Pathology & Reconstruction
An Oral and Maxillofacial Surgeon is a surgical specialist with expertise in the mouth, face and jaws. In addition, some Oral and Maxillofacial Surgeons undergo additional complex head and neck, and microvascular surgical training to offer patients comprehensive jaw and face reconstruction, and oral rehabilitation care.
Many patients may undergo initial screening through their dentist, family physician or other dental and medical specialist prior to being referred to an Oral and Maxillofacial Surgeon. Referral to an Oral and Maxillofacial Surgeon can be for identification and proper diagnosis of any abnormal soft or hard tissue finding in the region of the mouth, jaw, face or neck. After an initial clinical assessment with a surgeon there may be a need for further investigation, including, but not limited to:
- Special imaging: x-rays, panorex, CT scans, MRI, PET or bone scans
- Further screening tests: endoscopy, light amplification to identify tissue abnormalities (ex. Velscope) and brush biopsies (similar to Pap tests)
- Surgical biopsy with partial or complete removal to help identify the lesion/abnormality
Oral and Maxillofacial Surgeons have extensive training covering a vast array of disease processes that affect the oral cavity and surrounding structures, such as:
Soft Tissue Abnormalities which in the mouth, can be due to irritation, reaction to certain drugs and materials in the mouth, be an evidence of a vitamin or mineral deficiency, or represent an underlying infection.
Soft Tissue Tumours may represent abnormal growths of various origins, which can often be removed entirely.
Bone Cysts which are fluid filled sacs within the bone which can be decompressed, or removed entirely.
Bone Tumors are abnormal growths within bone that are caused by abnormal development of the bone, teeth or tooth related tissues. Treatment can vary from conservative removal, or removal with surrounding structures.
Skin Cancers - basal cell, squamous cell, and melanoma cancers are the most common types. Surgeons provide removal and can often provide simultaneous reconstruction to make affected tissue area appear as natural as possible.
Oral Cancer - which is most often squamous cell carcinoma. Oral cancer is largely caused by cigarette smoking, viruses and other environmental factors. Surgical removal is frequently the recommended treatment, often with combined removal of the lymph nodes. Reconstruction of the defect is frequently indicated to restore oral and facial form and function.
Other Head and Neck Malignancies are invasive lesions in the cancer spectrum that can involve various tissues, including bone and saliva glands. Treatment often requires surgical removal and possible reconstruction as appropriate.
Your Oral and Maxillofacial Surgeon is capable of providing reconstructive care that encompasses restoration of both form and function. The blend of backgrounds covering dentistry, medicine, and head and neck surgery offers a complete understanding of all facial components. By using various techniques from simple closure to complicated tissue transfers, the jaws and facial anatomy can be reconfigured with a cosmetic, natural appearance, and provide a proper functioning bite. For reconstructive purposes, soft tissues (skin, mucosa, fat, muscle) and hard tissues (bone, cartilage) can be taken from various parts of a patient’s own body based on necessary size and shape, or can be utilized from donated or engineered tissues, or growth factors.
Your Oral and Maxillofacial Surgeon can accordingly diagnose, surgically treat and repair all aspects of your oral and facial condition. In certain cases, referral to an Oral and Maxillofacial Surgeon with sub-specialty or fellowship training in a unique discipline may be required. Canadian Oral and Maxillofacial Surgeons are often using state of the art technology with computerized surgical planning, custom prosthesis design, robotics, and patient specific rehabilitation. As such, your Oral Maxillofacial Surgeon can provide optimal goal directed care for complex needs.