Objectives
Review the pathophysiology of maxillofacial trauma.
Discuss the surgical considerations for patients with facial trauma, including fractures of the upper and lower jaws, orbits, facial lacerations, and midface fractures (LeFort fractures).
Review the implications of head and neck infections including Ludwig's angina.
INTRODUCTION
Oral and maxillofacial surgeons (OMSs) are the surgical specialists of the dental profession. Their surgical expertise and thorough understanding of both aesthetics and function uniquely qualify them to diagnose, treat, and manage the conditions, defects, injuries, and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial regions.
As an oral and maxillofacial surgeon, extensive dental and medical training in the hospital-based environment is needed to treat and repair injuries to the face. OMSs are experts in treating facial trauma, including fractures of the upper and lower jaws and orbits and the cosmetic management of facial lacerations. As an OMS, responsibilities also extend into performing complex reconstruction of the maxillofacial and craniofacial complexes.
Important to the training of the OMS is the acquisition of knowledge and skill in advance and complex pain control methods, including intravenous (IV) sedation and ambulatory general anesthesia. An OMS resident receives up to 6 months of operating room (OR) general anesthesia experience alongside board-certified medical anesthesiologists. In addition, the OMS receives extensive training and experience in the initial and definitive care of the trauma patient, management of extensive odontogenic infections of the head and neck, management of oral pathologic lesions (such as cysts and tumors of the jaws), diagnosis and management of dentofacial deformities (congenital, developmental, or acquired), complex maxillofacial preprosthetic surgery (including the use of dental implants), reconstruction with bone grafts of missing portions of the jaws, and management of facial pain and temporomandibular joint disorders.
