Oral & Maxillofacial Surgery
 Oral and maxillofacial surgery is surgery to
correct a wide spectrum of diseases, injuries and
defects in the head, neck, face, jaws and the hard
and soft tissues of the oral and maxillofacial region.
 An oral and maxillofacial surgeon is a regional
specialist surgeon treating the entire
craniomaxillofacial complex: anatomical area of the
mouth, jaws, face, skull, as well as associated
structures.
These recently updated
photos obtained May 5,
2009 from the Cleveland
Clinic shows Connie Culp
after an injury to her face
and as she appears today.
Five years ago, a shotgun
blast left a ghastly hole
where the middle of her
face had been. Five
months ago, she received
a new face from a
deceased woman.
A multi-disciplinary team of
doctors and surgeons at
Cleveland Clinic performed
the first near-total face
transplant in the United
States. In a 22-hour
procedure, surgeons
transplanted 80 percent of a
woman's face who suffered
severe facial trauma �
essentially replacing her
entire face, except for her
upper eyelids, forehead,
lower lip and chin.
Terms
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Alveolar process - alveolar
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Arthroscopy
Calvarial - skull
Condyle - A rounded
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Coronal flap
Craniosynostosis - Premature
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Dentition - teeth
Glenoid fossa- jaw joint
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ridge: a ridge that forms the
borders of the upper and lower
jaws and contains the sockets of
the teeth
enlargement or process possessing
an artculating surface.
closing of joints or sutures in the
skull.
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Gnath-jaw
Labia - lip
Malar bone - cheek
Malocclusion
Maxillofacial - relating to
the lower half of the face
Meniscus - cartilage that
works to absorb weight and
provide stability
Mouth prop
Mental Nerve - nerve which
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Orbicular - circular in outline
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Inferior alveolar nerve -
enters the mandible on the
deep surface of the ramus,
providing sensation to the teeth
provides sensation to the
anterior aspects of the chin and
lower lip as well as the buccal
gingivae of the mandibular
anterior teeth and the
premolars.
Terms
 Osteotomy - operation in which the bone is
cut through
 Ramus - the posterior part of the mandible that is
more or less vertical
 Reduction
 Sagittal - [sagitt = arrow] Divides the body or
structure into mirror images of right & left sides.
 Symphysis -
the point of junction of two bones as in
the two parts of the lower jaw in front: the tip of the chin
 TMJ -
Tempero-mandibular joint, the two joints that
connect the jaw to the skull.
Oral (Buccal) Cavity
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Lips
Teeth
Palate
Cheeks
Tongue
Lips (labia)
 Thermal receptors for protection from
burns
 Muscles aiding in expressions, food
retention, and mastication
 Space between lips extending to the
cheeks is the vestibule (an entrance)
Teeth (Dentitions)
Rest in alveolar processes
 Deciduous (primary)
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Appear = 6 mos.
Continue to = 4 yrs
For each jaw:
2 central incisors
2 lateral incisors
2 cuspids or canines
4 molars
20 total
Loss begins = 6 yrs
 Permanent
(secondary)
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For each jaw:
2 central incisors
2 lateral incisors
2 cuspids or canines
4 bicuspids
6 molars
3rd molars or wisdom
teeth appear = 17-25
yrs
Teeth
 Speech
 Mastication
Teeth
(3 Regions)
1.
a.
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Crown is
above/outside
gumline
Enamel
covering of crown
Hardest part
Doesn’t reproduce
Degenerates with
age and injury
b.
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c.
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Dentin
Majority of tooth
Harder than bone
Encases pulp
Pulp
Blood vessels
Nerves
Connective tissue
Teeth
(3 regions)
2. Neck

Junction of crown and root
Teeth
(3 regions)
3. Root
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Held by periodontal ligament
Connects tooth to alveolar processes
Palate
Roof of the mouth
Anterior portion is hard palate
Posterior portion is soft palate
Uvula is the most posterior part of
the soft palate
 Soft palate separates mouth from
nasopharynx
 Soft palate rises with swallowing to
prevent food going into nasal cavity
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Cheeks
 Lateral walls of oral cavity
 Consist of major muscles for
mastication
Tongue
 Chemoreceptors for taste
 Attached to floor of buccal cavity by lingual frenulum
 Function in speech, propelling food through oral cavity
and swallowing
Skeletal System
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Axial Skeleton
Along or connecting
to the midline of the
body
Skull
Vertebral column
Sternum
Rib Cage
About 80 bones
total
Appendicular Skeleton
 Everything hanging
off the axial
skeleton
Skull
Skull
Skull
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Frontal
Temporal
Occipital
Parietal
Sphenoid
Ethmoid
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Maxilla
Zygomatic
Mandible
Lacrimal
Hyoid
Skull
1.
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Frontal bone
Protection
Twice as thick as others
Supraorbital foramen allow for
passage of blood vessels and nerves
servicing the face and head
Skull
2. Temporal Bone
 Protection
 External auditory canal allows for
sound to enter skull
 Openings at base for carotid arteries
and jugular veins called carotid
foramen and jugular foramen
 Mastoid process where
sternocleidomastoid muscle attaches
Skull
3. Occipital bone
 Forms posterior base of skull
 Large hole at base is foramen magnum
where spine enters skull
 Occipital condyles are connections
between skull and vertebrae
 C-1 vertebrae most superior is the atlas
which supports the skull/head
 C-2 is the axis which allows for movement
of the head
Skull
4. Sphenoid bone -
butterfly-shaped bone at the
base of the skull
 Center of base of skull
 Keystone of the skull (ties a lot of
other bones together
 Sella turcica is where the pituitary
gland sits - a saddle-shaped
depression in the sphenoid bone at
the base of the human skull.
Skull
5. Ethmoid bone
 Forms part of nasal cavities
 Olfactory foramen open into nasal
cavity
 Penetrates into frontal bone cribiform bone
 Nerve ending in cribiform plate
where sense of smell delivered and
received
Skull
6. Maxilla
 Attachment for upper teeth (alveolar
processes)
 Infraorbital foramen for vessels and
nerves
 Attachment for zygomatic
bones/cheek bones
Skull
7. Mandible
 Lower jaw
 Largest and only moving bone in
face
 Attachment for lower teeth (alveolar
processes)
 Articulates with glenoid fossa of each
temporal bone = TMJ
(temporomandibular joint)
Skull
8. Lacrimal bone
 Smallest bone in
face – very thin


Small foramen
become nasolacrimal
ducts where tears
drain
Tears come from
lacrimal gland in
eyebrows (keep eyes
and nares moist)
Skull
9. Hyoid bone
 Only bone in body that does NOT
connect directly to another bone
 Held in place by ligaments
 Holds tongue in place (tongue for
swallowing and mastication)
Orbital Bones
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Frontal
Lacrimal
Ethmoid-*
Maxilla- *
Zygomatic
Sphenoid
Palatine
(* =‘s weakest bones)
Facial Muscles
• Expressions
• Mastication
• Speaking