Maxillofacial and Oral Surgery

Maxillofacial and oral surgery is a special branch of medicine that requires the doctor to hold full university degrees in both medicine and dentistry.
Training in this field comprises five years of postgraduate surgical education and a further two-year qualification in plastic and aesthetic surgery.
The expertise gained through this intensive professional training, which takes around 18 years, enables these doctors to resolve the most serious medical and dental problems.

The therapeutic services of maxillofacial surgery include: dental implantation, bone augmentation using bone substitute materials as well as cultured autologous stem cells, the treatment and reconstruction of the facial bones of the skull affected by genetic and other disorders, post-traumatic plastic and reconstructive surgery, removal of tumours of the maxillofacial region with subsequent reconstruction, surgery for developmental malformations (cleft lip and cleft palate), correction of malocclusion, surgical tooth preservation, dental prosthetics, plastic and aesthetic facial surgery (blepharoplasty, correction of the nose, lips, ears and chin, face lift, wrinkle removal), laser treatment and treatment of the temporomandibular joints.

During surgery, German maxillofacial surgeons use dedicated intraoperative navigation systems that make it possible to define the required extent of the operation precisely, to see how the tissues are arranged and to build a multidimensional model of the procedure in advance. This approach makes it possible to restore or correct any deformity of the face or jaw, effectively eliminating both congenital defects and the consequences of trauma.

Range of services offered by maxillofacial and oral surgery clinics and departments:

• correction of maxillofacial anomalies, dysgnathia (malocclusion) and complete cleft lip, jaw and palate;
• treatment of haemangiomas and vascular malformations;
• treatment of bisphosphonate-related osteonecrosis of the jaw;
• dentoalveolar surgery, pre-prosthetic oral surgery and dental implantology (jaw augmentation, implantation, sinus lift);
• dental surgery: wisdom teeth, root apex resection, jaw cysts, changes of the oral mucosa;
• surgical dermatology;
• surgical treatment of malignant and benign tumours, plastic and reconstructive surgery (including microvascular grafting);
• oncological and non-oncological reconstructive facial surgery;
• maxillofacial traumatology (fractures of the jaw, zygomatic bone, eye socket and facial skull, orbital fractures, fractures of the nasal bones, frontal sinus fracture, scar correction, removal of metalwork after osteosynthesis surgery);
• surgery for facial paralysis;
• bimaxillary advancement for obstructive sleep apnoea syndrome (OSAS);
• plastic and aesthetic surgery and laser correction of age-related changes (including botulinum toxin treatment/face lift);
• plastic aesthetic facial correction (skeletal repositioning surgery, nose correction, ear correction, chin surgery, face lift, mid-face lift, micro-autologous fat transplantation (MAFT);
• maxillofacial procedures: jaw grafting, exposure of teeth, ligature placement, mini-implants, palatal suture expansion, distraction osteogenesis, tooth extraction;
• procedures in the field of orbital surgery (orbit = eye socket, orbital tumours, eyelid surgery, endocrine orbitopathy);
• implantology: jaw augmentation, implantation, sinus lift;
• paediatric plastic facial surgery (complete cleft lip, jaw and palate, including preoperative preparation using nasoalveolar moulding (NAM), malformations of the facial skull, facial tumours, vascular anomalies, craniosynostoses, skull deformities;
• osteonecrosis of the jaw;
• custom-made protective masks for professional and amateur athletes;
• outpatient surgical procedures;
• computer-assisted surgical and navigation technologies;
• microsurgical reconstruction in the head and neck area (including the use of CAD/CAM systems);
• care of patients with multimorbidity (who have several diseases at once);
  interdisciplinary patient treatment/tumour board.

Range of diagnostic services:

• diagnosis of the consequences of facial trauma;
• diagnosis of tumours of the oral cavity and face;
• orthodontics: counselling on malocclusion;
• 3D analysis and virtual planning of dysgnathia surgery, dental implants and restorative surgery;
• diagnosis of osteonecrosis of the jaw;
• second medical opinion on matters of oral surgery and maxillofacial surgery.

Specialist consultations by prior appointment:

• treatment of tumour conditions;
• dental implantation;
  interdisciplinary consultations with specialists in maxillofacial orthopaedics and surgery for patients with dysgnathia;
• consultations for patients with complete cleft lip, jaw and palate and other maxillofacial anomalies;
• consultations on plastic and reconstructive surgery;
• consultations on plastic and aesthetic surgery;
• consultations for patients with bisphosphonate-related osteonecrosis of the jaw.

Innovative technologies in maxillofacial surgery in Germany

In Germany, digital volume tomography and CAD/CAM technologies are used to diagnose and treat maxillofacial and oral conditions. Digital tomography gives doctors a precise three-dimensional image and allows them to take account of the smallest defects and concomitant conditions.

CAD/CAM technology is computer-aided design applied to surgical practice. With it, the maxillofacial surgeon can model the entire operation in advance, determine the size and shape of the dental or facial implants and identify the exact place where they are to be fitted. This innovative approach is particularly helpful in complex operations involving tumours and injuries. The same system draws on 3D printers as well as milling machines, which make it possible to create implants, endoprostheses and therapeutic devices tailored to each individual patient. Importantly, CAD/CAM technology makes it possible not only to model the operation but also to predict its outcome in full, checking on a computer model the postoperative function of the maxillofacial region and the performance of the prostheses and implants, and seeing how the operation will change the patient's appearance .

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