Oral & Maxillofacial Surgery

Oral & Maxillofacial Surgery Oral and maxillofacial surgery is surgery to

correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region.

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.

-The Extreme-OM surgery plus Plastics plus ENT,

plus...

These recently updated photos obtained May 5, 2009 from the Cleveland Clinic shows Connie Culp after an injury to her face and as she appears today. Five years ago, a shotgun blast left a ghastly hole where the middle of her face had been. Five months ago, she received a new face from a deceased woman.

A multi-disciplinary team of doctors and surgeons at Cleveland Clinic performed the first near-total face transplant in the United States. In a 22-hour procedure, surgeons transplanted 80 percent of a woman's face who suffered severe facial trauma � essentially replacing her entire face, except for her upper eyelids, forehead, lower lip and chin.

Terms Alveolar process - alveolar

ridge: a ridge that forms the borders of the upper and lower jaws and contains the sockets of the teeth

Arthroscopy Calvarial - skull Condyle - A rounded

enlargement or process possessing an artculating surface.

Coronal flap Craniosynostosis - Premature

closing of joints or sutures in the skull.

Dentition - teeth Glenoid fossa- jaw joint Inferior alveolar nerve -

enters the mandible on the deep surface of the ramus, providing sensation to the teeth

Gnath-jaw Labia - lip Malar bone - cheek Malocclusion Maxillofacial - relating to

the lower half of the face Meniscus - cartilage that

works to absorb weight and provide stability

Mouth prop Mental Nerve - nerve which

provides sensation to the anterior aspects of the chin and lower lip as well as the buccal gingivae of the mandibular anterior teeth and the premolars.

Orbicular - circular in outline

Terms Osteotomy - operation in which the bone is

cut through Ramus - the posterior part of the mandible that is

more or less vertical Reduction Sagittal - [sagitt = arrow] Divides the body or

structure into mirror images of right & left sides. Symphysis - the point of junction of two bones as in the

two parts of the lower jaw in front: the tip of the chin TMJ - Tempero-mandibular joint, the two joints that

connect the jaw to the skull.

Oral (Buccal) Cavity

Lips Teeth Palate Cheeks Tongue

Lips (labia)

Thermal receptors for protection from burns

Muscles aiding in expressions, food retention, and mastication

Space between lips extending to the cheeks is the vestibule (an entrance)

Teeth (Dentitions)Rest in alveolar processes

Deciduous (primary) Appear = 6 mos. Continue to = 4 yrs For each jaw: 2 central incisors 2 lateral incisors 2 cuspids or canines 4 molars 20 total Loss begins = 6 yrs

Permanent (secondary)

For each jaw: 2 central incisors 2 lateral incisors 2 cuspids or canines 4 bicuspids 6 molars 3rd molars or wisdom

teeth appear = 17-25 yrs

Teeth

Speech Mastication

Teeth(3 Regions)

1. Crown is above/outside gumline

a. Enamel covering of crown Hardest part Doesn’t reproduce Degenerates with

age and injury

b. Dentin Majority of tooth Harder than bone Encases pulpc. Pulp Blood vessels Nerves Connective tissue

Teeth(3 regions)

2. Neck Junction of crown and root

Teeth(3 regions)

3. Root Held by periodontal ligament Connects tooth to alveolar processes

Palate Roof of the mouth Anterior portion is hard palate Posterior portion is soft palate Uvula is the most posterior part of the

soft palate Soft palate separates mouth from

nasopharynx Soft palate rises with swallowing to

prevent food going into nasal cavity

Cheeks

Lateral walls of oral cavity Consist of major muscles for

mastication

Tongue Chemoreceptors for taste Attached to floor of buccal cavity by lingual frenulum Function in speech, propelling food through oral cavity

and swallowing

Skeletal SystemAxial Skeleton

Along or connecting to the midline of the body

Skull Vertebral column Sternum Rib Cage About 80 bones

total

Appendicular Skeleton Everything hanging

off the axial skeleton

Skull

Skull

Skull Frontal Temporal Occipital Parietal Sphenoid Ethmoid

Maxilla Zygomatic Mandible Lacrimal Hyoid

Skull

1. Frontal bone Protection Twice as thick as others Supraorbital foramen allow for

passage of blood vessels and nerves servicing the face and head

Skull

2. Temporal Bone Protection External auditory canal allows for

sound to enter skull Openings at base for carotid arteries

and jugular veins called carotid foramen and jugular foramen

Mastoid process where sternocleidomastoid muscle attaches

Skull

3. Occipital bone Forms posterior base of skull Large hole at base is foramen magnum

where spine enters skull Occipital condyles are connections

between skull and vertebrae C-1 vertebrae most superior is the atlas

which supports the skull/head C-2 is the axis which allows for movement

of the head

Skull

4. Sphenoid bone - butterfly-shaped bone at the base of the skull

Center of base of skull Keystone of the skull (ties a lot of

other bones together Sella turcica is where the pituitary

gland sits - a saddle-shaped depression in the sphenoid bone at the base of the human skull.

Skull

5. Ethmoid bone Forms part of nasal cavities Olfactory foramen open into nasal

cavity Penetrates into frontal bone -

cribiform bone Nerve ending in cribiform plate

where sense of smell delivered and received

Skull

6. Maxilla Attachment for upper teeth (alveolar

processes) Infraorbital foramen for vessels and

nerves Attachment for zygomatic

bones/cheek bones

Skull

7. Mandible Lower jaw Largest and only moving bone in face Attachment for lower teeth (alveolar

processes) Articulates with glenoid fossa of each

temporal bone = TMJ (temporomandibular joint)

Skull

8. Lacrimal bone Smallest bone in

face – very thin Small foramen

become nasolacrimal ducts where tears drain

Tears come from lacrimal gland in eyebrows (keep eyes and nares moist)

Skull

9. Hyoid bone Only bone in body that does NOT

connect directly to another bone Held in place by ligaments Holds tongue in place (tongue for

swallowing and mastication)

Orbital Bones (* =‘s weakest bones)

Frontal Lacrimal Ethmoid-* Maxilla- * Zygomatic Sphenoid Palatine

Facial Muscles

• Expressions• Mastication • Speaking