Maxillofacial surgery
   HOME

TheInfoList



OR:

Oral and maxillofacial surgery (OMFS) is a surgical specialty focusing on
reconstructive surgery Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implicat ...
of the
face The face is the front of the head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may affect th ...
, facial trauma
surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
, the
mouth A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...
,
head A head is the part of an organism which usually includes the ears, brain, forehead, cheeks, chin, eyes, nose, and mouth, each of which aid in various sensory functions such as sight, hearing, smell, and taste. Some very simple ani ...
and
neck The neck is the part of the body in many vertebrates that connects the head to the torso. It supports the weight of the head and protects the nerves that transmit sensory and motor information between the brain and the rest of the body. Addition ...
, and jaws, as well as facial plastic surgery including cleft lip and cleft palate surgery.


Specialty

An oral and maxillofacial surgeon is a specialist
surgeon In medicine, a surgeon is a medical doctor who performs surgery. Even though there are different traditions in different times and places, a modern surgeon is a licensed physician and received the same medical training as physicians before spec ...
who treats the entire craniomaxillofacial complex:
anatomical Anatomy () is the branch of morphology concerned with the study of the internal structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old scien ...
area of the
mouth A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...
, jaws,
face The face is the front of the head that features the eyes, nose and mouth, and through which animals express many of their emotions. The face is crucial for human identity, and damage such as scarring or developmental deformities may affect th ...
, and
skull The skull, or cranium, is typically a bony enclosure around the brain of a vertebrate. In some fish, and amphibians, the skull is of cartilage. The skull is at the head end of the vertebrate. In the human, the skull comprises two prominent ...
, head and neck as well as associated structures. Depending upon the national jurisdiction, oral and maxillofacial surgery may require a degree in
medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
,
dentistry Dentistry, also known as dental medicine and oral medicine, is the branch of medicine focused on the Human tooth, teeth, gums, and Human mouth, mouth. It consists of the study, diagnosis, prevention, management, and treatment of diseases, dis ...
or both.


United States

In the U.S., oral and maxillofacial surgeons, whether possessing a single or dual degree, may further specialise after residency, undergoing additional one or two year sub-specialty oral and maxillofacial surgery fellowship training in the following areas: * Cosmetic facial surgery, including eyelid (blepharoplasty), nose (rhinoplasty), facial lift, brow lift, and laser resurfacing * Cranio-maxillofacial trauma, including zygomatic (cheek bone), orbital (eye socket), mandibular and nasal fractures as well as facial soft tissue lacerations and penetrating neck injuries *
Craniofacial surgery Craniofacial surgery is a surgical subspecialty that deals with congenital disorder, congenital and acquired deformity, deformities of the human head, head, human skull, skull, face, neck, jaws and associated structures. Although craniofacial treat ...
/paediatric maxillofacial surgery, including cleft lip and palate surgery and trans-cranial craniofacial surgery including Fronto-Orbital Advancement and Remodelling (FOAR) and total vault remodelling * Head and neck cancer and microvascular reconstruction free flap surgery * Maxillofacial regeneration, which is re-formation of the facial region by advanced stem cell technique


United Kingdom and Europe

In countries such as the UK and most of Europe, it is recognised as a specialty of medicine with a degree in medicine and an additional degree in dentistry being compulsory. The scope of practice is mainly head and neck cancer, microvascular reconstruction,
craniofacial surgery Craniofacial surgery is a surgical subspecialty that deals with congenital disorder, congenital and acquired deformity, deformities of the human head, head, human skull, skull, face, neck, jaws and associated structures. Although craniofacial treat ...
and cranio-maxillofacial trauma, skin cancer, facial deformity, cleft lip and palate, craniofacial surgery, TMJ surgery and cosmetic facial surgery. In the UK, maxillofacial surgery is a specialty of the
Royal College of Surgeons of England The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgery, surgical care for patients, and regulates surgery and dentistry in England and Wa ...
, Royal College of Surgeons of Edinburgh. Intercollegiate Board Certification is provided through the JCIE, and is the same as plastic surgery, ENT,
general surgery General surgery is a Surgical specialties, surgical specialty that focuses on alimentary canal and Abdomen, abdominal contents including the esophagus, stomach, small intestine, large intestine, liver, pancreas, gallbladder, Appendix (anatomy ...
, orthopaedics, paediatric surgery,
neurosurgery Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the specialty (medicine), medical specialty that focuses on the surgical treatment or rehabilitation of disorders which affect any portion of the nervous system ...
and cardiothoracic surgery. The FRCS (Fellowship of the Royal College of Surgeons) is the specialist exam at the end of surgical training, and is required to work as a Consultant Surgeon in maxillofacial surgery. In the EU, OMFS is defined within Directive 2005/36 on professional qualifications (updated 2021). The two OMFS specialties are 'dual degree' dental, oral, and maxillofacial surgery (DOMFS) and 'single medical degree' maxillofacial surgery (MFS). In some cases a dental degree may be required to enter specialty training but in all cases the medical degree must be obtained before starting OMFS specialty training. In Poland, maxillofacial surgery has always been dominated by dentists and still the majority of current OMFS trainees are dental graduates. Since 2019, Norway switched from dual degree requirement for maxillofacial surgery to medical degree only. Similarly, Sweden has started several maxillofacial surgery training programs for medical graduates.


Canada and Asia

In Asia, oral and maxillofacial surgery is also recognized as a dental specialty and requires a degree in dentistry prior to surgical residency training. The Canadian model is the same as the model used in the United States of America.


Pakistan

In Pakistan, OMFS is recognized as a specialty of dentistry which requires FCPS from CPSP after 4 years BDS degree and a one-year housejob. The candidate has to pass FCPS-1 in order to commence their training followed by PGMI Exam (not in all cases).


India

Oral and maxillofacial surgery, also known as OMFS, is a branch recognized by DCI (Dental Council of India). Becoming a maxillofacial surgeon requires a five-year dental degree followed by three years of post-graduate specialisation. Oral and maxillofacial surgery includes the treatment of complex dental surgery, including wisdom tooth removal, dental implant, craniomaxillofacial trauma, orofacial pain ( trigeminal neuralgia) and jaw joint pain ( temporomandibular disorder) management, jaw joint replacement for ankylosis and deformed jaw joint cases, Lefort-3 distraction for craniosynostosis case, jaw tumour and cyst removal surgery, head and neck cancer, facial aesthetic like rhinoplasty, eye and ear plastic surgery, facial cosmetic surgery, microvascular surgery, and cleft and craniomaxillofacial surgery. A maxillofacial surgeon is considered one of the required members of an emergency team. Almost 20-25% of trauma patients usually have sustained facial trauma, and that needs urgent opinion and primary management that can be better managed by maxillofacial experts.


Australia and New Zealand

In Australia and New Zealand, oral and maxillofacial surgery is recognised as both a specialty of medicine and dentistry. Degrees in both medicine and dentistry are compulsory prior to being accepted for surgical training. The scope of practice is broad and there is the ability to undertake subspecialty fellowships in areas such as head and neck surgery and microvascular reconstruction.


Globally

In other countries, oral and maxillofacial surgery as a specialty exists but under different forms, as the work is sometimes performed by a single or dual qualified specialist depending on each country's regulations and training opportunities available. In several countries, oral and maxillofacial surgery is a specialty recognized by a professional association, as is the case with the Dental Council of India, American Dental Association,
Royal College of Surgeons of England The Royal College of Surgeons of England (RCS England) is an independent professional body and registered charity that promotes and advances standards of surgery, surgical care for patients, and regulates surgery and dentistry in England and Wa ...
, Royal College of Surgeons of Edinburgh, Royal College of Dentists of Canada,
Royal Australasian College of Surgeons The Royal Australasian College of Surgeons (RACS) is the leading advocate for surgical standards, professionalism and surgical education in Australia and New Zealand. Known by its common acronym RACS, it is a not-for-profit organisation, supp ...
and Brazilian Federal Council of Odontology (CFO).


Regulation in the United States

Oral and maxillofacial surgery is an internationally recognized surgical specialty. Oral and maxillofacial surgery is formally designated as either a medical, dental or dual (medical and dental) specialty. In the United States, oral and maxillofacial surgery is a recognised surgical specialty, formally designated as a dental specialty. A professional dental degree is required, a qualification in medicine may be undertaken optionally during residency training. In this respect, oral and maxillofacial surgery is ''
sui generis ( , ) is a Latin phrase that means "of its/their own kind" or "in a class by itself", therefore "unique". It denotes an exclusion to the larger system an object is in relation to. Several disciplines use the term to refer to unique entities. ...
'' among surgical specialties. Board certification in the U.S. is governed by the American Board of Oral and Maxillofacial Surgery (ABOMS). Oral and maxillofacial surgery is among the fourteen surgical specialties recognized by the American College of Surgeons. Oral and maxillofacial surgeons in the United States, whether single or dual degree, may become Fellows of the American College of Surgeons, "FACS" (Fellow, American College of Surgeons). The American Association of Oral and Maxillofacial Surgeons (AAOMS) is the chief professional organization representing the roughly 9,000 oral and maxillofacial surgeons in the United States. The American Association of Oral and Maxillofacial Surgeons publishes the peer-reviewed Journal of Oral and Maxillofacial Surgery.


Surgical procedures

Globally, treatments may be performed on the craniomaxillofacial complex: mouth, jaws, face, neck, and skull, and include: * Cosmetic surgery of the head and neck: ( rhytidectomy/facelift,
browlift A forehead lift, also known as a browlift or browplasty, is a cosmetic surgery procedure used to elevate a drooping eyebrow that may obstruct vision and/or to remove the deep "worry" lines that run across the forehead In human anatomy, the foreh ...
, blepharoplasty/ Asian blepharoplasty, otoplasty,
rhinoplasty Rhinoplasty (, nose + , to shape), commonly called nose job, medically called nasal reconstruction, is a plastic surgery procedure for altering and reconstructing the human nose, nose. There are two types of plastic surgery used – plastic sur ...
, septoplasty, cheek augmentation, chin augmentation, genioplasty, oculoplastics, neck liposuction, hair transplantation, lip enhancement, injectable cosmetic treatments like botox, fillers, platelet rich plasma, stem cells, chemical peel, mesotherapy. * Orthognathic surgery, surgical treatment/correction of dentofacial deformity as well as management of facial trauma, and
sleep apnea Sleep apnea (sleep apnoea or sleep apnœa in British English) is a sleep-related breathing disorder in which repetitive Apnea, pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor vent ...
* Oncology head and neck surgery with free flap microvascular reconstruction * Cutanous malignancy/skin cancer surgery of head and neck surgery skin grafts and local flaps * Diagnosis and treatment of: *
benign Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
( cysts,
tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
s etc.) *
malignant Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous benign tumor, ''benign'' tumor in that a malig ...
pathology (oral & head and neck cancer) with (ablative and
reconstructive surgery Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implicat ...
, microsurgery) * cutaneous malignancy (
skin cancer Skin cancers are cancers that arise from the Human skin, skin. They are due to the development of abnormal cells (biology), cells that have the ability to invade or metastasis, spread to other parts of the body. It occurs when skin cells grow ...
),
lip reconstruction Lip reconstruction may be required after trauma or surgical excision. The lips are considered the beginning of the oral cavity and are the most common site of oral cancer. Any reconstruction of the lips must include both functional and cosmetic ...
*
congenital A birth defect is an abnormal condition that is present at childbirth, birth, regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellectual disability, intellectual, or dev ...
craniofacial malformations such as
cleft lip A cleft lip contains an opening in the upper lip that may extend into the nose. The opening may be on one side, both sides, or in the middle. A cleft palate occurs when the palate (the roof of the mouth) contains an opening into the nasal cavi ...
and
palate The palate () is the roof of the mouth in humans and other mammals. It separates the oral cavity from the nasal cavity. A similar structure is found in crocodilians, but in most other tetrapods, the oral and nasal cavities are not truly sep ...
and cranial vault malformations such as craniosynostosis, (
craniofacial surgery Craniofacial surgery is a surgical subspecialty that deals with congenital disorder, congenital and acquired deformity, deformities of the human head, head, human skull, skull, face, neck, jaws and associated structures. Although craniofacial treat ...
) * chronic facial pain disorders * temporomandibular joint (TMJ) disorders * Orthognathic (literally "straight jaw")
reconstructive surgery Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implicat ...
, orthognathic surgery, maxillomandibular advancement, surgical correction of facial asymmetry. * soft and hard tissue trauma of the oral and maxillofacial region (jaw fractures, cheek bone fractures, nasal fractures, LeFort fracture,
skull The skull, or cranium, is typically a bony enclosure around the brain of a vertebrate. In some fish, and amphibians, the skull is of cartilage. The skull is at the head end of the vertebrate. In the human, the skull comprises two prominent ...
fractures and eye socket fractures). * Dentoalveolar surgery (surgery to remove impacted
teeth A tooth (: teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
, difficult tooth extractions, extractions on medically compromised patients, bone grafting or preprosthetic surgery to provide better anatomy for the placement of implants,
dentures Dentures (also known as false teeth) are prosthetic devices constructed to replace missing teeth, supported by the surrounding soft and hard tissues of the oral cavity. Conventional dentures are removable ( removable partial denture or comp ...
, or other dental prostheses) * Surgery to insert osseointegrated (bone fused) dental implants and maxillofacial implants for attaching craniofacial prostheses and bone anchored hearing aids.


Occupation

Oral and maxillofacial surgery is intellectually and physically demanding and is among the most highly compensated surgical specialties in the United States with a 2008 average annual income of $568,968. The popularity of oral and maxillofacial surgery as a career for persons whose first degree was medicine, not dentistry, seems to be increasing. At least one program (University of Alabama at Birmingham) exists that allows highly qualified candidates whose first degree is in medicine to earn the required dental degree, so as to qualify for entrance into oral and maxillofacial residency training programs and ultimately achieve board eligibility and certification in the surgical specialty.


Education and training

In the UK, oral and maxillofacial surgery is one of the ten medical specialties, requiring MRCS and FRCS examinations. In mainland Europe, its status, including whether or not oral surgery, maxillofacial surgery, and stomatology are considered separate specialties, varies by country. The required qualifications (medical degree, dental degree, or both, as well as the required internship and residency programs) also vary. In the US, Australia and South Africa, oral and maxillofacial surgery is one of the ten dental specialties recognised by the American Dental Association, Royal College of Dentists of Canada, and the Royal Australasian College of Dental Surgeons. Oral and maxillofacial surgery requires four to six years of further formal university training after dental school (''i.e.'', DDS, BDent, DMD, or BDS). Residency training programs are either four or six years in duration. In the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, four-year residency programs grant a certificate of specialty training in oral and maxillofacial surgery. Six-year programs granting an optional MD degree emerged in the early 1990s in the United States. Typically, six-year residency programs grant the specialty certificate and an additional degree such as a medical degree (e.g., MD, DO, MBBS, MBChB) or research degree (e.g., MS, MSc, MPhil, MDS, MSD, MDSc, DClinDent, DSc, DMSc, PhD). Both four– and six–year graduates are designated US "board eligible" and those who earn "board certification" are diplomats. Approximately 50% of the training programs in the US and 66% of Canadian training programs are "dual-degree." The typical length of education and training, in post-secondary school is 12 to 14 years. Beyond these years, some sub-specialise, adding an additional 1-2 year fellowship. The typical training program for an oral and maxillofacial surgeon is: * 2–4 years of undergraduate study (BS, BA, or equivalent degrees) * 4 years dental study ( DMD, BDent, DDS or BDS) * 4–6 years residency trainingSome programs integrate an additional degree such as a
master's degree A master's degree (from Latin ) is a postgraduate academic degree awarded by universities or colleges upon completion of a course of study demonstrating mastery or a high-order overview of a specific field of study or area of professional prac ...
(MS, MDS, MSc, MClinDent, MScDent, MDent), doctoral degree (PhD, DMSc, DClinDent, DSc), or
medical degree A medical degree is a professional degree admitted to those who have passed coursework in the fields of medicine and/or surgery from an accredited medical school. Obtaining a degree in medicine allows for the recipient to continue on into special ...
(e.g., MBBS, MD, DO, MBChB, MDCM) * After completion of surgical training most undertake final specialty examinations: US: "Board Certified (ABOMS)", Australia/NZ: FRACDS, or Canada: "FRCDC" * Some colleges offer membership or fellowships in oral/maxillofacial surgery: MOralSurg RCS, M(OMS) RCPS, FFD RCSI, FEBOS, FACOMS, FFD RCS, FAMS, FCDSHK, FCMFOS (SA) * Both single and dual qualified oral and maxillofacial surgeons may obtain fellowship with the American College of Surgeons ( FACS).


Surgical sub-specialty fellowship training

In addition, single and dual-qualified graduates of oral and maxillofacial surgery training programs can pursue post-residency sub-specialty fellowships, typically 1–2 years in length, in the following areas: * Head and neck cancer microvascular reconstruction * Cosmetic facial surgery (facelift, rhinoplasty, etc.) *
Craniofacial surgery Craniofacial surgery is a surgical subspecialty that deals with congenital disorder, congenital and acquired deformity, deformities of the human head, head, human skull, skull, face, neck, jaws and associated structures. Although craniofacial treat ...
and pediatric maxillofacial surgery (cleft lip and palate repair, surgery for craniosynostosis, etc.) * Cranio-maxillofacial trauma (soft tissue and skeletal injuries to the face, head and neck)


Charities

Several notable philanthropic organizations provide humanitarian oral and maxillofacial surgery globally. Smile Train was created in 1998 by Charles Wang focusing on childhood facial deformity. Operation Smile focuses on correcting cleft lips and palates in children. AboutFace, created by
Paul Stanley Paul Stanley (born Stanley Bert Eisen; January 20, 1952) is an American musician who was the co-founder, frontman, rhythm guitarist, and co-lead vocalist of the hard rock band Kiss (band), Kiss from the band's inception in 1973 to their retireme ...
, of the rock band KISS, who was born with a facial deformity, focuses on craniofacial disfiguration.


See also


References


External links


International Association of Oral and Maxillofacial Surgeons

British Association of Oral and Maxillofacial Surgeons

American College of Surgeons

American Association of Oral and Maxillofacial Surgeons

American Board of Oral and Maxillofacial Surgeons

Journal of Oral and Maxillofacial Surgery
{{medicine Surgical specialties Medical specialties