Oral Maxillofacial Surgery - An Outline

Oral Maxillofacial Surgery is a unique discipline that marries medicine and dentistry. It entails a whole wide range of diseases and procedures from simple ones like impacted wisdom tooth and wisdom tooth surgery to complex complicated ones like jaw abnormalities and corrective jaw surgery. Complex reconstructive work like in a fibula free transfer graft also falls under the arm of oral maxillofacial surgery and may be done with the proper support and expertise.

Oral maxillofacial surgery as the name suggests refers to disease and procedures of the oral cavity and the region immediately surrounding it. It may even stretch as far up as the eyes and as low down as the neck. Simple diseases that falls under the branch of oral maxillofacial surgery includes tooth decay warranting tooth extraction and impacted wisdom tooth or an impacted or buried tooth that requires wisdom tooth surgery in the case of a wisdom tooth or just dento- alveolar surgery in the case of other teeth.

Soft tissue lesions such as a lump on the lip e.g. mucocele and the management also falls under the care of oral maxillofacial surgery. The excision of the mucocele or any other soft lesions is done under local anesthesia and sometimes general anesthesia. And very often, the tissue is sent to the pathology lab for a routine histology to confirm the diagnosis. Biopsies be it an incisional biopsy or excisional biopsy is also done.

Bigger lesions and pathologies like a dentigerous cyst, odontogenic keratocyst or an ameloblastoma are also routinely managed under oral maxillofacial surgery. Managements includes simple enucleation of the cyst to resection of the pathology.

Facial trauma also falls under the management and care of oral maxillofacial surgery. Lacerations of the lips and face and fracture of the jaw bones and facial bones are common place in the hospital and the management is normally handled by the oral maxillofacial department. Toilet and suture of the lacerations may be done under local anesthesia or general anesthesia depending on the extent of the injury. And more often than not, if there is an associated fracture, the open reduction and internal fixation of the jaw or facial bones are done together with the lacerations under general anesthesia.

Dental and oral maxillofacial implants are another area where oral maxillofacial surgery is involved in. The placement of dental implants to replace missing teeth in the jaw is gaining popularity and is offered by oral maxillofacial surgery. Besides dental implants, the oral maxillofacial surgical team also do maxillofacial implants such as orbit implants and otic or ear implants. They also offer answers to complicated or difficult cases such as those with bone deficiencies

Temporomandibular joint disorders (TMD) also falls under the care and management of oral maxillofacial surgery. Jaw joint pain is a common problem and is normally attributed to stress or trauma. It may even be due to normal physiological wear and tear. But whatever the cause, it can be a worry for the patient. Most of the time though, the jaw joint pain or TMD pain is caused by myalgia which involves the inflammation of the muscles of mastication.

Dental infection or facial infection leading to swelling is also commonly treated by oral maxillofacial surgery. Many a times the swelling of the face is attributed to a dental cause and the prompt identification of the cause and removal of the source together with antibiotic therapy is adequate treatment. Incision and drainage (I&D) is also commonly instituted.

Corrective jaw surgery and reconstructive jaw surgery is also commonly carried out by the oral maxillofacial surgical team. In cases of jaw abnormalities requiring corrective jaw surgery, the oral maxillofacial surgical team will work together with the orthodontist to co manage the patient. In reconstructive surgery, after a major trauma or pathology removing surgery, the oral maxillofacial surgical team will decide the graft to be used and place it appropriately and reconstruct the face.

Cosmetic surgery and plastic surgery are also commonly done. Treatments such as botox administration for the treatment of wrinkles and use of fillers for the facial region is gaining popularity and more and more oral maxillofacial surgeons are venturing into this department due to the demand. Other treatments offered are rhinoplasty and blepharoplasty.