What is maxillofacial surgery and in which cases is it indicated?

The mouth is a very delicate area in humans and various studies show this. An investigation carried out in a Venezuelan hospital carried out more than 7,500 maxillofacial surgeries in a 6-year interval, where the average age of the patients was between 16 and 30 years old, with a predominance of the male sex.

In this clinic and in many others, the vast majority of patients go to the emergency room for injuries to the oral soft tissues (a 65%), that is, trauma that compromises the mucous skin lining that is responsible for limiting and protecting the environment of the mouth. The remaining percentage usually visit the clinic for facial fractures and odontogenic infections (15% in each case).

Maxillofacial surgery is responsible for all this oral pathological terrain and many other meanings, which It is not considered as a purely aesthetic intervention, but mainly based on the patient's health and in order to prevent the mishap from progressing. Today we show you in detail what maxillofacial surgery is and in which cases it is indicated. Do not miss it.

• We recommend you read: "Cheek surgery: procedures, results and prices"

What is maxillofacial surgery?

According to professional portals, maxillofacial surgery is defined as a dental specialty that is responsible for the diagnosis and medical and / or surgical treatment of injuries, defects and diseases that involve the functional and aesthetic aspect of the hard and soft tissues of the oral cavity and dental structures. This discipline includes the monitoring and intervention of the skull, mouth, teeth, jaws, face, head and neck.

In general, processes of a maxillofacial nature can be defined in two large blocks: those that are carried out in the office under local anesthesia (with or without sedation) and those performed in the operating room under anesthesia total. We will tell you about them below.

1. Procedures under local anesthesia

Here we can include all those procedures whose invasiveness is minimal, at least in comparison with those that we are going to tell you in the following lines. The most common are those that involve extraction or repair of dental structures, that is to say: placement of dental implants fixed in the bone, surgical extraction of remaining teeth or removal of localized benign cysts, for example.

2. Procedures under general anesthesia

In this category are a large number of interventions. We list them briefly in the following lines.

2.1 Drainage of odontogenic abscesses

A dental abscess is defined as the accumulation of pus in different areas of the tooth and its surroundings caused by a bacterial infection. Surgery is the way to go when the patient has the following symptoms: severe and persistent toothache, mouth tenderness, fever, swelling of the face or cheeks, swollen lymph nodes and difficulty in swallow. Together with the pertinent antibiotic treatment, the drainage of the abscesses is essential in any oral pathogenic process.

2.2 Removal of oral tumors and cysts

An oral tumor can originate in any oral tissue, including the lips, tongue, floor of the mouth, the back of the palate, bones, muscles, and nerves. In many cases, the tumor or cyst removal procedure must be complemented with a rebuilding process, that is, the placement of bone grafts or osteosynthesis material.

2.3 Reconstruction of the jaws

The jaws, essential bones for the facial bone structure, are especially relevant to biomechanics and anatomy of the face. Sometimes these can be compromised, either by accidents and injuries or by genetic malformations. Maxillofacial surgery is responsible for reconstructing them.

2.4 Orthognathic surgery

Orthognathic surgery is the most common variant of the maxillofacial interventions of all. In this case, the intervention try to correct jaw conditions and the face related to structure, growth, sleep apnea and temporomandibular joint disorders (among many other things).

Generally speaking, in this intervention the compromised maxillofacial bones are "cut", moved, modified and realigned to resolve a dentofacial deformity. It should be noted how common it is to undergo this type of process, since it is estimated that up to 5% of the general population must undergo orthognathic surgery in order to solve their problems mandibular.

2.5 Other interventions

Although we have shown you the most common maxillofacial interventions (either under local anesthesia or general), we have left some reasons for going under the knife just as important. Some of them are the following:

• Treatment of patients with cleft lip and palate.
• Realization of bone grafts.
• Management of temporomandibular joint disorders.

When is it necessary?

Maxillofacial surgery, in most cases, is an effective vehicle for provide a solution to functional and aesthetic problems due to deformities and conditions of the facial skeleton that make it impossible to correctly position between the teeth. In many cases orthodontics does not give the desired results, which is why it is necessary to resort to surgery.

The main objective of this procedure is to achieve good stability of the structures encompassed in oral physiology. For this reason, it includes interventions for both aesthetic and general health purposes.

Phases of a maxillofacial surgery

In the first place, the indicated professional must carry out a diagnosis and planning of the procedure, which will be unique for each patient. In this pre-operative period, facial analyzes, radiographs, soft tissue studies and other exploration techniques are attended.

In second place, an orthodontic is applied to the patient. Unfortunately, this step is unavoidable before any intervention that is not immediately necessary (such as removing a tumor or treating an injury or abscess) and usually lasts about 18 months approximately.

Third, the actual surgery is performed, either under local or general anesthesia. As for the postoperative period, it will vary drastically based on the procedure performed and the needs of each patient. In general, it is estimated that the patient will experience oral inflammation that can last between 6 weeks and 6 months. In addition, it is important to note that the recovery process before this type of intervention it is usually slow, which is why you have to arm yourself with patience and follow the recommendations proposed by the health professional to the letter.

Final thoughts

As indicated by professional sources in the field, the majority of interventions included in maxillofacial surgery are usually a success. Orthognathic surgery (correction of the jaw) is the best example of this because, being a condition that can be addressed in the long run term, professionals can afford a pre-planning process that takes into account the functional and aesthetic needs of each patient, as well as the anticipation of possible eventualities such as an airway that is difficult to access or the need for blood transfusion intraoperative

On the other hand, the approach to oral infections and bone accidents are medical emergencies that must be addressed as quickly as possible, as there is a probable risk of systemic deterioration irremediable. Faced with any bacterial infection, the risk of spreading the pathogen into the bloodstream is a threat that must always be taken into account.

Resume

As we have seen in these lines, maxillofacial surgery it is not only a question of aesthetics in the vast majority of cases. A faulty jaw can lead to poor dental contact, poor chewing, clear facial asymmetry, and many other events that go beyond “looking pretty”. On the other hand, bacterial infections of the mouth must be tackled as quickly as possible, since the risk of bacteremia puts pressure on immediate intervention.

Be that as it may, maxillofacial surgeries are processes that generally require a slow recovery and relatively expensive, which is why it is necessary to arm yourself with patience and follow the medical indications to rajatabla. Sometimes the only option to fix a problem is to go under the knife.

Bibliographic references

• What is maxillofacial surgery and when is it necessary? Estudidentalbarcelona.com. Picked up on November 24 at https://estudidentalbarcelona.com/la-cirugia-maxilofacial-cuando-necesaria/
• Maxillofacial Surgery, institutomaxilofacial.com. Picked up on November 24 at https://www.institutomaxilofacial.com/es/cirugia-oral-y-maxilofacial/que-es-la-cirugia-oral-y-maxilofacial/
• Gagliardi Lugo, A. F., Contreras Ravago, M. G., & Gudiño Martinez, R. TO. (2015). Reason for emergency consultation for maxillofacial surgery in a Venezuelan hospital from 2006 to 2012: a retrospective study. Spanish Journal of Oral and Maxillofacial Surgery, 37 (4), 215-219.
• Hupp, J. R. (2014). Contemporary Oral and Maxillofacial Surgery 6 ed ...
• Infante-Cossío, P., Gutiérrez-Pérez, J. L., Torres-Lagares, D., García-Perla García, A., & González-Padilla, J. D. (2007). Filling of bone cavities in maxillofacial surgery with autologous materials. Spanish Journal of Oral and Maxillofacial Surgery, 29 (1), 7-19.
• Liceaga-Escalera, C. J., Trujillo-Fandiño, J. J., Montoya-Pérez, L. A., & Vélez-Cruz, M. AND. (2016). Diagnoses and procedures in maxillofacial surgery. Mexican Journal of Anesthesiology, 39 (S1), 111-112.
• Raspall, G. (1997). Maxillofacial surgery: surgical pathology of the face, mouth, head and neck. Panamerican Medical Ed.