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ORAL & MAXILLOFACIAL SURGERY
The Evolution of Oral and Maxillofacial Surgery Untitled-3 1
21/07/11 1:40 PM
Bohdan Kryshtalskyj, BSc, DDS, MRCD(C), FADI, FICD, FACD Oral Health’s contributing consultant for oral and maxillofacial surgery.
Michael Kryshtalskyj A grade 11 student at Royal St. Georges College in Toronto.
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any advancements have occurred in oral and maxillofacial surgery over the last 100 years. This has been due to the enormous strides in technological, medical, radiologic imaging, and research initiatives that have been proposed by various investigators and have been built and augmented with time by each successive generation of surgeons. The many “firsts” have resulted in better patient care, reduced morbidity and operating time, and has increased the quality of life for our patients. The practice of oral and maxillofacial surgery is forever changing at an accelerated pace. By the time this article comes to print, many other advancements will have been documented. It is impossible to mention every single discovery in this specialty over the past 100 years given the space provided. We have gathered historical advances that we believe have influenced significantly the modern practice as it is known today. The lists are not definite by any means. This paper will outline the advances in surgery of the temporomandibular joint, orthognathic surgery, pre-prosthetic/dental implant surgery and sialoadenoscopy.
TEMPOROMANDIBULAR JOINT SURGERY
Meniscectomy In 1909, Lanz described to the first meniscectomy. It was the dominant procedure in the first three decades of the 20th century. It then appeared to fade from the 52
100 th Anniversary Issue 2011
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literature. After World War II it was performed with increasing frequency throughout the 1950s and 60s. This procedure was used where the patient presented with a displaced, damaged and deformed disc that may act as a joint irritant producing pain dysfunction and joint instability. Other surgeons have contributed to the body of knowledge of success rates for meniscectomy surgery: Dingman and Moorman (1951), Brown (1980), Carlson et al (1981) Westesson and Erickson (1985), Silver (1984) and others. Meniscectomy with Interpositional Implants In the early 1980s, interpositional implants post meniscectomy such as Proplast Teflon and Silastic were used to prevent bony ankylosis and degenerative joint disease. Because of the high incidence of destructive foreign body reactions associated with their use, they were removed from the market in 1988 and 1993 respectively. Surgeons now however continue to use a variety of autogenous material such as auricular cartilage, dermis, and temporalis muscle and fascia to replace the disc after its removal. Moreover fat has been used most recently to prevent ankylosis. Not all patients require an interpositional autogenous graft after meniscectomy as most do well without one. Disc Repositioning Surgery In 1887, Annandale performed www.oralhealthjournal.com
30/08/11 10:48 AM