Dental implants and extraction of wisdom teeth, or third molars, are the most common oral and maxillofacial surgical procedures. But OMSs do much more. Since the earliest days of the specialty, OMSs have expanded their scope of practice to include surgery of the entire maxillofacial complex. Their knowledge and skills make them proficient in the management of bony and soft tissue reconstruction of the entire maxillofacial skeleton. Major areas of OMS practice include:
OMSs are trained to become experts in all aspects of pain and anxiety control, including general anesthesia/deep sedation, and conscious sedation. Much of their training focuses on ambulatory anesthesia and airway management, preparing them to administer safe and effective anesthesia services in the dental office and other ambulatory settings.
The mainstay of most OMS practice involves the extraction of diseased or impacted teeth. Surgical exposure of impacted teeth to enable the orthodontic assisted eruption of those teeth into a functional and esthetic position is an important part of dentoalveolar surgical practice. Other traditional office procedures include preparation of the mouth for dentures, treatment of oral infections and biopsy of suspicious lesions of the hard and soft tissue. OMSs also serve as the primary referral source for general dentists needing advice or assistance with the diagnosis of oral surgical problems.
Dental implants are titanium metal cylinders that replace tooth roots. They are placed into the jaw bones where bone grows into them and locks them in place. Dental implants are used very effectively to replace missing teeth. Dental implants may comfortably and permanently replace one or more teeth, and are regarded by many as one of the most important advances in dentistry in the last 50 years. OMSs plan and place dental implants used to replace missing teeth. Training in the placement of implants includes proper diagnosis, treatment, site preparation, (including the reconstruction of bone and soft tissues), and maintenance.
Surgical Correction of Maxillofacial Skeletal Deformities
Surgical correction of maxillofacial skeletal deformities includes the reconstructive procedures that correct deformities of the jaws, facial skeleton, and associated soft tissues. These abnormalities may be caused by genetic, environmental, developmental, functional, and/or pathologic aberrations apparent at birth or manifested in subsequent growth and development or acquired through trauma, neoplastic processes, and degenerative diseases. Musculoskeletal deformities of the facial bones can occur in all three planes of space (anteroposterior, vertical, and transverse) or any combination of the three, unilaterally or bilaterally, and in either one or both jaws. The surgical procedures involve repositioning and recontouring the facial bones to correct functional and/or pathologic problems. The principal goal of surgical correction of these skeletal deformities is restoration and/or improvement in function and prevention of potential sequelae.
Orthognathic surgery is performed to correct developmental growth abnormalities of the jaws and facial bones. Patients with these abnormalities usually present with a malocclusion. These problems can effect not only chewing but speech and the overall health of the individual as well as the esthetic appearance of the face. Surgical treatment is usually conducted in combination with orthodontics. The surgery is performed under general anesthesia. During the surgery, the jaws are moved to the correct position, not only to improve the patient's occlusion, but to restore normal facial appearance as well.
Cleft and Craniofacial Surgery
OMSs surgically correct congenital and acquired defects of the maxillofacial region including cleft lip and palate. The majority of cleft and craniofacial surgery occurs in children. The optimal management of patients with cleft and craniofacial deformities traditionally involves a multidisciplinary team which is necessary to correct all adjunctive procedures.
OMSs repair routine and complex facial injuries, set fractured jaw and facial bones, reconnect severed nerves and ducts, and treat other injuries of the face and neck region.
OMS training includes the diagnosis and surgical and non-surgical management of temporomandibular joint (TMJ) disorders. It also includes the differential diagnosis of head, neck, and facial pain. This comprehensive knowledge affords the patient the ability to regain normal function while eliminating pain.
OMSs diagnose and manage patients with diseases of the oral and maxillofacial region, including cysts, benign and malignant tumors, soft tissue, and severe infections of the oral cavity and salivary glands. The reconstruction of the mouth and face following the removal of tumors represents the ability of the oral and maxillofacial surgeon to return patients to optimum levels of appearance and function.
Reconstructive and Cosmetic Surgery
OMSs correct jaw, facial bone and facial soft tissue problems left as the result of previous trauma or removal of pathology. This surgery which restores form and function often includes moving skin, bone, nerves, and other tissues from other parts of the body to reconstruct the jaws and face. These same skills are also used when oral and maxillofacial surgeons perform cosmetic procedures for improvement of problems due to unwanted facial features or aging.