oral and maxillofacial surgery

HISTORY, TRAINING AND SCOPE OF

ORAL AND MAXILLOFACIAL

SURGERY

JOEL D’SILVA1ST YEAR OMFS PG STUDENT

DEFINITION

• “Oral and Maxillofacial surgery is the specialty of dentistry that includes the diagnosis and

surgical and adjunctive treatment of disease, injuries and defect, including both the

functional and esthetic aspects of hard and soft tissues of oral and maxillofacial region”

Peterson

HISTORY OF ORAL & MAXILLOFACIAL SURGERY

EVOLUTION OF A SURGEON

HIPPOCRATES (460 BC)

• The famous Greek physician Hippocrates, described manually reducing dislocation of the

mandible, indicating the long history of this discipline

• 1210, A Group of Barbers was created in France, split into two groups; surgeons for more

complex operations, and surgeons for simpler procedures.

• 1575 Ambrose Pare (the Father of Surgery) published Complete Works. Carried information

on tooth extraction and jaw fractures.

• Pierre Fauchard in 1728 wrote a treatise called "The Surgeon Dentist.

• Simon Hullen after completing medical degree was inspired about Oral and Maxillofacial

Surgery. He helped develop many modern tecinique of Maxillofacial surgery and contributed

to the establishment of Oral and Maxillofacial Surgery as a surgical speciality in U.S. he is

considered to be the first oral surgeon in U.S

Ambrose Pare

• CHALMERS J. LYONS (1874-1935)

He established principles of gentle surgery that advanced the specialty and made extensive

contributions to the oral surgery literature.

• MATHEW H. CRYER (1840-1921)

He invented many instruments for the removal of teeth and other surgical procedures In

1901 he established the first dental service at the Philadelphia hospital.

• ROBERT H. IVY(1881-1974)

He was a great founder of oral surgery and plastic surgery.

“Ivy loop” for the treatment of jaw fractures

FATHER OF ORAL SURGERYJAMES EDMUND GARRETSON

• James Edmund Garretson (1829-1895) MB DDS was a professor of Dental college in Philadelphia.

• With his work a treatise on the diseases and surgery of mouth jaws and associated parts first published

in 1869, helped to establish Oral & Maxillofacial surgery in U.S

• He is known as the father of oral surgery he established oral surgery as a branch of medicine and

dentistry though distinct from both

WORLD WAR IIDuring the second world war, OMFS emerged as one of the major specialties.

INDIAN HISTORY

SUSHRUTA -FATHER OF INDIAN SURGERY

• “Surgery is the first and the highest division of the healing art, pure in itself, perpetual in its applicability, a

working product of heaven and sure of fame on earth" - Sushruta (400 B.C.)

• Sushruta (600 BC) taught and practiced surgery on the banks of the Ganges

• His contribution:

1. authored Susrutha Samhita.

2. 120 surgical instruments,

3. 300 surgical procedures

4. 650 drugs .

5. Father of plastic surgery and cosmetic surgery

SUSRUTA’S KNOWLEDGE FROM INDIA TO WORLD

• The Sushruta samhita was translated into Arabic and Persian.

• Sushrutha used skin flaps for repairing nose, procedure is described in Sushruta Samhita. This procedure was

observed in India by a British Surgeon in 1793 and published in London

SCOPE OF ORAL & MAXILLOFACIAL SURGERY

• Oral and Maxillofacial Surgery is an evolving field and evolvement of new

techniques has widened the scope of Oral and Maxillofacial Surgery

• Today the scope of OMFS practice continues to expand as a result of

educational process that is responsive to the changing needs of the specialty

• Stem cell technology and Microvascular surgery is finding a promisable scope

in Oral and Maxillofacial Surgery

SCOPES …….

• Dentoalveolar surgery

• Diagnosis and treatment of benign pathology, cysts, tumors head and neck oncology.

• Diagnosis and treatment of congenital craniofacial malformations

• Diagnosis and treatment of soft and hard tissue trauma of the oral and maxillofacial region.

• Diagnosis and treatment of chronic facial pain disorders

• Diagnosis and treatment of temporomandibular joint (TMJ) disorders.

• Cosmetic surgery limited to the head and neck.

• implants

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, CYST TUMORS AND HEAD AND NECK ONCOLOGY

DIAGNOSIS AND TREATMENT OF HARD AND SOFT TISSUE TRAUMA OF THE MAXILLOFACIAL REGION• Mandibular fractures

• Zygomatic fractures

• Nasal bone fractures

• Le-Fort fractures

• Skull fractures

• Orbital fractures

ORTHOGNATHIC SURGERY

DIAGNOSIS AND TREATMENT OF CHRONIC FACIAL PAIN DISORDERS

DIAGNOSIS AND TREATMENT OF CONGENITAL CRANIOFACIALMALFORMATIONS

Cleft lip and palate and cranial vault malformations such as craniosynostosis (Craniofacial Surgery)

TMJ DISORDERS

• Muscle disorders

• Derangement disorders

• Degenerative disorders

• Ankylosis

MANAGEMENT OF DENTOALVEOLAR PATHOLOGY PATHOLOGY

IMPLANTS

COSMETIC SURGERY

• Rhytidectomy/facelift, browlift/blepharoplasty, otoplasty, rhinoplasty, septoplasty.

• Cheek augmentation, chin augmentation, genioplasty, neck liposuction, lip enhancement.

• Injectable cosmetic treatments, botox, chemical peel.

TRAINING IN OMFS

AUSTRALIA, NEW ZEALAND AND NORTH AMERICA

4–6 years of further formal university training after dental school (DDS, BDent, DMD or BDS)

Four year residency program Six year residency program

Four year residency program

• Residents will be granted the speciality training certificate in Oral & Maxillofacial surgery

Six year residency program

• Residents will be granted the speciality certificate in addition to the medical degree

CANADA

• Canadian training programs, are "dual-degree". The trainees obtain a degree in medicine as

well as a specialty certificate in oral and maxillofacial surgery.

• The training followed in most of the countries is like

• After high school candidate should do a pre med degree (BS, BA) which will take 2-4 years

• Two years in case of full time course and four years in case of part time course

• Then 4 years of basic dental degree training (DMD, BDent, DDS or BDS)

• Then 4-6 years of speciality training program i.e four year residency program or six year residency program

• after completing six year residency program oral and maxillofacial surgeons are now also obtaining fellowships

with the American College of Surgeons (FACS)

TRAINING IN INDIA

• 5 years of undergraduate course in dentistry (BDS)

• 3 years of post graduation in OMFS (MDS)

• Research and specialization in micro vascular surgery and reconstruction.

• MBBS after MDS , here the candidate has to undergo training for 3 years to obtain the degree

• Maxillofacial surgeons having the medical degree can go for fellowships like FACS FORCS

• The IAOMS Foundation (IAOMSF) was established in September 1996 with the mission of passing on the

priceless gift of knowledge. The Foundation directly supports surgeon-to-surgeon educational efforts

led by experienced clinicians who travel from East Africa and Asia to Indonesia, Malaysia, Cambodia,

Eastern Europe and Latin America to teach young surgeons and trainees state-of-the art skills and

procedures. The Foundation also works to help secure donations for needed medical equipment in

these underserved areas.

Kishore Nayak President of The IAOMS Foundation (IAOMSF)

ASIAN ASSOCIATION OF ORAL AND MAXILLOFACIAL SURGEONS

• Asian Association of Oral and Maxillofacial Surgeons (Asian AOMS) is a not-for-profit professional

association. Asian AOMS aims to improve the quality and standards of the specialty of Oral and

Maxillofacial Surgery and is committed towards promoting academic and clinical excellence amongst

oral and maxillofacial surgeons in the Region. Asian AOMS is affiliated to the International Association of

Oral and Maxillofacial Surgeons.

ASSOCIATION OF ORAL AND MAXILLOFACIAL SURGEONS IN INDIA (AOMSI)

• The AOMSI is a registered organization and admits qualified Oral and Maxillofacial Surgeons as Life or

Annual members. The Association is committed to the promotion of the specialty through its scientific

deliberations and social causes.

• The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization

representing more than 9,000 oral and maxillofacial surgeons in the United States, supports its

members' ability to practice their specialty through education, research, and advocacy. AAOMS

members comply with rigorous continuing education requirements and submit to periodic office

examinations, ensuring the public that all office procedures and personnel meet stringent national

standards.

• EACMFS was established in 1970 by a group of innovative European surgeons who were keen to

advance the specialty. It is has become the most prominent and highly respected professional group for

the specialty in Europe and has a high profile in other parts of the World.

• BAOMS is a registered charity, and a company limited by guarantee, not having share capital. The overall

strategic direction of the charity is determined by the trustees, who are assisted and advised by the

other officers and members of the Council of the Association.

ONE MORE STEP AHEAD

1st International Oral & Maxillofacial Surgery

PG convention in IndiaAOMSI in association with Asian

AssociationSuccessfully conducted this

international event

CONCLUSION

Oral surgery has emerged as a specialised branch of dentistry over the course of time and has

opened new options in fields of surgery beyond basic dentistry.

As a OMFS surgeon one can move out of oral cavity and explore the fields of oncology, plastic

surgeries, craniofacial surgeries ,microvascular surgeries and much more……………..

THANK YOU…………..