Oral and maxillofacial surgery
|Names||Oral and Maxillofacial Surgeon|
|Education required||Medical degree (depending on country)|
Oral and maxillofacial surgery is surgery to treat 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 most countries around the world, including the United States, Canada, and Australia it is a recognized specialty of dentistry; in others, including the UK, it is recognized as a medical specialty.
In several countries oral and maxillofacial surgery is a speciality recognized by a professional association, as is the case with the American Dental Association, Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Dentists of Canada, Royal Australasian College of Dental Surgeons and the Brazilian Federal Council of Odontology (CFO).
In other countries oral and maxillofacial surgery as a specialty exists but under different forms as the work is sometimes performed by a single or dual qualified specialist depending on each country's regulations and training opportunities available.
Depending upon the jurisdiction, maxillofacial surgeons may require training in dentistry, surgery, and general medicine; training and qualification in medicine may be undertaken optionally even if not required.
Oral and maxillofacial surgery is widely recognized as one of the specialties of dentistry. In the UK however, maxillofacial surgery is a medical specialty requiring both medical and dental degrees, culminating in an appropriate qualification (e.g. Fellow of the Royal College of Surgeons, FRCS, in the UK). All oral and maxillofacial surgeons however must obtain a university degree in dentistry before beginning residency training in oral and maxillofacial surgery.
They also may choose to undergo further training in a 1 or 2 year subspecialty Oral and Maxillofacial Surgery Fellowship Training in the following areas:
- Head and neck cancer – microvascular reconstruction
- Cosmetic facial surgery
- Craniofacial surgery/Pediatric Maxillofacial surgery/Cleft Surgery
- Cranio-maxillofacial trauma
- Head and neck reconstruction (plastic surgery of the head and neck region)
- Maxillofacial regeneration (reformation of the facial region by advanced stem cell technique)
The popularity of oral and maxillofacial surgery as a career for persons whose first degree was medicine, not dentistry, seems to be increasing in a few EU countries[clarification needed]. However, the public funds spent for 14 years of training are of a major concern for governments. Integrated programs are becoming more available to medical graduates allowing them to complete the dental degree requirement in about 3 years in order for them to advance to subsequently complete Oral and Maxillofacial surgical training.
Treatments may be performed on the craniomaxillofacial complex: mouth, jaws, face, neck, skull, and include:
- Dentoalveolar surgery (surgery to remove impacted teeth, difficult tooth extractions, extractions on medically compromised patients, bone grafting or preprosthetic surgery to provide better anatomy for the placement of implants, dentures, or other dental prostheses)
- Surgery to insert osseointegrated (bone fused) dental implants and Maxillofacial implants for attaching craniofacial prostheses and bone anchored hearing aids.
- Cosmetic surgery of the head and neck: (rhytidectomy/facelift, browlift, blepharoplasty/Asian blepharoplasty, otoplasty, rhinoplasty, septoplasty, cheek augmentation, chin augmentation, genioplasty, oculoplastics, neck liposuction, lip enhancement, injectable cosmetic treatments, botox, chemical peel etc.)
- Surgical treatment and/or splinting of sleep apnea, maxillomandibular advancement, genioplasty
- Diagnosis and treatment of:
- benign pathology (cysts, tumors etc.)
- malignant pathology (oral & head and neck cancer) with (ablative and reconstructive surgery, microsurgery)
- cutaneous malignancy (skin cancer), lip reconstruction
- congenital craniofacial malformations such as cleft lip and palate and cranial vault malformations such as craniosynostosis, (craniofacial surgery)
- chronic facial pain disorders
- temporomandibular joint (TMJ) disorders
- Dysgnathia (incorrect bite), and orthognathic (literally "straight bite") reconstructive surgery, orthognathic surgery, maxillomandibular advancement, surgical correction of facial asymmetry.
- soft and hard tissue trauma of the oral and maxillofacial region (jaw fractures, cheek bone fractures, nasal fractures, LeFort fracture, skull fractures and eye socket fractures).
In Australia, New Zealand, and North America
Oral and maxillofacial surgery is one of the nine dental specialties recognized by the American Dental Association, Royal College of Dentists of Canada, the Royal Australasian College of Dental Surgeons. Oral and maxillofacial surgery requires 3–6 years of further formal university training after dental school (DDS, BDent, DMD or BDS). In the United States, four-year residency programs grant a certificate of specialty training in oral and maxillofacial surgery. Six-year residency programs grant the specialty certificate in addition to a additional degree such as a medical degree (MD, DO, MBBS, MBChB etc.), or research degree (MS, MSc, MPhil, MDS, MSD, MDSc, DClinDent, DSc, DMSc, or PhD). Both 4 and 6 year graduates are designated US "Board Eligible," those that earn "Certification" are Diplomats'. Approximately 50% of the training programs in the US, Australia, and New Zealand, and 20% of Canadian training programs, are "dual-degree". Dual degree trainees obtain a degree in medicine (MD, DO, MBBS, MBChB etc.) as well as a specialty certificate in oral and maxillofacial surgery, although the scope of surgery remains unchanged.
The typical training program for an oral and maxillofacial surgeon is:
- 2 – 4 years undergraduate study (BS, BA, or equivalent degrees)
- 4 years dental study (DMD, BDent, DDS or BDS)
- 3 – 6 years residency training - Some programs integrate an additional degree such as: a masters degree (MS, MDS, MSc, MClinDent, MScDent, MDent), doctoral degree (PhD, DMSc, DClinDent, DSc), or medical degree (MBBS, MD, DO, MBChB, MDCM)
- After completion of surgical training most undertake final specialty examinations: (US "Board Certified (ABOMS)"), (Australia/NZ: "FRACDS"), or (Canada: "FRCDC")
- Some Colleges offer Membership or Fellowships in oral/maxillofacial surgery: MOralSurg RCS, M(OMS) RCPS, FFD RCSI, FEBOS, FACOMS, FFD RCS, FAMS, FCDSHK, FCMFOS(SA)
- Many dually qualified oral and maxillofacial surgeons are now also obtaining fellowships with the American College of Surgeons (FACS)
- Average total length after secondary school: 12 – 14 years
In addition, graduates of oral and maxillofacial surgery training programs can pursue fellowships, typically 1 – 2 years in length, in the following areas:
- Head and neck cancer – microvascular reconstruction
- Cosmetic facial surgery (facelift, rhinoplasty, etc.)
- Craniofacial surgery and pediatric maxillofacial surgery (cleft lip and palate repair, surgery for craniosynostosis, etc.)
- Cranio-maxillofacial trauma (soft tissue and skeletal injuries to the face, head and neck)
Notable oral and maxillofacial surgeons
- Luc Chikhani reconstructed Trevor Rees-Jones's face, which was flattened by the impact of the car crash that killed Diana, Princess of Wales.
- Bernard Devauchelle a French oral and maxillofacial surgeon at Amiens University Hospital who in November 2005 successfully completed the first face transplant on Isabelle Dinoire.
- Varaztad Kazanjian Pioneer in plastic and reconstructive surgery, Harvard's first professor of plastic surgery
- Paul Tessier (August 1, 1917 – June 6, 2008) This French surgeon was considered the father of modern craniofacial surgery. In response to questions about his approach to problem-solving, Tessier would say, "Pourquoi pas?". This phrase became the motto of the International Society of Craniofacial Surgery, founded in 1983, of which Tessier was invited to be Honorary President.
- Craniofacial surgery
- Craniofacial team
- Dental implant
- Distraction osteogenesis
- Forensic facial reconstruction
- Hilotherapy, a therapy to improve healing post surgery
- Journal of Oral and Maxillofacial Surgery
- Léon Dufourmentel
- Operation Smile
- Oral surgery
- Orthognathic surgery
- Project Harar
- Scalp surgery
- The Smile Train
- "Baylor College of Dentistry: OMS Residency Admission Requirements". Archived from the original on May 8, 2008. Retrieved 2 July 2009.
- Lengelé B, Testelin S, Cremades S, Devauchelle B (September 2007). "Facing up is an act of dignity: lessons in elegance addressed to the polemicists of the first human face transplant". Plast. Reconstr. Surg. 120 (3): 803–6. doi:10.1097/01.prs.0000271097.22789.79. PMID 17700135. Retrieved 2008-05-16.
- Naomi Austin (17 October 2006). "My face transplant saved me". BBC News. Retrieved 20 May 2010.
- International Association of Oral and Maxillofacial Surgeons
- Journal of Cranio-Maxillofacial Surgery
- British Association of Oral and Maxillofacial Surgeons
- American Academy of Oral and Maxillofacial Pathology
- American Board of Oral and Maxillofacial Surgery
- Indonesian Association of Oral and Maxillofacial Surgeons
- Sociedad Española de Cirugía Oral y Maxilofacial