Oral & Maxillofacial surgery (OMS) specializes in treating many diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the Oral (mouth) and Maxillofacial (jaws and face) region. It is an internationally recognized surgical specialty. In some countries around the world, including the United States, Canada and Australia, it is a recognized specialty of dentistry; in others, such as the UK and most of Europe, it is recognized as both a specialty of medicine and dentistry and a dual degree in medicine and dentistry is compulsory.
OMF surgery is unique in requiring a dual qualification in medicine and dentistry, and is often seen as the bridge between medicine and dentistry, treating conditions that require expertise from both backgrounds such as head and neck cancers, salivary gland diseases, facial disproportion, facial pain, temporomandibular joint disorders, impacted teeth, cysts and tumours of the jaws as well as numerous problems affecting the oral mucosa such as mouth ulcers and infections.
Cancer is defined as the uncontrollable growth of cells that invade and cause damage to surrounding tissue. Oral cancer appears as a growth or sore in the mouth that does not go away. Oral cancer, which includes cancers of the lips, tongue, cheeks, floor of the mouth, hard and soft palate, sinuses, and pharynx (throat), can be life threatening if not diagnosed and treated early.
Symptoms :The most common symptoms of oral cancer include:
• Swellings/thickenings, lumps or bumps, rough spots/crusts/or eroded areas on the lips, gums, or other areas inside the mouth
• The development of velvety white, red, or speckled (white and red) patches in the mouth
• Unexplained bleeding in the mouth
• Unexplained numbness, loss of feeling, or pain/tenderness in any area of the face, mouth, or neck
• Persistent sores on the face, neck, or mouth that bleed easily and do not heal within 2 weeks
• A soreness or feeling that something is caught in the back of the throat
• Difficulty chewing or swallowing, speaking, or moving the jaw or tongue
• Hoarseness, chronic sore throat, or change in voice
• Ear pain
• A change in the way your teeth or dentures fit together
• Dramatic weight loss
Treatment :(a) Surgery : Surgery to remove the tumor in the mouth or throat is a common treatment for oral cancer. Patients may have surgery alone or in combination with radiation therapy.
(b) Radiation therapy : Radiation therapy (also called radiotherapy) is a type of local therapy. It affects cells only in the treated area. Radiation therapy is used alone for small tumors or for patients who cannot have surgery. It may be used before surgery to kill cancer cells and shrink the tumor. It also may be used after surgery to destroy cancer cells that may remain in the area.
(c) Reconstruction : Some people with oral cancer may need to have plastic or reconstructive surgery to rebuild the bones or tissues of the mouth. Some people may need dental implants Or they may need to have grafts (tissue moved from another part of the body).
(d) Rehabilitation : The goals of rehabilitation depend on the extent of the disease and type of treatment. Rehabilitation may include being fitted with a dental prosthesis (an artificial dental device) and having dental implants. It also may involve speech therapy, dietary counseling, or other services.
If oral cancer or its treatment leads to problems with talking, speech therapy will generally begin as soon as possible. A speech therapist may see you in the hospital to plan therapy and teach speech exercises. Often speech therapy continues after you return home.
Numerous tumor types, both benign and malignant, originate in the jaw. Symptoms are swelling, pain, tenderness, and unexplained tooth mobility; some tumors are discovered on routine dental x-rays, whereas others are found on routine examinations of the oral cavity and teeth. Treatment depends on location and tumor type. Bony outgrowths may develop on the palate or mandible. These are common growths and may prompt concerns about cancer, although they are benign and of concern only if they interfere with dental care or function of the submandibular gland. The most common tumor of the mandible and maxilla is squamous cell carcinoma invading the bone through dental sockets. Ameloblastoma, the most common epithelial odontogenic tumor, usually arises in the posterior mandible. It is slowly invasive and rarely metastatic. Odontoma, the most common odontogenic tumor, affects the dental follicle or the dental tissues and usually appears in the mandibles of young people. Osteosarcoma, giant cell tumor, Ewing tumor, multiple myeloma, and metastatic tumors may affect the jaw. Treatment is the same as for those tumors in other bony sites.
Maxillofacial injuries, also referred to as facial trauma, encompass any injury to the mouth, face and jaw.
As per our expert maxillofacial surgeon blunt or penetrating trauma can cause injury to the area of the face that includes the upper jaw, lower jaw, cheek, nose, or forehead. Common causes of injury to the face include :
The Tempro-Mandibular Joint (TMJ) is the jaw joint between the lower jaw (mandible) and the skull (in the temporal bone). There is one on each side of your face, just in front of each ear. The joint is made up of the two bony parts of each joint, which have a disc of cartilage between them. Around the joint there are some ligaments holding it in place and some muscles that attached to the bones and the disc, allowing movement of the joint.
A cyst is a sack or pouch which forms within tissues and contains fluid. This cyst is not a cancerous growth. Cysts can develop in many places in the body. Around the face and mouth they can develop under the skin, under the mouth lining, within the saliva glands, and within the jawbones. The treatment for cysts is to remove them. This is done by a small incision inside the mouth and removal of part of the bone. Occasionally when cysts are very large it is possible to treat them by surgical decompression. Following the surgery the cyst is sent to a specialist pathologist for examination under a microscope to confirm the diagnosis.
Corrective jaw, or orthognathic, surgery is performed by Oral and Maxillofacial Surgeons to correct a wide range of minor and major skeletal and dental irregularities, including the misalignment of jaws and teeth, which, in turn, 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.
Cleft lip and palate is a congenital deformity best managed by a team of specialists. They are facial and oral malformations that occur very early inpregnancy, while the baby is developing inside the mother. Clefting results when there is not enough tissue in the mouth or lip area, and the tissue that is available does not join together properly.
A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of a body part or organ compared to the average shape of that part.
Craniofacial reconstruction refers to a group of procedures used to repair or reshape the face and skull of a living person, or to create a replica of the head and face of a dead or missing person. The word "craniofacial" is a combination of "cranium," which is the medical word for the upper portion of the skull, and facial. Craniofacial reconstruction is sometimes called orbital-craniofacial surgery; "orbital" refers to the name of the bony cavity in the face that surrounds the eyeball.
Craniofacial reconstruction may be done if there are : Birth defects and deformities from conditions such as —