Oral and maxillofacial surgery is the specialty of dentistry that includes the diagnosis, surgical, and adjunctive treatment of diseases, injuries, and defects, including both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial regions.
Many of the extensive surgical procedures done by Oral and maxillofacial surgery experts are accomplished in operation theaters of hospitals. Some of the complex procedures performed by Oral and maxillofacial surgery experts include:
• Removal of teeth that have complications either due to positioning in the jaws or because of conditions of infection.
• Surgery before the making of dentures to reshape the gums and bone.
• Oral and maxillofacial surgery repairs of the jaws due to injury and fracture or due to conditions that exist because of bone development, for example, the repair of a cleft palate, placement of implants, the treatment of diseases of the sinuses.
• Surgical repositioning of the jaws with or without additional treatment by an orthodontist (orthognathic surgery).
• Treatment of temporomandibular joint problems.
• Management of extensive oral infections.
INDICATIONS FOR ORAL AND MAXILLOFACIAL SURGERY
There are many reasons and indications a patient might need an Oral and maxillofacial surgery procedure. Some of the common situations, which need surgical interventions include:
1. Removal of carious teeth that can not be restored.
2. Removal of teeth with insufficient bony support,
3. Removal of impacted teeth that have not erupted into the mouth and are still below the gingival tissues and in some cases beneath the bone. It is not uncommon for these teeth to lie sideways or at an angle within the jaw.
4. Removal of teeth to provide space so that orthodontic movement can be accomplished
5. Removal of root fragments from the gingiva and/or bone from teeth that are carious or have broken off.
6. Removal of soft tissue tumors that are biopsied for study under a microscope by a pathologist
7. Removal of hard tissue tumors and excess bone growth.
8. Repair of a fractured mandible or maxilla.
9. Removal of excess gingival tissues to allow for fabrication of a denture.
10. Placement of implants.
11. Treatment of oral infections.
12. Oral and maxillofacial surgery repair of bony and soft tissue defects of the jaws and sinuses.
13. Surgical repositioning of the jaws to change the bite and esthetic appearance of teeth.
14. Some plastic surgery procedures in the facial region.
15. Treatment of temporomandibular joint disease (TMD).
16. Treatment of nerve problems in the facial and oral regions.
In oral surgery procedures there are certain medical conditions that have a bearing on the decisions the dentist makes for how and when to perform a given procedure. Many of the conditions that require either premedication or additional precautions before the procedure is performed, include:
1. Extraction of a tooth is contraindicated in the presence of a large, active infection. The patient may need to either be started on antibiotic therapy before extraction and or the infectious area incised and drained.
The infection must first be controlled for two basic reasons – adequate anesthesia may not be achieved in the presence of a, large infection, and the infection may spread to other areas.
2. Extraction of a tooth may be contraindicated for a patient with a serious disease such the as diabetes, or recent history of a heart attack; for a patient on blood thinners where bleeding may cause a problem; or for a patient with hemophilia.
3. Extraction of teeth should be postponed for some patients who undergo Oral and maxillofacial surgery due to acute medical conditions, which can include pregnancy, active chemotherapy or radiation therapy, acute heart problems, or extremely high blood pressure.