17 Nov 2021

Oral and Maxillofacial Surgery

Post by uday patel

Surgical intervention performed in the mouth, jaw, and face is called oral maxillofacial surgery. Face and jaw together are termed as maxillofacial while oral refers to mouth. These operations are performed by trained dental surgeons.    

Oral and maxillofacial surgeries are complex and belong to a comprehensive group. These interventions are performed to treat various anomalies in the craniomaxillofacial complex by a specialist dentist. The degree required by the specialist may pertain to medicine and dentistry combined. These procedures are performed to rectify anomalies as well as reconstructive measures in case of congenital defects and damage caused by an accident.  There is a greater affinity with plastic surgery as well, and there is a confluence of both skills.

There are many specializations and divisions in this segment often termed subspecialties.  

  • Cosmetic facial surgery
  • Blepharoplasty
  • Rhinoplasty
  • Cranio-maxillofacial trauma
  • Craniofacial or trans-cranial surgery
  • Paediatric maxillofacial
  • Maxillofacial regeneration using stem cells
  • Remodelling of various parts of mouth, face and jaw

All trauma and facial deformity, related problems are mainly rectified by OMFS. 

Specialist Surgeons

Maxillofacial Surgeons undergo subspecialization in many countries for which the training period is usually one to two years. They have to undergo four to five months of intense training in general and pediatrician anesthesia besides subspecialization.  OMFS specialists also deal with facial pain, bacterial infections, oral mucosal diseases, and non-invasive management of soft and hard tissues of the craniofacial complex.  

The OMFS are trained to operate on jawbones and faces besides the oral cavity or mouth. But as a matter of fact, there is no limit to specialized surgery the specialist can perform. Since the mouth is an integral part of the face the discipline is often termed Oral Maxillofacial Surgery or OFMS.  But this does not mean that all oral surgeons specialize in the face and jaw bone operations or reconstruction. They are restricted to the mouth and do not specialize in treating the face and jaw. Most of the dentists we come across in the clinics and hospitals are capable of performing simple dentistry and nothing more.  

In India, an OMFS surgeon or a dentist needs an undergraduate degree followed by a three-year program in the EU or USA. An OMFS surgeon can earn as much as seven to eight lakhs per annum here.

Mouth Surgery
The female dentist performing an oral surgery

Scope of Maxillofacial Surgery

This is a widespread specialization, and OMFS clinics manned by experts are available everywhere. The complexities of OMFS have led to a wide spectrum range of interventions, and thus there is a greater scope of services. Specialty Clinics specialize in many subspecialties and require a patient to know as to what kind of surgery they specialize in this discipline. The scope of specialty is further enlarged by the addition of non-surgical treatments where operations are not a necessity.

The anomalies, defects, and damages are present in people of all ages including children who mostly suffer from congenital defects. The interventions also include oncological incisions usually performed to remove tumors and parts of the face or jaw. 

Latest Technology & Procedures

The procedures range from simple to complex. In the case of the latter complex invasive techniques are involved and the medical outcome depends much upon the surgeon’s expertise and experience.

Using MRI and CT scan 3 D mapping of the region to be operated is possible for assisting in invasive procedures. These virtual 3 D Models assist the surgeon in comprehending the person’s complex facial and cranial structures, during the operation, a navigation apparatus acts as a guide for the specialist to keep a tab of where the surgical instrument is at the same time. This leads to high precision work and the outcome much better than using conventional methods. Nowadays radiological imaging further assists in these operations. The radiographic imagery acts as a virtual 3rd eye of the specialist and results in greater accuracy.

Surgical skills are assisted by surgical microscope in microvascular interventions mostly used in tissue transplantation when required. The small blood vessels or capillaries too are connected using this microscope.  Computer tomography or the latest CBCT which stands for cone-beam computed tomography delivers a volumetric image of complex structures which is converted into a 3D image for greater assistance.     

Technology is used in preoperative planning, execution, and closure in OMFS extensively. The aim is to mitigate surgical complications and post-surgery pain and discomfort.  

OMFS in India

OMFS is a rapidly expanding specialty in India.   Maxillofacial surgery can cost anywhere from 50,000 to over a few lakhs in the country depending upon the complexity. There is no dearth of OMFS Surgeons and Clinics in the country and it is well represented Worldwide in this discipline.  

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