Oral-Maxillofacial Surgery is a surgical specialty which involves the diagnosis, surgery and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
More simply put, the oral and maxillofacial surgeon is the orthopedi
c surgeon of the facial region. He or she is an individual who addresses problems ranging from the removal of impacted teeth to the repair of facial trauma.
What an oral and maxillofacial surgeon do?
Minor Oral Surgeries –
Surgical removal of impacted wisdom teeth and canine
Exposure of impacted tooth for bringing to dental arch
Surgery in relation to the maxillary sinus,
Treatment of various lesions in the oro-facial region,
Management of oral submucous fibrosis and related precancerous conditions,
Pre-orthodontic surgical procedures,
Major oral Surgeries:-
Dental & Maxillofacial Trauma – it includes soft tissue injuries of the facial region, fra
ctures of the mandible, maxilla, zygoma, it can be due to road traffic accident or due to assault.
Infections of the orofacial region.
Pathologic lesions of the maxillofacial region such as cysts and tumors
Cosmetic surgical treatment (Orthognathic Surgery) of malalignment and maldevelopment of
the jaws, including dentofacial deformities, assymetry etc.
Cleft lip and palate surgeries
Reconstructive procedures following trauma or cancer surgery of the maxillofacial region
Preprosthetic surgery and Dental Implants
Temporomandibular Joint disturbances
Oro-facial pain and other neurological abnormalities of the oro-facial region
Periodontal surgical procedures – involving teeth associated with mobility and severe gingival recession.
What are some reasons to visit an Oral-Maxillofacial Surgeon?
Have teeth replaced by having dental implants inserted.
Have oral surgical procedures performed in the office under outpatient ambulatory anesthesia.
Have a jaw, oral, or facial cyst or tumor diagnosed, removed and reconstructed.
Have your jaw aligned with orthognathic surgery.
Have your jaw joint(s) repaired with TMJ surgery.
Have facial and jaw reconstruction following cancer surgery.
Have your facial bones realigned after facial trauma.
Have a consultation to determine whether you are a candidate for aesthetic surgery.
Have a tooth extracted.
Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.
There are a number of possible causes of facial trauma. Motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries account for many. 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), bony injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).
When soft tissue injuries, such as lacerations, occur on the face, they are repaired by “suturing”. In addition to the obvious concern of providing a repair which 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). A well trained oral and maxillofacial surgeon is proficient at diagnosing and treating all types of facial lacerations.
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, and 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 and 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. However, 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 by allowing them to return to normal function more quickly.
The treatment of facial fractures should be accomplished in a thorough and predictable manner. 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”.
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 which 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 for the survival of the tooth. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to “wipe the tooth off”, since remnants of the ligament which 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 require the expertise of specialists that are well versed in the emergency care, acute treatment and long term reconstruction and rehabilitation of the patient.
Removal of Cyst
Removal of tumours
Management of oral cancer
What Is Orthognathic Surgery?
Corrective jaw surgery, or orthognathic surgery is performed by an Oral and Maxillofacial Surgeon to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth. Surgery 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
Who Is A Candidate For Orthognathic Surgery?
Most individuals who would become orthognathic surgical patients are aware of their problem prior to the diagnosis. It is common, however, for that patient to be unaware of the current options that are available to treat their condition. In addition, they may have been misled to think that treatment is barbaric and only reserved for the worst of circumstances (the other guy or gal). How do we become candidates for orthognathic surgery? As our jaws mature through the course of normal growth and development (i.e. adolescence), it is possible for the growth of the jaws to cease or to come to completion leaving a disharmony of function and esthetics. For any number of reasons the jaws can, at that time, remain disproportionate in size and shape. Following are some of the conditions that may indicate the need for corrective jaw surgery:
Difficulty chewing, or biting food
Chronic jaw or jaw joint (TMJ) pain and headache
Excessive wear of the teeth
Open bite (space between the upper and lower teeth when the mouth is closed)
Unbalanced facial appearance from the front, or side
Receding lower jaw and chin
Inability to make the lips meet without straining
Chronic mouth breathing
Sleep apnea (breathing problems when sleeping, including snoring)
An unfavorable genetic expression of growth (most common)
Tumor or other pathology
Your orthodontist and maxillofacial surgeon will work together to determine whether you are a candidate for corrective jaw, or orthognathic, surgery. The Oral & Maxillofacial Surgeon determines which corrective jaw surgical procedure is appropriate and performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics before and after surgery, may take several years to complete. Your maxillofacial surgeon and orthodontist understand that this is a long-term commitment for you and your family, and will try to realistically estimate the time required for your treatment.