Surgery and management for facial disorders
- By: Kieron McVeigh, Nicholas Grew
Maxillofacial surgery is needed for many conditions, including facial injuries, head and neck cancer, salivary gland disease, impacted teeth, cysts and tumours of the jaws, oral mucosal diseases, facial pain, and disorders of the temporomandibular joint. Maxillofacial surgeons need undergraduate degrees in dentistry and medicine. Medical undergraduates often receive limited training in maxillofacial surgery, and junior doctors may find themselves unprepared.
Extraction of teeth and the management of conditions such as jaw cysts are the most common operations performed by maxillofacial surgery departments. Charting systems have been developed to record the teeth to be treated. One of the commonest schemes is Palmer’s notation, which divides the mouth into four quadrants and allocates each permanent (adult) tooth a number, starting with the central incisor (1) and progressing to the wisdom tooth (8) (fig 1). Deciduous (milk) teeth are allocated letters instead of numbers, and the tooth’s location in the mouth is