Change is an inevitable part of growth. We live and work in an ever-changing world. Without change, there would be no growth and no progress. The way we practice our specialty has changed tremendously over the ages. It has evolved over centuries and has undergone significant advancements especially in the recent times.
HISTORY OF ORAL AND MAXILLOFACIAL SURGERY
The earliest recorded evidence of oral surgery dates back to the great Indian surgeon Sushruta, who has described a unique technique of a forehead flap for the reconstruction of nasal defects. Ancient Egypt records evidence of dental problems treated using crude tools made of flint, bone, and copper. In ancient Greece, Hippocrates, the father of modern medicine, wrote about the treatment of facial injuries and the use of dental splints to immobilize fractured jaws. In the Middle Ages, barbers and blacksmiths performed tooth extractions and other dental procedures, as the dental profession did not exist at that time. However, in the eighteenth century, Pierre Fauchard, a French dentist, introduced modern dentistry and developed new tools and techniques for treating dental problems.
One development that revolutionized the field of medicine was the invention of anesthesia in the nineteenth century. This transformed surgical care and made it possible for complex procedures to be performed without pain and discomfort to the patient. This also paved way for oral and maxillofacial surgery to be identified as a specialized branch, and formal training programs were established in the early twentieth century. History documents the crucial role played by oral and maxillofacial surgeons in restoring damaged and destroyed faces during World War II.
DEVELOPMENTS IN THE FIELD OF ORAL AND MAXILLOFACIAL SURGERY
The development of surgical techniques in OMFS has been greatly influenced by the advances in medical knowledge and technology. One of the most significant developments in OMFS was the introduction of orthognathic surgery in the 1950s. Jaw corrective surgeries were a game-changer for not just patients with esthetic concerns but also for those with functional bite problems and skeletal imbalances.
The world saw a great revolution in the 1960s with the advent of dental implants. Over time rehabilitation of edentulous jaws with dental implants has been transformed into routine day care procedures. Added to them is the advantage of zygomatic implants which has enabled dental prosthesis for almost impossible cases like jaw resections due to trauma or pathology. CAD-CAM technology is another addition to maxillofacial surgery enabling surgeons to visualize the complex anatomy of the head and neck. Three-dimensional models created by the CAD-CAM technology have been used to plan surgical cuts of orthognathic surgeries, determine optimal positioning of the jaws, size, and shape of dental implant placements, and plan for the reconstruction of resected jaw segments. This technology has improved the accuracy of surgical planning, reduced the duration of surgery, and increased the success rate of surgical procedures.
Regenerative medicine is another significant advancement in the field of medicine where biologic materials are used to regenerate damaged tissue. In OMFS, regenerative medicine is used to promote bone growth and tissue regeneration in patients with facial trauma, bone defects, and periodontal disease. Stem cells can be harvested from the patient’s own bone marrow or adipose tissue and used to promote healing and tissue regeneration. This technology has significantly improved the outcomes of reconstructive surgery, leading to faster healing, reduced scarring, and improved function.
Oral and maxillofacial surgeons are increasingly using virtual surgical planning (VSP) in their daily practice. This technology involves the creation of a virtual surgical plan using 3D imaging and computer software. The surgeon can use this plan to determine the optimal surgical approach, plan the placement of implants or orthognathic surgery, and simulate the outcome of the surgery. VSP enables accurate surgical planning, reduced duration of surgery, and increased success rate of surgical procedures.
The use of nanotechnology is another recent advance in OMFS. Nanoparticles can be used to deliver drugs or other therapeutic agents to targeted tissues. In OMFS, nanoparticles can be used to promote bone growth, prevent infection, and reduce inflammation. For example, nanoparticles can be used to deliver antibiotics directly to the site of infection, reducing the risk of systemic side effects. Nanoparticles can also be used to deliver growth factors and other biologic materials to promote tissue regeneration and healing.
The way ahead……
We are now in technology-driven surgical world. Present-day surgeons need to be equipped not just in surgical skills but also in skills to navigate medical technology. Robotic surgery is one such area which is making its way into OMFS. Robots can be programmed to perform delicate and precise surgical procedures, such as orthognathic surgery, dental implant placement, and cosmetic procedures. The surgeon can control the robot’s movements using a computer console, which provides a magnified view of the surgical site. Robotic surgery has several advantages over traditional surgery, including reduced risk of infection, reduction of human error, smaller incisions, and faster healing.
Virtual reality (VR) technology is another area to look out for in OMFS. With VR, patients can be immersed in a simulated surgical environment, where they can interact with virtual objects and surgical tools. This technology has several benefits, including reduced anxiety, improved patient education, and better surgical outcomes. A patient can use VR to familiarize themselves with the surgical procedure and understand the expected outcome. This technology has also been used to train surgeons, enabling them to practice surgical techniques in a simulated environment.
OMFS has had humble beginnings but with the latest developments in medicine and collaborative work in the field of technology, there is greater work yet to be done in this field. Far are not the days when science and skill can be put together to provide greater comfort to the patients, accurate surgical planning, faster surgeries, and more reliable surgical outcomes. New horizons are opening up, and it is for the new generation of surgeons to create greatness in the ever-emerging field of oral and maxillofacial surgery!