Journal of Surgery Current Trends & Innovations Category: Clinical Type: Editorial

New Trends Oral and Maxillofacial Surgery past Two Decades

Gagik Hakobyan1*
1 Head Of Department Of Oral And Maxillofacial Surgery, Yerevan State Medical University, Yerevan, Armenia

*Corresponding Author(s):
Gagik Hakobyan
Head Of Department Of Oral And Maxillofacial Surgery, Yerevan State Medical University, Yerevan, Armenia
Tel:+374 91750404,
Email:hakobyan_gv@rambler.ru

Received Date: May 13, 2020
Accepted Date: Jun 09, 2020
Published Date: Jun 18, 2020

EDITORIAL

The specialty of Oral & Maxillofacial Surgery (OMFS), as we know it now, will inevitably change in our lives. The use of new scientific and technological achievements has revolutionized field of oral and maxillofacial surgery [1]. 

With unique training in oral and maxillofacial surgery underpinned by medical and dental science, OMS surgeons expanded into speciality areas and many now participate in craniofacial surgery and aesthetic facial surgery. OMS is, in itself, an integral field that encompasses aspects of science, clinical techniques and esthetics and constantly re-creates itself. 

Over the past two decades, the field of Oral and Maxillofacial Surgery (OMS) has grown significantly, and every breakthrough in the history of our field has taken occurred due to the ingenious step to invent a new technique, and also because of the many practitioners who later learned about the technique, saw its significance, then popularized and perfected it [2]. 

With the rapid development of science and technology, oral and maxillofacial reconstructive surgery has kept pace with time to bring a prosperous future. OMS reconstructive surgery was focused on with major achievements made in the following aspects: transplantation of revascularized tissues, bone graft substitutes, platelet-rich plasma, tissue engineering, distraction osteogenesis, microsurgery, arthroplasty, dynamic repair, lazer surgery, computer-assisted design. 

Microvascular tissue transfer was one of the most important stages in the reconstruction of the lower jaw and upper jaw after ablative tumor surgery. Modern methods using a vascularized composite fibula flap together with dental implants have led to successful rehabilitation in terms of speech, mastication and facial esthetics [3-5]. 

In tissue engineering, cells, stimulatory factors (growth factors) and scaffold materials as the three main factors, provide the opportunity to create various tissues and organs with their forms and functions by changing combinations of these three factors [6]. 

The search for the ideal bone graft substitutes is an actual problem of oral surgery and oral implantology. Bone grafting material should provide scaffolds for bone regeneration (osteoconduction) and, at the same time, should promote the recruitment of bone forming cells and induce new bone formation (osteoinduction) [7]. 

The use of autogenous bone has been considered the gold standard in bone regeneration procedures for many years, but donor site morbidity, pain, and prolonged hospitalization have prompted the search for bone graft substitutes [8]. 

Study showed demonstrated favorable bony healing in guided regenerative surgery procedures using demineralized tooth graft is able to maintain the autogenous growth factors (such as osteopontin, dentin sialoprotein and BMP) [9,10]. 

Recently, an innovative medical device (TT Tooth Transformer SRL, Milan, Italy) using patient’s tooth and that can process and transform extracted tooth into bone graft material in a short time [11].
The autogenous demineralized tooth graft contains of BMP-2 (Bone Morphogenic Proteins that stimulate bone growth) and guarantees absolute com-patibility with the recipient site [12]. 

However, clinical and histological studies with a long follow-up period are necessary in order to better assess the potential of demineralized dentin auto grafts. 

Applications of 3D printing in medicine and allied fields are quite diverse which includes bioprinting, tissues and organs, creation of customized prosthesis, anatomic models for high risk surgeries [13]. 

Depending on the application, appropriate printing technique is selected, for example, Fused Deposition Modelling (FDM), Stereo Lithography (SLA), and Selective Laser Sintering (SLS), inkjet bioprinting, extrusion bioprinting and laser-assisted bioprinting [14]. 

The use of three-dimensional printing (3D) application technology in maxillofacial surgery include trauma surgery, pathology induced defects, complex temporomandibular joint reconstruction and correction of complicated facial asymmetry [15]. 

Prerequisites for three-dimensional (3D) visualization and programs for computer-assisted 3D planning of surgical procedures have been established [16-18]. 

There is an increasing use of 3-dimensional (3D) imaging applications for pre-surgical planning and transfer of oral implant treatment [19,20]. 

The effectiveness of the navigation system for oral and maxillofacial surgery has been confirmed by clinical applications including complex fractures of the middle and facial region, reconstruction of orbital trauma, removal of a foreign body, surgery based on the skull, orthognathic surgery and provides more safe and accurate guidance in the field of maxillofacial surgery [21]. 

Preoperative surgical simulations with 3D models, such as stereo lithographic models, are useful to evaluate treatment plans and to acquire precise representations of the underlying skeletal anatomy of the patient [22]. 

In this digital age, we have also embraced the revolutionary changes that modern computer technologies have brought to our field. From anatomical scans using imaging techniques such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans, computer-aided design/computer-aided manufacturing to surgical navigation to robotic surgery. Transoral robotic surgery is also gathering steam with the prospects of offering surgeons greater precision, sensitivity and flexibility to overcome challenges associated with conventional approaches. 

Computer-aided surgery has gradually become an indispensable part of our modern practice-one with greater accuracy, safety and simplicity. Computer-assisted navigation has gained acceptance in maxillofacial surgery with application in an increasing range of procedures [23]. 

Intraoperative computer-assisted navigation continuously monitors the surgical field and carries out surgical navigation in accordance with the preoperative plans of the doctor. 

The development of navigation assisted surgery has improved execution and predictability, allowing for greater precision during oral and maxillofacial surgery [24,25]. 

The use of a navigation system for osteotomy and resection in tumor surgery, particularly at the skull base, allows the procedure to be performed more quickly, safely, and precisely. The use of navigation for areas where surgical approaches are difficult and areas requiring anatomical attention provides confidence in the approach. In the near future, the application of computer-assisted surgery is expected to further reduce operative risks and time, accompanied with a considerable decrease in patient stress. Therefore, the use of a navigation system will also be effective and feasible in oral and maxillofacial surgery. 

Since the emergence of endoscopic surgery, minimally invasive procedures have garnered popularity among surgeons in every discipline. The last 20 years endonasal endoscopic sinus surgery increased. Now endoscopic surgery is successfully performed for processes involving the maxillary sinus. Advantages of the endoscopic approach include shorter operative time, decreased bleeding, decreased pain and provides better surgical access [26,27]. 

In OMS, arthroscopy of the temporomandibular joint and sialendoscopy are now routinely performed. TMJ arthroscopy an effective and minimally invasive form of surgical intervention for treating TMJ disorders [28,29]. 

The use of new technologies also played an important role in the diagnosis and treatment of cancers maxillofacial region. Positron Emission Tomography / Computed Tomography (PET/CT) is used diagnosis for many types of cancers and detecting lymph node metastases. The main clinical application of Positron Emission Tomography (PET) in head and neck oncology is the diagnosis of squamous cell carcinoma [30,31]. 

Over the years, we have witnessed simple modifications to procedural steps setting forth paradigm shifts in the field; we have also seen innovations in other disciplines being borrowed and adapted to aid our cause. 

OMS is, in itself, an integral field that encompasses aspects of science, clinical techniques and esthetics. A review of recent progress in our field reveals the importance of an active and critical scholarly forum that allows the development of revolutionary concepts and innovative ideas such as functional and minimally invasive surgical approaches as well as the computer-aided surgical techniques. The development of oral and maxillo-facial surgical technique is still constantly evolving and we sincerely hope that our special issue keeps up with the waves of change. 

Purpose of this special issue entitled “Oral and Maxillofacial Surgery” is to explore major advancements in the field of OMS.

CONFLICT OF INTEREST

None

 

REFERENCES

  1. Mathew N, Gandhi S, Singh I Solanki M, Bedi NS (2020) 3D Models Revolutionizing Surgical Outcomes in Oral and Maxillofacial Surgery: Experience at Our Center. J Maxillofac Oral Surg 19: 208-216.
  2. Yu GY (2013) Oral and maxillofacial surgery: Current and future. Ann Maxillofac Surg 3: 111-112.
  3. Khachatryan L, Khachatryan G, Hakobyan G (2018) The treatment of lower jaw defects using vascularized fibula graft and dental implants. Journal of Craniofacial Surgery 29: 2214-2217.
  4. Grigor K, Armen H, Levon K, Gagik H (2018) Functional Outcomes with Implant-Prosthetic Rehabilitation Following Simultaneous Mandibulectomy and Mandibular Reconstruction by Fibula Graft. Journal Clinics in Surgery 3: 2092.
  5. Qaisi M, Kolodney H, Swedenburg G, Chandran R, Caloss R (2016) Fibula Jaw in a Day: State of the Art in Maxillofacial Reconstruction. J Oral Maxillofac Surg 74: 1284- 1284.
  6. Dzobo K, Thomford NE, Senthebane DA, Shipanga H, Rowe A, et al. (2018) Advances in Regenerative Medicine and Tissue Engineering: Innovation and Transformation of Medicine. Stem Cells Int 2018: 2495848.
  7. Domenech M, Polo-Corrales L, Ramirez-Vick JE, Freytes DO (2014) Scaffold Design for Bone Regeneration. J Nanosci Nanotechnol 14: 15-56.
  8. Sakkas A, Wilde F, Heufelder M, Winter K, Schramm A (2017) Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent 3: 23.
  9. Gual-Vaqués P, Polis-Yanes C, Estrugo-Devesa A, Ayuso-Montero R, Mari-Roig A, et al. (2018) Autogenous teeth used for bone grafting: A systematic review. Med Oral Patol Oral Cir Bucal 23: 112-119.
  10. Minamizato T, Koga T, I Takashi, Nakatani Y, Umebayashi M, et al. (2018) Clinical application of autogenous partially demineralized dentin matrix prepared immediately after extraction for alveolar bone regeneration in implant dentistry: A pilot study. Int J Oral Maxillofac Surg 47: 125-132.
  11. Minetti E, Berardini M, Trisi P (2019) A New Tooth Processing Apparatus Allowing to Obtain Dentin Grafts for Bone Augmentation: The Tooth Transformer. The Open Dentistry Journal 13: 6-14.
  12. Bono N, Tarsini P, Candiani G (2019) BMP-2 and type I collagen preservation in human deciduous teeth after demineralization. J Appl Biomater Funct Mater 17: 2280800018784230.
  13. Ventola CL (2014) Medical Applications for 3D Printing: Current and Projected Uses. Jurnal P T 39: 704-711.
  14. An J, Teoh JEM, Suntornnond R, Chua CK (2015) Design and 3D Printing of Scaffolds and Tissues. Engineering 1: 261-268.
  15. Ahmad Z, Austin E, Bajalan M (2017) Three-dimensional printing in oral and maxillofacial surgery. Oral and Maxillofac Surg 46: 341.
  16. Aldaadaa A, Owji N, Knowles J (2018) Three-dimensional Printing in Maxillofacial Surgery: Hype versus Reality. J Tissue Eng 9: 2041731418770909.
  17. Lichtenstein JT, Zeller AN, Lemound J, Lichtenstein TE, Rana M, et al. (2017) 3D-printed simulation device for orbital surgery. J Surg Educ 74: 2-8.
  18. Marro A, Bandukwala T, Mak W (2016) Three-dimensional printing and medical imaging: a review of the methods and applications. Curr Probl Diagn Radiol 45: 2-9.
  19. Gagik H, David H, Samadbin N, Long NK, Phong My H, et al. (2019) Clinical Effectiveness of Guided Implant Surgery. The Journal of Implant & Advanced Clinical Dentistry 11: 6-14.
  20. Vercruyssen M, Laleman I, Jacobs R, Quirynen M (2015) Computer-supported implant planning and guided surgery: a narrative review. Clin Oral Implants Res 26: 69-76.
  21. Sukegawa S, Kanno T, Furuki Y (2018) Application of computer-assisted navigation systems in oral and maxillofacial surgery. Japanese Dental Science Review 54: 139-149.
  22. Sinn DP, Cillo JE Jr, Miles BA (2006) Stereolithography for Craniofacial Surgery. Journal of Craniofacial Surgery 17: 869-875.
  23. Zhao L, Patel PK, Cohen M (2012) Application of Virtual Surgical Planning with Computer Assisted Design and Manufacturing Technology to Cranio-Maxillofacial Surgery. Arch Plast Surg 39: 309-316.
  24. Azarmehr I, Stokbro K, Bell RB, Thygesen T (2017) Surgical navigation: a systematic review of indications, treatments, and outcomes in oral and maxillofacial surgery. J Oral Maxillofac Surg 75: 1987-2005.
  25. Bell RB, Weimer KA, Dierks EJ, Buehler M, Lubek JE (2011) Computer planning and intraoperative navigation for palatomaxillary and mandibular reconstruction with fibular free flaps. J Oral Maxillofac Surg 69: 724-732.
  26. Ten Dam E, Helder HM, van der Laan BFAM, Feijen RA, Korsten-Meijer AGW (2020) The effect of three?dimensional visualisation on performance in endoscopic sinus surgery: A clinical training study using surgical navigation for movement analysis in a randomised crossover design. Clinical Otolaryngology 45: 211-220.
  27. Khachatryan L, Khachatryan G, Hakobyan G, Khachatryan A (2019) Simultaneous endoscopic endonasal sinus surgery and sinus augmentation with immediate implant placement: A retrospective clinical study of 23 patients. Journal of Cranio-Maxillofacial Surgery 47: 1233-1241.
  28. Liu DG, Jiang L, Xie XY, Zhang ZY, Zhang L, et al. (2013) Sialoendoscopy-assisted sialolithectomy for submandibular hilar calculi. J Oral Maxillofac Surg 71: 295-301.
  29. Choi DD, Vandenberg K, Smith D, Davis C, McCain JP (2020) Is Temporomandibular Joint Arthroscopy Effective in Managing Pediatric Temporomandibular Joint Disorders in the Short- and Long-Term? J Oral Maxillofac Surg 78: 44-51.
  30. Wong WL, Batty V (2009) Role of PET/CT in maxillo-facial surgery. Br J Oral Maxillofac Surg. 47: 259-267.
  31. Kobayashi J, Miyazaki A, Dehari  H, Ogi  K, Hiratsuka  H (2015) A clinical analysis of 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) on patients with oral cancer. J Oral Maxillofac Surg 44: 247-248.

Citation: Hakobyan G (2020) New Trends Oral and Maxillofacial Surgery past Two Decades. J Surg Curr Trend Innov S2: 001.

Copyright: © 2020  Gagik Hakobyan, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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