.
1. Step 1: Evaluation and Planning: All implant patients are first seen at Dolman Oral Surgery for a consultation. During this initial visit, Dr. Dolman will compile a detailed medical and dental history. This will be followed by a thorough oral examination of both the hard and soft tissues along with a standard head and neck examination.
A baseline panoramic radiograph will be required. Dr. Dolman will combine all of this information, and he will determine the need for a 3D image using the in-house state-of-the-art I-Cat CT scanner.
At this stage, Dr. Dolman will determine the possibility of placing an implant(s) and he will discuss all associated risk and benefits of both implant and non-implant treatment options. Should it be determined that bone availability is compromised, then Dr. Dolman will also discuss bone graft options in preparation for implant placement.
Dental impressions are often required in order to evaluate the occlusion (the way teeth bite together). These models also allow for fabrication of a surgical splint which helps guide the placement of the implants in the most prosthetically appropriate position. Alternately, as the case dictates, a 3-D computer-generated surgical guide may be employed.
Once all of the information is gathered and evaluated, Dr. Dolman will discuss and coordinate the details of your treatment with your restorative dentist to optimize your results.
2. Step 2: Dental Implant Surgery: At Dolman Oral Surgery, Dr. Dolman will place your implants following specific and recognized implant protocols. Surgery will be completed under either local anesthesia and/or intravenous sedation – depending on what a patient wants or needs.
Dr. Dolman will utilize custom-made surgical guides to optimize and streamline the placement of the implants. Also, Dr. Dolman will incorporate the use of customized 3-D generated guides using either STRAUMANN® CARES® Guided Surgery or NobelGuide technology or Simplant Technology depending on the specific requirements of each case.
At Dolman Oral Surgery, Dr. Dolman utilizes the highest quality materials without compromise. It would be difficult to find implants with greater success rates and history of longevity, durability and scientific validation than either the Straumann Implant or NobelBiocare Implant.
Combining his experience with both systems, Dr. Dolman has easily placed more than 1000 implants. He trained directly with professor Branemark in the late 1980's on what's now known as the Nobel System, and he has lectured on and taught others regarding the use of the Straumann Implant System.
There are two basic implant protocols to choose from:
Two-staged approach: In this scenario, the implant is placed into the bone and the soft tissue is closed over the top of the implant. The implant is left to heal in this submerged manner for 3 months. After 3 months, the implant is uncovered and after a brief period of soft tissue healing, the restorative dentist can proceed with fabrication of the teeth on top of the implants. This approach is generally restricted to the cosmetic zone.
Single-stage/Transgingival Approach: This is the preferred method at Dolman Oral Surgery – the implant is placed in the bone and the soft tissue is closed around (not over) the implant. This allows the soft tissue to heal at the same time as osseointegration is occurring. Thus, there is no need for a second intervention and the implant can be loaded sooner than in the two-stage approach. For this single-stage approach, Dr. Dolman will frequently use the Straumann Implant System, the industry leader in single-stage surgery, which allows for restoration to occur within 30 days and with success rates of 99.4%.

**After Implant Surgery**
- Single-Stage/Transgingival Approach: Single-Stage/Transgingival Approach: If a single-stage approach is performed, then no additional surgery is required. The implant is verified for its integration and stability between weeks 4-8 post-surgery. The patient then returns to their restorative dentist for fabrication of their new teeth.
- Two-Staged Approach: Two-Staged Approach : If a two-stage approach is employed, then a minor second procedure is required at the 4-8 week time frame. The implant is uncovered, and the surrounding soft tissue must heal for an additional 2-4 weeks prior to restoration by the dentist.

**FAQs**
- Q: Is there more than one way to treat my problem?
  A: Rarely is there just one path. I make a point of carefully listening to your concerns and then recommending the specific treatment you actually need, not a one-size-fits-all plan. Dental implants are a good example: a single implant can replace one missing tooth, or several can be placed together to restore many. And not every case even calls for surgery; with wisdom teeth, for instance, not all of them require removal. We’ll walk through your options together at your consultation.
- Q: When is the best time to have this surgery?
  A: That depends on your diagnosis, and it’s worth getting right. With wisdom teeth, earlier is often easier, and removal in the late teens to early twenties tends to mean a more rapid, comfortable recovery. With something like TMJ, I examine you thoroughly first to decide whether a surgical procedure would truly help or whether a more conservative approach makes more sense. The right time is the one that fits your situation, and that begins with an evaluation.
- Q: Where will my procedure be performed?
  A: Most procedures are performed right here in our Midtown Manhattan office, near Rockefeller Center and just a few blocks from Grand Central, easy to reach from uptown, downtown, New Jersey, and Connecticut. For more complex cases, such as major facial trauma, care is provided in a hospital setting. We’ll tell you exactly where your procedure will take place as we plan your treatment.
- Q: How long is the procedure/recovery?
  A: Implant surgery can be performed without any pain whatsoever. Local anesthesia is often adequate, however, Dr. Dolman will utilize intravenous sedation for your comfort as required. Remarkably, post-operative discomfort is usually minimal.
- Q: How long does it take to get my teeth?
  A: Once the implant has integrated (Straumann’s SLA active implant has the fastest integration time at 30 days), then teeth can be fabricated on top of the implants. Although there are cases where the implant can be loaded immediately, this is a temporary scenario and should be done only in very carefully selected cases. The 30-day loading time is the fastest permanent loading time.
- Q: Why would I have one-stage vs. two-stage?
  A: This is a determination that is made by Dr. Dolman. Whenever possible, Dr. Dolman will utilize a single-stage protocol. However, certain esthetic scenarios require the use of a two-stage approach.
- Q: Will implants feel exactly like natural teeth?
  A: An implant supported tooth/teeth will be imperceptible from the natural dentition and offer the comfort, function and esthetics of natural teeth. Initially, there will be a difference in “feel” when compared to neighboring teeth. However, the new teeth will “blend in” with the natural teeth and eventually the patient will not recognize any difference at all.

### Bone Grafting & Reconstruction
URL: https://dolmanoralsurgery.com/services/bone-grafting

Rebuilding lost jaw bone to support dental implants and restore structure. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

Restoring Bone, Function & Building A Strong Foundation
Bone grafting is a procedure where bone is transferred from one area or location and placed into a new location in order to optimize comfort, function and esthetics. The oral and maxillofacial surgeon can therefore "build bone" in areas where it is missing.
In the practice of oral and maxillofacial surgery, the need for bone grafting presents itself in a multitude of situations. Bone grafting is required to replace missing bony tissue, and in many cases support the placement of dental implants.
At Dolman Oral Surgery, Dr. Robert M. Dolman has had extensive training and experience in the areas of bone grafting and reconstruction. He employs an evidenced-based approach utilizing the industry's highest quality materials and standards of care.
Two Categories of Bone Grafting
Types of Bone Grafting
The typical needs for bone grafting can be best explained by dividing it into two main categories. Regardless of the group, the principles and protocols of grafting remain the same.
The first group includes minor bone grafting which typically falls within the parameters of oral surgery and can generally be managed in an office setting. These grafts are generally placed in preparation for future dental implants.
The second group will consist of major grafting which will fall within the scope of maxillofacial surgery and is usually performed in a hospital setting. These grafts are usually required to replace large bony defects resulting from trauma or pathology.
Your Bone Graft Choices
Where Does The Bone Come From?
The usual question is "Where Do You Get The Bone?" or "Where Does The Bone Come From?"
There are four graft choices:
Autogeous Grafts: The bone comes from within the same individual. In other words, the patient is his/her own donor.
Allografts: The bone comes from another human donor.
Xenografts: Donor bone derived from another species, usually bovine sources.
Synthetic Grafts: Bone created from Hydroxyapatite, Hydroxyapatite combined with B-Tricalcium phosphate, and Calcium Sulfate.

**Minor Bone Grafting And Reconstruction**
The first group includes minor bone grafting which typically falls within the parameters of oral surgery and can generally be managed in an office setting. These grafts are generally placed in preparation for future dental implants.
Bone grafting in this group of patients is generally performed in preparation for placement of dental implants. The basic requirement for the placement of a dental implant is having the adequate bone height and bone thickness. If either is lacking, then a bone graft may be required in order to allow for placement of an implant. Typical scenarios include the following:
1. Socket Preservation Graft with Guided Bone Regeneration: In these cases, a patient's tooth needs to be extracted because the tooth is beyond repair. This may occur as a result of caries (decay, cavity), advanced periodontal disease (gum disease & bone loss), or trauma (broken or fractured tooth). Prior to extraction, Dr. Dolman will review tooth replacement options along with the associated risks/benefits, as well as durability and outcomes. If an implant is determined to be the best treatment, then a socket preservation graft is usually required. In preparation for an implant, a bone graft is advantageous because it optimizes the residual bone height and thickness and in so doing allows for the proper placement of the implant.
2. Sinus Lift Procedure: Oftentimes in the back part of the upper jaw (posterior maxilla), the maxillary sinus dips downwards and reduces the amount of bone in the area. When teeth are missing, and the patient requires implants in this area, a sinus lift and bone graft may be required to create the height for implant placement. After careful clinical examination and appropriate x-rays, which may include a panoramic radiograph and possibly a 3-D I-Cat CT scan, Dr. Dolman will be able to determine the available bone for implant placement and the need for a sinus lift.
3. Ridge Augmentation: In the absence of a tooth or teeth, the bony ridge may be too thin for implant placement. In order to thicken the bone, an onlay graft may be required: A small block of bone is harvested from either the chin or the back of the jaw bone and the bone is tacked on to the thin site to improve the thickness. Other augmentations can be accomplished with a split ridge graft or distraction osteogenesis.

**Major Bone Grafting And Reconstruction**
- Restoring Bone After Trauma or Disease: The second group will consist of major grafting which will fall within the scope of maxillofacial surgery and is usually performed in a hospital setting.
These grafts are usually required to replace large bony defects resulting from trauma or pathology. Major grafting procedures are required when an individual loses part of the jaw bone. This can result from either a traumatic injury or a pathologic entity, usually a large cyst or tumor whether benign or cancerous. The bony reconstruction in these cases will require advanced techniques, often requiring a multidisciplinary approach. Bone will usually be harvested from the hip bone or wrist bone or tibia (leg).

### Corrective Jaw Surgery
URL: https://dolmanoralsurgery.com/services/corrective-jaw-surgery

Orthognathic surgery to correct alignment of teeth and jaws for better function, comfort and facial balance. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

Correcting Jaw Alignment With Precision
Oral and maxillofacial surgeons utilize orthognathic surgery, or corrective jaw surgery, to treat patients with severe malocclusions that involve misalignment of both the teeth and the jawbones.
As a board certified oral and maxillofacial surgeon, Dr. Robert M. Dolman is uniquely qualified to perform corrective jaw surgery combining his foundation of a dental education together with advanced and extensive surgical training.
Whenever there is an imbalance in the relationship between the upper jaw (maxilla) and lower jaw (mandible), individuals may benefit from procedures that align the jaws into a more functional and comfortable, balanced position.
This imbalance or disharmony is referred to as a dentofacial deformity. Although the objective of orthognathic surgery is to achieve balance and occlusal stability (stable bite), the results will generally yield improved esthetics as well.
Below, you’ll find more information on the types of dentofacial imbalances, how these imbalances can be corrected, as well as a typical treatment course through Dolman Oral Surgery.
Corrective Jaw Surgery 101
Process for Correcting Dentofacial Imbalances
It is important to recognize that a dentofacial imbalance is a condition of bone development and consequently a misalignment beyond the teeth alone. When only the teeth are in an improper position, then orthodontics alone will be adequate to correct any existing problems. However, in the presence of a skeletal (bone) discrepancy or disharmony, the jawbones will need to be surgically repositioned as well.
Detailed dental and facial measurements combined with radiographic analysis and surgical simulation will allow the oral maxillofacial surgeon to determine the contributing elements of the deformity.
A surgical plan can then be mapped out to pre-determine all phases of the surgery. Correction of all imbalances can almost always be achieved by combining specific bony cuts and movements, including such procedures as:
Lefort I Osteotomy of the Maxilla: An osteotomy is defined as a cut in the bone. A Lefort I osteotomy is a bony cut through the maxilla at a level just below the nose, extending around the entire aspect of the upper jaw.
Osteotomy of the Mandibular Ramus: A sagittal split osteomy which allows the lower jaw to be slid forwards or backwards or a vertical osteomy which allows the lower jaw to be pushed backwards.
Genioplasty: A bony cut through the chin allowing for its movement in any desired direction.
A combination of the above procedures, with modifications, will solve most dentofacial deformities and lead to a vastly improved comfort, function and esthetics.

**Types of Dentofacial Imbalances**
- Retrognathism: This imbalance is often referred to as an overbite wherein the lower jaw appears retruded or shortened.
- Prognathism: This is the opposite situation in which the lower jaw appears more prominent or longer and is often referred to as an underbite.
- Apertognathism: This condition is defined as an open bite, where the front teeth do not meet. It is often combined with either retrognathism or prognathism.
- Asymmetry: This situation occurs when the jawbones appear tilted or rotated such that the face appears larger (or more prominent) on one side versus the other. It can occur in combination with any of the above categories.
- Vertical Excess and Deficiency: Relationships of the jaws and face appear long or short in a vertical direction. This also will occur in combination with any of the above situations.

**Typical Orthognathic Surgery Procedure**
Oftentimes, an orthodontist will evaluate a patient and recognize the need for corrective jaw surgery (orthognathic surgery). He will then refer the patient to a board certified oral and maxillofacial surgeon for evaluation.
At Dolman Oral Surgery, Dr. Robert M. Dolman has extensive training and a long-standing experience in the area of corrective jaw surgery. As always, Dr. Dolman will meet with you for a consultation. He will carefully listen to your concerns and answer all of your questions.
1. History, Examination & Imaging: Dr. Dolman will compile a detailed dental and medical history after which he will complete a thorough clinical examination. As needed, Dr. Dolman will obtain the required radiographs to support his clinical findings. If required, Dolman Oral Surgery has an I-CAT 3D CT Scanner on site.
2. Comprehensive Orthodontic-Surgical Plan: Once Dr. Dolman has accumulated all necessary information, he will meet with your orthodontist to discuss his findings and create a comprehensive and coordinated orthodontic-surgical plan.
3. Orthodontic Preparation, Surgery & After Care: A period of orthodontic preparation will be required in advance of surgery. When proper tooth alignment has been achieved, Dr. Dolman will then plan the details of surgery and coordinate hospital admission and follow up care.

**Healing Comfortably After Surgery**
- A Team Approach To Your Healing: Consultation with a nutritionist will be required along with a physical therapist. Dr. Dolman will follow you closely throughout your recovery period, making himself easily available to address any questions or concerns that you may have, at any time.
After several weeks of bone healing, you will return to the orthodontist for the final phases of your treatment.

### Apicoectomy
URL: https://dolmanoralsurgery.com/services/apicoectomy

Surgical root canal to clear infection and save a tooth after prior treatment. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

When A Root Canal Isn’t Enough
An apicoectomy is often referred to as a surgical root canal. To better explain, the tip of the tooth is referred to as the "apex" of the tooth, and the term "ectomy" means to excise or cut.
Therefore an apicoectomy can be defined as cutting or excising the tip of a tooth. The treatment is usually required when an individual has a "toothache" in a tooth that has already had a root canal procedure.
Determining If You Need Treatment
How Do I Know If I Need An Apicoectomy?
Typically, an individual will complain of pain associated with a tooth that may occur with or without swelling. This would create the need to visit the dentist. The dentist will examine the patient and take the appropriate x-rays. If the toothache is identified as occurring in a tooth that has already received root canal treatment, then an apicoectomy may be required. The patient should then be referred to a board certified oral and maxillofacial surgeon for evaluation.
Alternately, the patient may have no complaints at all, but the dentist may identify a new infection or cyst at the tip of a tooth that has already had a root canal treatment.
At Dolman Oral Surgery, Dr. Robert M. Dolman will carefully examine you and review the appropriate x-rays. He will determine at that time if an apicoectomy is the appropriate treatment or if alternate options are available.
Treatment Options
What Are My Options Other Than An Apicoectomy?
If a "toothache" exists in a tooth that has already had a root canal treatment, or a new infection occurs in the absence of pain, then the first option may be to redo the root canal treatment which is referred to as a "retreatment."
Dr. Dolman may refer you to an endodontist (root canal specialist) to accomplish a retreatment and help avoid the need for surgery.

**Typical Apicoectomy Treatment Course**
1. Assessment: Once it has been determined that an apicoectomy is the appropriate treatment, Dr. Dolman will review the nature of the procedure and its associate risks/benefits and expected outcomes.
2. Treatment: On the day of the treatment, you will be escorted into the treatment room and the required anesthesia will be provided. Local anesthesia is generally appropriate and if desired, Dr. Dolman is able to provide you with intravenous sedation to make your treatment as comfortable as possible.
Treatment will completed with both magnification and ultrasonic instrumentation – the industry’s highest standards.
3. Recovery & After Care: After surgery, the patient will be observed in the office and discharged when appropriate. Follow up will be arranged for the following week. Typically, recovery is rapid with perhaps 1-3 days of minor swelling and discomfort. Patients can usually resume usual activities within 24 hours.

### Cuspid Exposure
URL: https://dolmanoralsurgery.com/services/cuspid-exposure

Surgically uncovering an impacted canine and guiding it safely into place. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

Guiding Your Smile Into Place
Sometimes a cuspid or canine tooth is blocked from pushing into the mouth. This in turn can alter the position of the teeth and affect both function and esthetics. Surgical exposure and orthodontic alignment are generally required.
The cuspids (or canine teeth) are easily visualized as the corner teeth in the front of the mouth. These teeth appear as pointed "fangs" and are referred to as "eye teeth". Cuspids are the last of the front teeth to surface into the mouth and they do so at or around the age of 12-13. These teeth are naturally positioned between the premolar teeth behind them, and the incisor teeth in front. Notably, the cuspids are the longest teeth in the mouth and they serve the important role of tearing food and guiding the jaws during grinding motions. In doing so, they protect the other teeth.
Cuspid Exposure 101
Impacted Cuspids (Canine Teeth)
Occasionally, the canine teeth become impacted. The term "impacted" essentially means that the teeth are unable to erupt or push through into the mouth because they are blocked from doing so. This usually occurs as a result of inadequate space or a tilted angle of eruption, meaning the canine tooth is misdirected or poorly aligned.
Impacted Canines
How Do I Know If My Canines Are Impacted?
Many people, including many parents, wonder if their (or their children's) canine teeth are impacted, and if so, what they should be doing about it.
An impacted canine is typically a silent situation and is not accompanied by any discomfort or altered function whatsoever. Typically, the condition is only identified by a dentist during a routine examination.
Through the combination of a careful examination and standard x-rays, the dentist will observe an abnormality in the alignment of a child's teeth which will generally lead to a referral for an orthodontic consultation.
Occasionally, a parent may question why one deciduous (baby) canine tooth has not yet fallen out when compared to the opposite side which fell out several months earlier. The parent would then bring their child to the dentist who in turn may identify an impacted canine as the cause.
After thorough evaluation and work up with an orthodontist, a comprehensive treatment plan is established. Sometimes the orthodontist can create space to facilitate the normal eruption of the impacted canine. When this cannot be accomplished, referral to a board certified oral surgeon is required.
At Dolman Oral Surgery, Dr. Robert M. Dolman has exposed hundreds of impacted canines for their orthodontic alignment. Dr. Dolman will work carefully with your orthodontist to optimize your results. Treatment will be accomplished in an unhurried, careful and caring manner. Intravenous sedation is available as indicated.

**Typical Treatment Course For Exposing Cuspids**
Because this is a childhood condition, it is always facilitated by a parent.
Once the orthodontist has outlined the appropriate plan, he will refer you to Dolman Oral Surgery to meet with Dr. Dolman for a consultation. At the time of the consultation, Dr Dolman will meet with you and your child.
1. History, Comprehensive Examination & Imaging: A thorough medical history will be completed and reviewed, combined with a comprehensive examination and any necessary x-rays. Oftentimes, Dr. Dolman will be able to use the x-rays that have already been taken by your child's orthodontist and/or dentist. Occasionally, and only when absolutely necessary, a 3-D CT scan image may be required to best image the situation. Fortunately, Dolman Oral Surgery is one of the few offices in NYC that has its own I-Cat CT scanner, along with many other state-of-the-art surgical technologies.
2. Coordinated & Compassionate Surgical Plan: Once all information has been gathered, a coordinated surgical plan will be established. Recognizing that this is an imposing experience for a child, Dr. Dolman will spend the time to get to know your child, explain the treatment to them and carefully answer all of their questions, alleviating any concerns that they may have. The nature of the procedure will be carefully reviewed along with any associated risks and benefits. Anesthesia options will be discussed and the use of intravenous sedation will be reviewed as well.
3. Surgery & After Care: On the day of surgery, an appropriate amount of time will be scheduled to allow for a careful and unhurried approach. Once the surgery is completed, all post-operative instructions will be reviewed and the appropriate follow up will be arranged. Dr. Dolman will make sure that you can easily reach him via phone, email or text message should any questions or concerns arise after surgery.

### TMJ Disorders
URL: https://dolmanoralsurgery.com/services/tmj-disorders

Diagnosis and treatment of jaw-joint pain, clicking, locking and dysfunction. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

A Personalized Approach To TMJ Care
The temporomandibular joint is located in front of the ear, and in diseases states it may cause jaw pain, ear aches, headaches and restriction in mouth opening.
It represents the articulation between the lower jaw (mandible) and the temporal bone (base of skull). Separating this "ball and socket" is a fibrocartilage disc that acts as a cushion between the two bones.
UNDERSTANDING YOUR TMJ SYMPTOMS
TMJ Disorders
When an individual complains of TMJ, they are generally complaining about a pain and dysfunction within this joint. The dysfunction usually presents as a clicking within the jaw joint and/or a locking of the jaw joint.
Both of these conditions represent a disharmony between the movement of the "ball and socket" and the gliding of the interposing fibrocartilage. In addition to the problems within the jaw joint, individuals may also complain about pain and dysfunction around the supporting musculature of the jaw and jaw joint.
At Dolman Oral Surgery, Dr. Dolman will take the time to listen to your TMJ complaint and after gathering all the required information, he will outline the appropriate treatment plan.

**Evaluation and Treatment of TMJ Dysfunctions**
- Details Assessment: Assessment of a ‘TMJ’ patient requires compilation of a detailed history, together with a thorough clinical and radiographic examination – which may even include MRI in certain situations.
- Non Surgical Treatment: Non-surgical management of TMJ issues generally involves the combination of soft diet, moist heat application, mouthguard/nightguard therapy, physical therapy, stress reduction, NSAIDs, as well as muscle relaxants to alleviate stress and its impact on the TM
- Surgical Intervention: For severe cases, surgical intervention may require TMJ arthroscopy and possible open-joint TMJ surgery.

### Oral Pathology
URL: https://dolmanoralsurgery.com/services/oral-pathology

Evaluation, diagnosis and surgical treatment of diseases of the mouth and jaw (cysts, tumors, lesions). Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

Expert Evaluation For Oral Health Concerns
Oral pathology is defined as the study and diagnosis of diseases of the mouth.
At Dolman Oral Surgery, Dr. Robert Dolman combines his training and background in dentistry, medicine and surgery to evaluate the oral cavity along with the head and neck area. Patients may visit the office with a varied list of complaints and/or diseases. Problems may include but are not limited to cysts or tumors of the jaw bones and soft tissue lesions of the oral mucosa, gingiva, lips, cheeks and tongue.

**Comprehensive Evaluation & Early Detection**
- Onsite Patient Evaluation: Dr. Dolman carefully listens to every patient's complaints and gathers a detailed dental and medical history. As required, Dr. Dolman will combine his detailed examination with radiographs inclusive of I-Cat 3D imaging which is available onsite at Dolman Oral Surgery.
This state-of-the-art equipment allows Dr. Dolman to evaluate his patients in a comprehensive, in-depth manner. Dr. Dolman will engage your Internist, GP or supporting specialists as required in order to optimize the desired outcome.
- Routine Examinations and Cancer Screening: In the absence of complaints, patients can also be seen in the office for a routine examination and cancer screening.
At Dolman Oral Surgery, Dr. Dolman will utilize Velescope Illuminator to help identify suspicious lesions along with OraRisk HPV – Salivary DNA Test that determines who is at increased risk for HPV-related oral cancers. As required, Dr. Dolman is able to determine the need for biopsy, and if indicated, Dr. Dolman has the expertise to provide this service, on site, in a fully comfortable and painless fashion.
Results will be processed with minimal delay and Dr. Dolman will pre-arrange a follow-up visit to review results together with you, and detail the appropriate treatment plan going forward.

### Facial Trauma
URL: https://dolmanoralsurgery.com/services/facial-trauma

Surgical repair of facial injuries to the teeth, jaws, and soft tissues. Performed by a board-certified oral & maxillofacial surgeon at Dolman Oral Surgery in Midtown Manhattan.

Compassionate Care For Facial Injuries
Oral and facial injuries are unfortunately highly common. Injuries often result from motor vehicle accidents and acts of violence along with sporting injuries like cycling, skateboarding, hockey and several others.
The skill set of an oral and maxillofacial surgeon is a unique combination of dentistry, medicine and surgery. This collection of skills is never more valuable then when treating a patient with facial injuries.
Moreover, the needs of the trauma patient extend above and beyond the advanced skills of the surgeon, requiring the sensitivity and compassion that is often required in managing both the patient and their family.
As a board certified oral maxillofacial surgeon, Dr. Robert M. Dolman brings these qualities together to treat his patients at the highest level of care and compassion.
INJURIES WE TREAT
Type of Facial Trauma
Oral and maxillofacial surgeons have broad training and experience in treating oral and facial injuries including:
Facial Lacerations
Fractured or avulsed teeth
Mandibular Fractures
Maxillary and midface injuries
Zygoma (cheekbone) Fractures
Orbital Fractures
Combination of all the above
The in-depth knowledge of the dentition and occlusion (the way teeth bite together) combined with extensive surgical training allows the oral surgeon to achieve results that maximize comfort, function and cosmetics.

**Treatment Scenarios**
- Expert Evaluation of Severity: The severity of the injury will dictate the level of treatment required. Although most injuries will require hospital admission, many isolated and minor injuries can be handled in the office with IV sedation, in turn avoiding the need for lengthy emergency room visits.
- Advanced Treatment Technology: At Dolman Oral Surgery, we are equipped with an I-Cat 3-D CT scanner allowing for superior imaging of the oral-facial injuries. Additionally, Dr. Dolman has advanced training and extensive experience to manage both minor and complex facial injuries.

## Doctors

### Dr. Robert M. Dolman — Board-Certified Oral & Maxillofacial Surgeon & Implant Specialist
URL: https://dolmanoralsurgery.com/doctors/robert-m-dolman

With more than 30 years of private practice experience, Robert was trained through McGill University in Montreal (Canada) and its associated teaching hospitals, and is renowned for his surgical excellence and delivering the highest standards of care for his patients.

Approach to care: I treat one patient at a time, and on time. You will receive courteous and timely service in an unhurried and relaxed atmosphere. Your surgery is a responsibility I take very seriously, and your care and comfort are my top priority.

Background: Robert is a graduate of McGill University Dental School, with subsequent training in oral and maxillofacial surgery, and completed his residency training at Montreal General Hospital during which time he attended McGill University’s School of Medicine and was granted a Master of Science degree in Oral and Maxillofacial Surgery. Dr. Dolman has earned the distinction of being named a Diplomate of the American Board of Oral and Maxillofacial Surgery, is a Fellow of the American Association of Oral and Maxillofacial Surgeons, a member of the New York State Society of Oral and Maxillofacial Surgeons, and one of America’s Top Dentists in the category of Oral and Maxillofacial Surgery.

Special interests (Caring expertise, recognized internationally): Dr. Dolman brings a caring and compassionate manner to every patient, along with sound surgical skills and judgment. Robert has lectured internationally on maxillofacial trauma, implantology, and bone grafting and reconstruction.

### Dr. Joel Ayon — Board Certified Oral & Maxillofacial Surgeon
URL: https://dolmanoralsurgery.com/doctors/joel-ayon

Dr. Joel Ayon is a board-certified oral and maxillofacial surgeon and implant specialist. He received his dental degree from the University of Pennsylvania School of Dental Medicine as a Dean Scholar, graduating with Honors in Public Health, and completed his specialty training in Oral and Maxillofacial Surgery at Montefiore Medical Center.

Approach to care: Dr. Ayon brings a compassionate and disciplined approach to patient care, combining advanced surgical training with a commitment to delivering exceptional treatment in a comfortable and supportive environment.

Background: Dr. Ayon is a graduate of the University of Pennsylvania School of Dental Medicine, where he was a Dean Scholar and graduated with Honors in Public Health. He completed his residency training in Oral and Maxillofacial Surgery at Montefiore Medical Center, serving as Chief Resident during his final year. Dr. Ayon has earned the distinction of being named a Diplomate of the American Board of Oral and Maxillofacial Surgeons.

Special interests (Advanced Surgical Care, Delivered with Compassion): Dr. Ayon provides the full scope of oral and maxillofacial surgery, with advanced training in dental implants, bone grafting, anesthesia, maxillofacial trauma, orthognathic surgery, and oral pathology.