A young lady came to our clinic complaint that she was not happy about her face because of her lower jaw was too long. On top of that, her teeth weren’t aligned well. After examination and a few x-ray, we found that she had a few problems:
Her lower jaw was long as compared to her cranial base
Her upper jaw was shorter in relation to her cranial base
Her cheek looked more flatten
She can’t close her lips as her lower jaw as too forward
Her lower teeth were very far forward as compared to her upper teeth
Her dental mid-line was not coincide with her face mid-line
Corrective jaw, or orthognathic, is a surgery performed by the Oral and Maxillofacial Surgeons aimed to correct wide range of skeletal irregularities that cause disharmony in teeth and facial facial appearance; as well as interfering speaking and reduce chewing efficiency, and worst of all, obstruct breathing. Beside enhancing patient’s appearance dramatically, orthognathic surgery is also performed to correct functional problems.
An oral and maxillofacial surgeon is a regional specialist surgeon treating the entire craniomaxillofacial complex: anatomical area of the mouth, jaws, face, skull, as well as associated structures.
In the US, the name oral and maxillofacial surgery should be abbreviated most appropriately as OMS, rather than OMFS as some sources suggest. The abbreviation OMFS may be appropriate only in the European system where Maxillo-Facial is hyphenated. In the US, maxillofacial is the official entry in the American language dictionary defining the anatomical region, and is also the official term used by all related surgical organizations, including the AAOMS, ABOMS, and ACOMS.
Maxillofacial surgeons are usually initially qualified in dentistry and have undergone further surgical training. Some OMS residencies integrate a medical education as well and an appropriate degree in medicine (MBBS or MD or equivalent) is earned, although in the United States there is legally no difference in what a dual degree OMS can do compared to someone who earned a four year certificate. Oral & maxillofacial surgery is universally recognized as a one of the nine specialties of dentistry. However also in the UK and many other countries OMFS is a medical specialty as well culminating in the FRCS (Fellowship of the Royal College of Surgeons). Regardless, all oral & maxillofacial surgeons must obtain a degree in dentistry (BDS, BDent, DDS, or DMD or equivalent) before being allowed to begin residency training in oral and maxillofacial surgery.
They also may choose to undergo further training in a 1 or 2 year subspecialty fellowship training in the following areas:
Head and neck cancer – microvascular reconstruction
Cosmetic facial surgery
Craniofacial surgery/Pediatric Maxillofacial surgery
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 few EU countries However the public fund spend for 14 years of training is a big concern of the state. 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, neck, face, 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)
Diagnosis and treatment of benign pathology (cysts, tumors etc.)
Diagnosis and treatment (ablative and reconstructive surgery, microsurgery) of malignant pathology (oral & head and neck cancer).
Diagnosis and treatment of cutaneous malignancy (skin cancer), lip reconstruction
Diagnosis and treatment of congenital craniofacial malformations such as cleft lip and palate and cranial vault malformations such as craniosynostosis, (craniofacial surgery)
Diagnosis and treatment of chronic facial pain disorders
Diagnosis and treatment of temporomandibular joint (TMJ) disorders
Diagnosis and treatment of dysgnathia (incorrect bite), and orthognathic (literally “straight bite”) reconstructive surgery, orthognathic surgery, maxillomandibular advancement, surgical correction of facial asymmetry.
Diagnosis and treatment of 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).
Splint and surgical treatment of sleep apnea, maxillomandibular advancement, genioplasty (in conjunction with sleep labs or physicians)
Surgery to insert osseointegrated (bone fused) dental implants and Maxillofacial implants for attaching craniofacial prostheses and bone anchored hearing aids.
Cosmetic surgery limited to 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.)