Maxillofacial Surgery

Oral and maxillofacial surgery (OMS) is a highly specialized surgical discipline dedicated to addressing complex conditions involving the anatomical structures of the mouth, jaws, face, and neck. Positioned at the intersection of medicine and dentistry, it requires extensive training in both fields and encompasses surgical expertise in functional, reconstructive, and aesthetic procedures.

Oral and maxillofacial surgeons are uniquely qualified to perform procedures that restore or enhance essential functions such as chewing, speaking, and breathing, while also addressing structural integrity and facial harmony. Their scope includes managing acquired, congenital, and developmental conditions that may affect soft tissue, bone, and nerve structures in the craniofacial region.

The specialty plays a critical role in comprehensive patient care, often working in collaboration with other medical and dental professionals such as oncologists, plastic surgeons, ENT specialists, orthodontists, and prosthodontists. By integrating surgical precision with an understanding of facial anatomy, OMS contributes significantly to both functional rehabilitation and aesthetic restoration, ultimately improving patients’ quality of life.

Why Cuba

Oral and Maxillofacial Surgery (OMS) in Cuba is delivered through a comprehensive, multidisciplinary approach that focuses on restoring function, structure, and aesthetics to the craniofacial region. These programs are led by highly trained Cuban surgeons whose expertise spans both dental and medical surgical disciplines. Rooted in Cuba’s integrated healthcare system and commitment to equitable access, OMS services are carried out with precision, compassion, and adherence to internationally recognized protocols.

By combining advanced surgical techniques, cutting-edge diagnostic tools, and personalized patient management, Cuba’s OMS programs effectively address a broad range of complex conditions involving the mouth, jaw, face, and neck. Whether the goal is functional rehabilitation, trauma recovery, or reconstructive intervention following tumour resection, treatment is tailored to support both physical recovery and long-term quality of life. With an emphasis on interdisciplinary collaboration, affordability, and continuity of care.

Conditions Treated by Oral and Maxillofacial Surgery (OMS) 

Oral and maxillofacial surgery (OMS) encompasses a wide range of surgical procedures, classified according to the anatomical region involved, the nature of the condition, and the complexity of the intervention. The field addresses both functional and aesthetic concerns, and its scope spans from routine procedures to advanced reconstructive and oncologic surgeries.

Dentoalveolar Surgery

Focused on procedures involving the teeth, gums, and alveolar bone,

• Tooth extractions
• Pre-prosthetic surgery
• Exposure of impacted teeth for orthodontic traction
• Surgical endodontics

Maxillofacial Trauma Surgery

Involves the reconstruction and repair of facial injuries due to accidents, violence, or falls.

• Fracture reduction and fixation (mandible, maxilla, zygomatic arch, orbital floor)
• Soft tissue repair (lacerations, nerve injuries)
• Dental trauma management
• Reconstruction of traumatic bone defects

Orthognathic (Jaw) Surgery

Corrects skeletal and dental irregularities to improve function and facial aesthetics.

• Mandibular advancement or setback
• Maxillary osteotomy
• Genioplasty (chin surgery)
• Surgical management of obstructive sleep apnea

Reconstructive Surgery

Restores form and function following trauma, tumour resection, or congenital anomalies.

• Bone grafting (autogenous or alloplastic)
• Soft tissue reconstruction
• Use of free flaps, local flaps, or distraction osteogenesis
• Post-oncologic reconstruction

Oncologic Surgery

Management of benign and malignant tumours in the oral and maxillofacial region.

• Excision of cysts and tumours (e.g., ameloblastoma, odontogenic tumours)
• Neck dissection for lymphatic spread
• Wide local excisions for oral squamous cell carcinoma
• Surgical planning for adjunctive radiotherapy or chemotherapy

Implant and Pre-Implant Surgery

Surgical preparation and placement of dental implants and associated procedures.

• Implant placement
• Sinus lift procedures
• Ridge augmentation
• Guided bone regeneration

Temporomandibular Joint (TMJ) Surgery

Treatment of TMJ disorders, which may be mechanical, inflammatory, or degenerative.

• Arthrocentesis and arthroscopy
• Disc repositioning surgery
• Joint reconstruction or replacement

Congenital and Developmental Anomaly Surgery

Corrects craniofacial anomalies that are present at birth or develop in early life.

• Cleft lip and palate repair
• Craniosynostosis correction
• Syndromic craniofacial deformity management
• Speech-improving surgeries

Cosmetic (Aesthetic) Maxillofacial Surgery

Focuses on improving facial appearance and symmetry.

• Rhinoplasty (Nose job)
• Facial implants (chin, cheek, jaw)
• Facial contouring
• Scar revision and dermal procedures

Elective vs. Emergency Procedures

Oral and maxillofacial procedures are categorized based on urgency:

Elective Procedures

• Jaw realignment (orthognathic surgery)
• Dental implants
• Cleft lip and palate repair
• Cosmetic or reconstructive facial surgery
• TMJ arthroscopy

Emergency Procedures

• Management of facial fractures
• Treatment of oral abscesses or infections causing airway compromise
• Hemorrhage control following trauma
• Urgent tumour resections or biopsies
• Surgical intervention for locked jaws or severe TMJ dislocation

FOR PATIENTS REQUIRING EMERGENCY ORAL AND MAXILLOFACIAL PROCEDURES, IT IS ESSENTIAL TO SEEK IMMEDIATE MEDICAL ATTENTION AT THE NEAREST EMERGENCY FACILITY FOR URGENT CARE.

Causes and Risk Factors

Causes of oral and maxillofacial conditions vary by disease type but may include:

• Genetic factors (e.g., cleft palate)
• Dental decay and poor oral hygiene (leading to infections)
• Traumatic incidents (motor vehicle accidents, assaults, falls)
• Chronic conditions (e.g., arthritis affecting TMJ)
• Tobacco and alcohol use (increasing oral cancer risk)
• Poorly aligned teeth and jaw structure
• Impacted wisdom teeth
• Viral infections (e.g., HPV in oral cancers)

Pre-Surgical Diagnosis

Pre-surgical diagnosis in oral and maxillofacial surgery is a critical step in ensuring safe, effective, and tailored surgical care. It involves a comprehensive evaluation of the patient’s condition, functional needs, anatomical structure, and overall health status. Accurate diagnosis allows the surgical team to determine the most appropriate intervention, anticipate complications, and design a treatment plan that optimizes outcomes while minimizing risk.

The diagnostic process typically includes:

• Clinical Examination
  A detailed head, neck, oral, and facial assessment to evaluate soft tissue, skeletal symmetry, occlusion, range of motion, and presence of lesions, swelling, or trauma.
• Medical and Dental History
  Identification of systemic conditions (e.g., diabetes, hypertension, bleeding disorders), medications, allergies, and prior surgeries that may impact surgical planning and healing.
• Imaging Studies
  • Panoramic radiographs (OPG) for general jaw and tooth evaluation
  • Cone Beam CT (CBCT) for 3D imaging of bone structures, nerve paths, and sinus anatomy
  • CT or MRI for complex cases involving tumours, trauma, or TMJ disorders
  • Cephalometric analysis for orthognathic (jaw) surgery planning
• Laboratory Investigations
  Routine bloodwork (CBC, coagulation profile, blood glucose, renal and liver function) to assess surgical readiness or anesthetic risk.
• Functional Assessments
  May include occlusal analysis, temporomandibular joint evaluation, airway assessments, or speech and swallowing studies, depending on the case.
• Histopathological Evaluation
  For lesions, masses, or cystic conditions, a biopsy may be performed preoperatively to confirm a benign or malignant diagnosis.
• Multidisciplinary Consultation
  In complex cases, input may be required from orthodontics, oncology, ENT, prosthodontics, anesthesiology, or reconstructive surgery to ensure coordinated care.

Qualification for Procedures and Surgeries

Not every patient is suited for oral and maxillofacial surgery, as eligibility depends on a combination of medical, functional, anatomical, and psychosocial factors.

Patients Eligible for Surgery:

• Medically stable patients
• Patients with a clear Indication for surgery
• Patients With adequate support and compliance
• Age-appropriate candidates

Patients Not Suitable for Surgery:

• Medically unstable patients
• High anesthesia risk
• Poor bone or tissue quality (for certain surgeries)
• Active substance abuse
• Pregnancy (in many non-urgent cases)

Conditional Candidates for Surgery

• Diabetic patients with poor glucose control may qualify after endocrinology clearance
• Patient with anemia may proceed after iron therapy or transfusion
• Patients with infections may qualify after antibiotics or drainage

Surgical Approaches: Minimally Invasive vs. Open Procedures

Oral and maxillofacial surgeries can be performed using either:

Minimally Invasive Techniques

• Arthroscopy for TMJ disorders
• Endoscopic-assisted facial fracture repair
• Flapless dental implant placement

Benefits include reduced postoperative pain, faster recovery, less scarring, and lower risk of complications.

Open Surgical Approaches

• Indicated for large tumours, complex fractures, or severe deformities
• Allows direct visualization and complete excision or reconstruction
• Often requires hospitalization and multidisciplinary support

The choice of technique depends on the nature of the condition, the surgeon’s expertise, and available resources.

Aftercare and Recovery

Postoperative care is essential for healing and optimal outcomes. Aftercare may include:

• Pain management (analgesics, anti-inflammatories)
• Antibiotic therapy, especially after infection or open surgery
• Dietary modifications (soft or liquid diets in jaw surgeries)
• Wound care and oral hygiene instructions
• Physical therapy, particularly for TMJ and jaw function restoration
• Speech therapy when necessary (e.g., cleft palate cases)
• Regular follow-ups for monitoring healing, function, and recurrence

Recovery timelines vary by procedure type—from a few days (tooth extraction) to several weeks or months (jaw reconstruction or tumour resection).