Maxillo-facial and Oral Surgery - past, present and future. Maxillo-facial and Oral Surgery most probably started as a speciality of Dentistry in 1915, during the First World War. Dr Kazanjian, who was at the time a dentist in the United States Army, was probably the first to establish a clinic for treating combat injuries of the jaws and face. Sir Harold Gillies, an English plastic surgeon, was so impressed by Dr Kazanjian's work that he attempted to persuade him to remain in England at the end of the war to work in his unit, but he was unsuccessful and Dr Kazanjian returned to the United States in 1919. During the Second World War, Maxillo-Facial and Oral Surgery once again provided an excellent service in the treatment of injuries of the face. Present apart from war Injuries, there are many injuries, e.g. caused by motor vehicle accidents, that are treated by Maxillo-facial and Oral Surgery. From the mass of experience acquired in the treatment of fractures of the face, a new ray of hope has emerged for patients afflicted with congenital malformation of the facial bones. A new field has opened up, which developed from the classic lines of fracture of the upper two-thirds of the face as described by Rene Le Fort. This has enabled unsightly syndromes of the face to be corrected surgically by means of osteotomies corresponding to these fracture lines, as described. Techniques developed by Professor Hugo Obwegeser have made the repositioning of the lower jaw an exclusively intra-oral operation which gives outstanding functional and aesthetic results. Obwegeser, Converse and Tessier have also developed safe surgical techniques for treating cases of hypertelorism by osteotomy and thereby moving the eyes closer together. Surgery designed to improve the ridges of the jaws for better retention of dentures, has also shown promising results. With improved techniques, the implantation of dentures has been revived, with excellent results. Impacted teeth, occurring in 17% of persons over the age of 20 years, are today removed prophylactically to avoid later complications. Future As the Department of Maxillo-Facial and Oral Surgery of the University of Pretoria can compare with the best in the world, the time has perhaps come where, through publications and the delivery of papers, we should begin to share our experience and knowledge with others. There is also great room for improvement in relations between maxillo-facial and oral surgeons and their medical colleagues, in particular the plastic surgeons. Improved co-operation between all branches of dentistry and medicine can only enrich both professions, to the benefit of patient and practitioner alike.
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