Oral and Maxillofacial Surgery

Department of Stomatology, the First Attached

Hospital of Zhengzhou University
Introduction
Oral and Maxillofacial Surgery

 Oral and maxillofacial surgery is that branch and

specialty of dentistry which is concerned with the
diagnosis, surgical treatment of disorders,
diseases, injuries and defects involving both the
functional and aesthetic aspects of the hard and
soft tissues of the oral and maxillofacial regions
and related structures. including extracting teeth,
treating cysts, tumors, traumatic facial injuries ,
fracture, cleft lip and cleft palate, etc.
 Chapter one

Oral and Maxillofacial

Anatomy and Examination
 Part one
Oral and Maxillofacial
Anatomy

1. Oral Anatomy
 1 Oral Cavity ( 口腔）
 The oral cavity
is split into the
vestibule and
the oral cavity
proper by the
dental arches
,the alveolar
processes and
the gums.
 1: Oral Vestibule
 .
1.the dental arch:
2. Alveolar processes:
The sockets in all these
bones that contain the
teeth are termed alveolar
processes.
3.Orifice of parotid
gland :in buccal mucosa
opposite the upper second
molar .
4. the gums :normal,
healthy gingiva appears
pink or salmon colored and
can be smooth or stippled.

 2:oral cavity proper
 1:the soft palate:
the soft part of the
palate, located the
posterior one third of
the palate , and
posterior to the hard
palate.
 2:the hard palate: The
hard palate is firmly
adhered to the bones .
 3:the uvula:
 4:the palatine tonsil:
 the hard palate
 The hard palate is a
composite of several
bony structures and the
soft tissues ( mucosae )
covered on them.
 Two primary sets of
bones comprise the hard
or bony palate. From
front to back they are,
the maxillas and the
horizontal processes of
palatine They meet in
the center of the palate
at the midline.
 3:The Tongue

 1). Dorsal Tongue:

On the surface of
the tongue are rough
projections called
papillae. They provide
the tongue with friction
in dealing with food.
 Papillae
 Papillae consisting of:
1. Filiform papillae.
2. Fungiform papillae.
3. Foliate papillae
4. Vallate papillae.
a. Can vary in size
and number.
b. Six to nine in
front of terminal
sulcus.
c. Form a V or Y
shape.
 Taste Buds
 The four types of taste
sensations are sweet, sour,
bitter, and salty, all
resulting from stimulation of
the taste buds.
 1 Bitterness - on the
back of the tongue
 2 Sweetness - on the
tip
 3 Sourness - on the
sides of the tongue
 4 Saltiness - just to
rear and sides of tip
 2.Ventral Tongue
 Lingual frenulum
may be either too
short or anteriorly
placed , resulting in
Tongue- Tie
( Ankyloglossia ).
 3.The teeth
As humans, we have two sets of teeth during our
lifetime:
 1). Deciduous Teeth :The primary dentition is the
first set of teeth we get. These are often referred
to as baby teeth. There are 20 teeth in the
primary dentition.
 2) .Permanent Teeth :The second set of teeth that
we have is referred to as the permanent dentition.
The permanent dentition contains 32 teeth.
2. Maxillofacial Anatomy
The location of the bones
The Maxilla
 The Maxillary Sinus
 The maxillary sinus
is intimately related
to the upper
teeth ,especially to
5-8.
The Mandible
Muscles of Mastication
Muscles of Facial Expression
 Facial Nerve
 posterior auricular
(pa)
 motor branch to
posterior belly of
digastric (db)
 temporal branch (t)
 zygomatic branch
(z)
 buccal branches (b)
 mandibular branch
(m)
 cervical branch (c)
 Trigeminal
 Mixed nerve with both
sensory and motor
functions .
 The nerve divides into
three branches:
V1 (Ophthalmic)
V2 (Maxillary)
V3 (Mandibular).
Facial Blood Supply
Individual Lymph Nodes in the
Head and Neck
 The salivary glands
 1). Parotid Gland: located on side of face
 2). Submandibular Gland : beneath the floor
of the mouth
 3). Sublingual Glands: located below the
floor of the mouth
 4). Minor Salivary Glands : scattered
throughout the oral mucosae.
The Salivary Glands
 Part two
Oral and Maxillofacial
Examination

1. physical check-up
 Dental Check-up Tools
 Dental / mouth mirror
 Dental explorer / probe
 Dental tweezers:

Disposable ~
Oral Cavity ( 口腔）
1.The teeth
2.The gums
3. The tongue
4. The salivary gland ducts
5. The oral mucosa
 Inspection
 By inspection, we can see whether there
are asymmetry, swelling, tumor, defect and
malformation in the oral and maxillofacial
region. It is important to get the primary
impression of the disease.
 palpation
 Palpation is the basilic physical examination
for inflammation, injury, fracture, cyst, tumor
in oral and maxillofacial surgery.
 This is the palpation for the fluctuation of
abscess
2. auxiliary examination
 Imageology
 A radiograph is an extremely important
diagnostic tool. These pictures show the
dental professional many things that are not
visible by just looking in the mouth.
Therefore, radiographs are an essential part
of a thorough and complete examination.
 CT, MRI and ultrasound are the important
diagnostic tool for the hard and soft tissue
disease.
 Radiographs
 There are three type of radiographs that are routinely taken:
 Bite wing
 used to help diagnose cavities between the teeth, as these areas are not
visible when looking directly in the mouth.

 Periapical
 shows the entire tooth, including the root and surrounding bone.
 useful in diagnosing an abscess, impacted tooth or bone loss due to
periodontal disease.


 Panoramic
 gives a view of the whole jaw.
 good screening tool.
 used for the extraction of wisdom teeth.
 shows any abnormal growths or cysts in the jaw bone.

 It is also important that old and new radiographs are compared in order to
achieve an accurate diagnosis.

 Radiographs

 曲面断层片
( 全景片 )
Panoramic

 牙片 Periapical
 Laboratory and Biopsy
 Laboratory such as WBC , classify and
bacteriology are important to diagnose
inflammation.
 Biopsy is the important diagnostic tool for
cyst ,benign tumor and malignant tumor.
 Needle biopsy is
of significance
to diagnose the
tumor